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Urticaria and Hives

Urticaria, also known as hives are raised, red, itchy welts (wheals, or swellings) of various sizes that seem to appear and disappear on your skin.

In most cases, hives and angioedema are harmless and don't leave any lasting marks, even without treatment. The most common treatment for hives and angioedema is antihistamine medications. Serious angioedema can be life-threatening if swelling causes your throat or tongue to block your airway and leads to loss of consciousness.

Hives can be either acute or chronic. By definition, acute urticaria can last from less than a day to up to six weeks, whereas chronic urticaria last more than six weeks — sometimes occurring for months to years at a time. Mild hives usually aren't life-threatening. You can usually be treated at home.

The causes of hives and urticaria may be difficult to determine, especially with chronic urticaria, where the causes can be unknown up to 50% of the time.

Common triggers, especially with acute urticaria are:

  • Foods. Many foods can cause problems in sensitive people, but shellfish, fish, nuts, eggs, chocolate and milk are frequent offenders. Food additives, such as salicylates and sulfites, are other potential allergens.

  • Medications. Almost any medication may cause hives. Common culprits include penicillin, aspirin, ibuprofen (Advil, Motrin), other NSAIDS and blood pressure medications.

  • Other allergens. Other substances that can cause hives include direct contact with pollen, animal dander, latex and insect stings.

Additional triggers that may produce hives or angioedema include:

  • Physical factors. Environmental factors can result in the release of histamine with subsequent hives or angioedema in some people. Examples of these factors include heat, cold, sunlight, water, pressure on the skin, emotional stress and exercise.

  • Dermatographia. The name of this condition literally means "write on the skin." When pressure is applied to the skin or the skin is scratched, raised lines appear on those areas due to histamine-based angioedema that leads to swelling beneath the skin.

In addition to these triggers, hives sometimes occur in response to your body's production of antibodies. This may occur because of blood transfusions, immune system disorders, such as lupus or cancer, certain thyroid disorders, infections, such as hepatitis, or even a cold.

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