Hives specialists & information on the disease

Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors
Urticaria is also known as urticaria or hives. It is a pathological skin reaction in the form of itching, wheals or redness. While acute urticaria usually only lasts a few days, the chronic form can last from weeks to years.

You can find all the information you need and experienced hives specialists here.
ICD codes for this diseases: L50

Article overview

In medicine, hives or urticaria occur when wheals cover an area of skin. The wheals are caused by water accumulating in the upper layers of the skin; the skin itself is red, swollen and itchy. Around one in four people suffer from hives in the course of their lives. The disease usually heals within a few weeks.

Causes of hives

Skin changes can have various causes. The most common triggers include
  • allergic reactions
  • Intolerance to medication
  • Environmental stimuli, for example cold

Human skin consists of different types of cells, one of which is the mast cell. Mast cells are so-called inflammatory cells and contain the messenger substance histamine. They normally support the immune system by fighting foreign substances. Histamine causes the blood vessels to dilate and their walls to become more permeable. This causes circumscribed accumulations of water (wheals) in the upper layers of the skin.

If this process takes place in deeper layers of the skin, the doctor speaks of angioedema. The nerve cells in the skin react to the histamine with itching. A layperson cannot judge whether the symptoms require treatment. You should therefore always have yourself examined by a doctor.

Hives2010
Wheals with hives

The symptoms of hives

The medical term for the condition - urticaria - refers to its Latin origin Urtica, which means stinging nettle; the wheals actually resemble the appearance of an area of skin after contact with the stinging hairs of this plant.

The skin changes caused by hives vary greatly. Sometimes individual, tiny wheals appear that resemble mosquito bites; in other cases, larger wheals join together and cover entire areas of the body. A wheal usually disappears by itself after about 24 hours. This does not mean that the disease disappears. It is possible for new wheals to form in a different area. Hives can spread to different parts of the body. Angioedema is a variant of hives. This swelling penetrates into deeper layers of the skin and covers larger areas. Those affected report that the areas of skin hardly itch at all; instead they hurt and burn. Angioedema primarily occurs in the following areas:

  • palms
  • soles of the feet
  • eyelids
  • lips
  • Throat and pharynx
Skin changes on the face are often an additional burden for those affected. If the disease spreads to the throat and pharynx, it may make breathing difficult. Shock symptoms very rarely accompany hives, for example after a bee or wasp sting. In this case, you must call an emergency doctor immediately.

Forms of the disease: as varied as the clinical picture

Modern medicine has identified several forms of hives. It distinguishes between
  • acute-spontaneous hives
  • chronic spontaneous urticaria
  • inducible urticaria
  • chronic intolerance urticaria
In the case of spontaneous urticaria, medicine distinguishes between two forms, namely acute and chronic. Spontaneous acute urticaria lasts a maximum of six weeks. Triggers include allergies and infections. If the doctor cannot identify a cause, he diagnoses idiopathic urticaria. Chronic spontaneous urticaria has been present for at least six weeks. Hives can also be caused by environmental stimuli or stimuli in the body itself. Doctors call it inducible urticaria. They distinguish between the following subtypes:
  • Physical urticaria, for example due to stress, pressure, scratching, cold, light
  • cholinergic urticaria: reaction to a rapid rise in body temperature during exertion, hot baths or psychological stress
  • Aquagenic urticaria due to contact with water
  • Contact urticaria when touching certain materials, for example copper

Chronic intolerance urticaria occurs when the body reacts to the ingredients of certain medications or foods.

Treatment of hives: Treatment and healing process

Acute-spontaneous forms of hives heal on their own after a few weeks. The doctor may prescribe an antihistamine to treat the wheals and itching. The preparation is available as a gel or ointment and in tablet form. If an acute infection has triggered the hives, they usually subside on their own - at the latest three weeks after the infection. Nevertheless, you should discuss possible causes and treatments with your doctor.

In the case of chronic spontaneous hives, the doctor will treat the causes. A chronic infection, such as sinusitis, is treated with an antibiotic. Sometimes an operation is necessary. As soon as the infection heals, the hives subside. This can take up to three weeks.

In the case of inducible hives, the doctor researches the triggers with the affected person. If a person reacts to copper, for example, they must avoid contact with it as much as possible. Such problems often occur with ear jewelry.

In the case of intolerance urticaria, the patient must avoid certain foods or medications. Painkillers and anti-inflammatory drugs (e.g. ASA, ibuprofen or diclofenac) can trigger or worsen hives. Be sure to talk to your doctor if you already suffer from the skin condition. If the doctor is aware of your symptoms, he or she can switch to a safer preparation. If you have the impression that the antihistamine therapy is not working for you, contact your doctor immediately. For some people, the dose is not sufficient to noticeably alleviate the symptoms. Only a consultation with your doctor can solve this problem. Under no circumstances should you change the dosage without authorization. An antihistamine can also lead to side effects. High-dose antihistamine treatments are not administered by the family doctor. They will refer the patient to a hospital.

Specialists for urticaria

Urticaria is a disease of the skin, so you should consult a dermatologist if you have the symptoms mentioned above. Dermatologists deal with all diseases of the skin, mucous membranes, hair and nails. Allergic skin diseases and sexually transmitted diseases are also part of the specialist field of dermatology.

To become a specialist in dermatology, doctors must complete 60 months of further training in the field of skin and sexually transmitted diseases after successfully completing their studies. At Leading Medicine Guide you will find experienced specialists for urticaria.

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