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Suffer the body if it wanted to – the popular saying goes. Itchy skin with hives is hardly a punishment, especially when the cause is no fault and a tendency to allergy resulting from the body’s predisposition. If you have experienced this unpleasant ailment, check what does hives manifest itself, what are its types, causes and treatment methods.
The experience of the sick – symptoms
Probably everyone had blisters on the body, but the hives have their own specificity. They come in various sizes – from the head of a pin, to beans, to chicken, indeed! – ostrich egg! They appear immediately or with a delay after contact with the allergen, form clusters or single points on the skin, cover the entire body surface or only a part of it, e.g. the head, chest or limbs.
– Common to all types and subtypes of urticaria is the development of wheals, angioedema, or both. Urticaria blisters disappear without leaving a trace, and skin lesions are almost always accompanied by pruritus, explains Dr. Zygmunt Nowacki, MD, an allergologist, specialist in children’s diseases, lecturer at the Polish Society for Combating Allergic Diseases. Other – rarer – accompanying symptoms may be redness within the lesions and bubbles with oozing fluid that forms scabs after drying.
As with any allergic reaction, the appearance of urticaria is a direct result of immune system disorders. In an allergy sufferer, it produces an excessive amount of antibodies in response to seemingly harmless factors such as pollen or food. In general, hives pass as quickly as it appeared and do not wreak havoc on our skin. Sometimes, however, it can make our lives more difficult.
Textbook knowledge – typology
Allergic hives are just a drop in the ocean of many types of this disease. And the allergic type is a real “family” of its variants, about which medical textbooks write. – The classification of urticaria based on the time criterion distinguishes urticaria: acute and chronic. On the other hand, the division according to the immune mechanism differentiates urticaria into dependent IgE (I mechanism according to Gell-Coombs) and independent IgE (II, III, IV mechanism according to Gell-Coombs) and non-allergic urticaria, where the immune mechanism has not been proven – noted Dr. med. Zygmunt Nowacki. We present several varieties of the disease in a nutshell.
Acute urticaria It mainly affects children and young people, lasts up to 6 weeks – permanently or disappears and comes back (recurrent urticaria). Usually it takes several hours or days. The most common culprits are food, drugs, insect venom or inhaled allergens (pollen, animal hair, etc.).
Chronic urticaria – less frequent than acute – exceeds the magic limit of 6 weeks. In the worst case scenario, it can last up to 5 years! Its “victim” are most often women over 40 and older, and the cause is often difficult to determine.
Idiopathic urticaria (both allergic and non-allergic) is the most common representative of chronic autoimmune urticaria. Its distinguishing feature is the inability to determine the cause. And it is not uncommon – as many as 70% of cases are considered spontaneous.
Serum sickness type urticaria it is one of the few that coexists with fever. Patients also sometimes report joint pain or proteinuria. Here, too, the sensitizing factor is difficult to detect, but more than once drugs (serums) are hidden behind this type of urticaria.
Contact urticaria appears at the point of contact of the skin surface with the allergenic factor. The list includes chrome, nickel, latex, topical medications, insect venom, animal hair, etc. The disease may also be non-allergic, eg cold urticaria, heat urticaria.
Aspirin urticaria it concerns about 1/3 of cases of chronic urticaria. It is caused by drugs and anything that may contain aspirin – food colors, benzoates, sulfates, monosodium glutamate, avocados, plums, raspberries, cherries, blueberries, thyme, oregano, linden and willow trees.
Cholinergic urticaria affects about 5% of patients, mainly young men. Hives are usually smaller here. Their sowing takes a short time, but they come back. The “culprits” are physical exertion, strong emotions, hot drinks and baths that increase the production of sweat. Patients are allergic to acetylcholine – a neurotransmitter that triggers sweat.
Food-related urticaria may coexist with vomiting, diarrhea, abdominal pain and feeling broken. Foods that please our palate are responsible for urticarial skin changes.
Want to find out if an inhaled or food allergy is causing hives? Buy shipping allergy tests with an atopic profile in a variant with 20 or 30 allergens.
Drug treatment – recommendations
It is best to treat hives in the same way that you contracted it, i.e. avoiding the allergenic factor. However – as you know – this is not always an easy task. In addition, the patient needs help in combating persistent skin symptoms. – Second-generation antihistamines are the gold standard in the treatment of urticaria. Steroids are not the first-line drugs to treat urticaria. The guiding principle is also the treatment of the underlying disease, which is accompanied by urticaria – emphasizes the allergist.
Currently, the latest generation antihistamines are used in the treatment of urticaria, e.g. bilastine, whose task is to block the activity of histamine – a neurotransmitter that initiates the inflammatory process in urticaria. Thanks to this, it is possible to quickly alleviate the intensity of itching and reduce the number and size of the blisters. Even with long-term therapy with bilastine, there are no concerns about the occurrence of undesirable side effects, such as drowsiness and inability to drive vehicles. The drug is also considered safe because it does not interact with alcohol and other pharmaceuticals, as its metabolism takes place outside the cytochrome P 450 system, especially active in the liver. At the same time, the agent works quickly and long – up to 24 hours.
For hives or eczema skin, choose the right cosmetics, such as Exema, a soothing hemp cream with a low pH of 4,7, which reduces itching, burning and redness.
Indications and contraindications – prophylaxis
Low temperature also acts as a soothing balm on skin with urticaria. That is why it is worth sleeping and working in cooler rooms, and use cool compresses for hives. On the other hand, it’s better to avoid hot baths, tight clothes, and body irritating fabrics.
– You should also beware of known triggers and worsening symptoms of urticaria, such as alcohol, smoking, intense physical stimuli, and non-steroidal anti-inflammatory drugs. You also need to carefully treat bacterial infections and tooth inflammation – adds Zygmunt Nowacki, MD, PhD.
However, for care purposes, it is recommended to use gentle cleansing agents, give up perfumed cosmetics and avoid direct contact of the skin with detergents that may irritate it.
Zobacz: Body lotion – how to choose the one that suits your skin needs?
– Skin care is of particular importance in the case of physical urticaria, such as cold urticaria, delayed urticaria, thermal urticaria, light urticaria, induced urticaria, vibrational urticaria, cholinergic urticaria or contact urticaria. On the other hand, in the case of urticaria caused by immunology, special care for the proper selection of care products is no longer such an important issue – concludes the doctor.
Zygmunt Nowacki, MD, PhD – specialist in children’s diseases, allergist, lecturer at the Polish Society for Combating Allergic Diseases. Author of many guides on the principles of diagnosis and prevention of allergic diseases.