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Some people develop a sudden outbreak of red welts or patches on the surface of the skin that may be accompanied by intense itching or a burning sensation. These are commonly known as hives, and they can appear in the face and anywhere in the body. The welts vary in size and may join together to form larger plaques. These can last for hours, disappear within 24 hours, or persist for several days before gradually fading.

Sometimes, a reaction similar to hives develops in the deeper layers of the skin, causing larger and thicker welts that are red, warm, swollen and even painful. This condition is called angioedema, which commonly appears around the eyes, lips, and cheeks, and sometimes in the hands, feet, and genitals. Angioedema can cause the eyelids to shut the eyes and can sometimes cause difficulty in breathing when it affects the throat and airways. They can last longer than hives, but swelling may go away within 24 hours. Severe cases can cause disfigurement because of prolonged tissue swelling.

Hives and angioedema may occur together. They may go away on their own, without treatment, but you must consult a doctor if your symptoms do not disappear after two to three days or when they are associated with difficulty in breathing, which may be life-threatening.

Causes of Hives and Angioedema

Acute cases of hives and/or angioedema are often triggered by an allergic reaction to food, medicines, latex, cosmetics, soaps, or detergents. They may also occur due to insect bites, pollen or animal dander. Environmental factors such as heat, cold, water, sunlight, physical stimulation of the skin, emotional stress, exercise, and sweating may also contribute to these reactions. Acute cases usually last for less than six weeks.

Chronic cases of hives and/or angioedema last more than six weeks and may be more difficult to diagnose. These may be due to autoimmune conditions, chronic infection, hormonal disorders or certain cancers.

In rare cases, angioedema is an inherited condition that is related to having low levels of certain proteins in the blood that are involved in regulating immune system functions.

People who have a tendency to have allergic reactions or have other medical conditions associated with hives and angioedema have an increased risk of developing these outbreaks.

Treatment

Mild symptoms usually go away on their own, even without treatment. However, for intense itching and discomfort, you may need to take antihistamines, which help reduce allergy symptoms, swelling and itching. Doctors may also prescribe prednisone, an oral corticosteroid drug to relieve severe itching and swelling. If these medications do not relieve your symptoms, autoimmune drugs may be prescribed. In severe cases, when anaphylactic reaction is suspected, an epinephrine injection may be given.

Hives and angioedema may take a while to disappear, and you may need to do some measures to reduce discomfort. These include using lukewarm water instead of hot water for bathing, using mild soap, applying cool compress or wet cloth to affected areas, wearing loose clothes, and staying in a cool room.

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