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Allergies Allergy Treatment

Wheals of Fire: Getting Help with Hives

Some people break out in hives whenever they share a room with a cat. Others find themselves covered in these itchy red bumps when they're feeling stressed. While stress-induced hives usually resolve on their own, other types of hives require treatment that can range from antihistamines to oral steroids. Most of the time hives are short-term, but some people suffer from chronic hives that can last for years, leading to problems such as sleep loss and depression.

Hives are usually part of an allergic reaction that occurs when a chemical called histamine is released by cells in the body called mast cells. The release of histamine can be triggered in response to a variety of stimuli, including certain foods, medication, or even temperature.

Below, Dr. Barbara Muller, professor of allergy-immunology at the University of Iowa Hospitals in Iowa City, discusses common causes of hives and treatment approaches for short-term and chronic hives.

What are hives?
Hives are raised, itchy wheal-and-flare reactions on the skin medically referred to as "urticaria." The lesions look and itch similar to mosquito bites. They can be very small, a few millimeters in size, or become quite large, several centimeters in size, especially with scratching. Separate lesions often merge to involve an entire portion of an extremity, such as a foot or hand, or extend to the abdomen or trunk. The itching associated with hives is bothersome and can be intense. If severe, an outbreak can include symptoms such as fatigue, chills or joint aches.

Individuals who develop hives may also suffer from a condition called "angioedema," where swelling occurs in the deeper layers of the skin. Swelling can be severe and lead to deformity of a portion of the face, lips, eye area, or genitalia. If swelling occurs in the throat, breathing may be affected and medical attention must be sought immediately.

How long do hives last?
An individual hive should not last longer than 24 hours. Yet a hive outbreak can develop suddenly and last a few hours or days, or continue for weeks or months at a time. Hives lasting less than six weeks are referred to as acute. Outbreaks can also be long-term, or chronic, lasting longer than six weeks. If you have chronic hives it may a sign of an underlying non-allergic condition. Hives can reoccur often over years.

What causes hives?
Acute cases of hives that come on suddenly and are short-term are generally caused by an allergic reaction to food or medication, or by contact with or exposure to an allergen in your environment.

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