Learn how to prepare for Severe Allergy Attacks.


What is urticaria?

Urticaria is also called hives. Hives can change size and shape, and appear anywhere on your skin. They can be mild or severe and last from a few minutes to a few days. Urticaria that lasts longer than 6 weeks may be a chronic condition that needs long-term treatment. Hives may be a sign of a severe allergic reaction called anaphylaxis. Anaphylaxis is an emergency. Seek care immediately if you feel dizzy, your mouth tingles, or you have trouble swallowing or breathing.

What causes urticaria?

Hives are caused by an immune system reaction. The following are common triggers:

  • Food allergies, such as to nuts, eggs, or shellfish

  • Food dyes, additives, or preservatives

  • Medicine allergies, such as to ibuprofen or antibiotics

  • Infections, such as a cold or mono

  • Bug bites

  • Pets or plants

  • Stress

How is urticaria diagnosed?

  • A skin test is used to see how your skin reacts to possible triggers. Your healthcare provider will put a small amount of the trigger onto your skin. He will cover the area with a patch that stays on for 2 days. Then he will check your skin for a reaction.

  • A challenge test is used to give you increasing doses of what may be causing your hives. Your healthcare provider will watch for a reaction.

How is urticaria treated?

Hives usually go away without treatment. Chronic urticaria may need to be treated with other medicines if the following medicines used for mild symptoms do not work:

  • Antihistamines help decrease itching. This medicine is available without a doctor's order.

  • Steroids may decrease redness, pain, and swelling.

What can I do to manage my urticaria?

  • Carry an emergency kit as directed. The kit has a medicine called epinephrine. You can give it to yourself as a shot if you have a severe allergic reaction. Your healthcare provider will teach you and your family when and how to give epinephrine shots. Always carry your anaphylaxis kit with you. Check the expiration date on the kit every month and replace it before it expires.

  • Cool your skin. This may help decrease your itching. Apply a cool pack to your hives. Dip a hand towel in cool water, wring it out, and place it on your hives. You may also soak your skin in a cool oatmeal bath.

  • Do not rub your hives. This can irritate your skin and cause more hives.

  • Wear loose clothing. Tight clothes may irritate your skin and cause more hives.

  • Keep a record of triggers and symptoms. Record everything you eat, drink, or apply to your skin for 3 weeks. Include stressful events and what you were doing right before your hives started. Bring the record with you to follow-up visits with your healthcare provider.

  • Manage stress. Stress may trigger hives, or make them worse. Learn new ways to relax, such as deep breathing.

Call 911 for any of the following signs or symptoms of anaphylaxis:

  • You have trouble swallowing or breathing because your lips, tongue, or throat are swollen.

  • You have swelling in your face or hands or tingling in your mouth or throat.

  • You have chest tightness or are dizzy.

When should I seek immediate care?

  • Your stomach is upset, or you vomit.

  • Your heart is beating faster than it normally does.

  • You feel like you are going to faint.

  • You have cramping or severe pain in your abdomen.

When should I contact my healthcare provider?

  • You have a fever.

  • Your skin still itches 24 hours after you take your medicine.

  • You still have hives after 7 days.

  • Your joints are painful and swollen.

  • You used your emergency kit.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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