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What is hives and what are the symptoms?
It is currently estimated that 15-20% of the world’s population, or one in five people, will suffer from an episode of hives at least once in their lifetime. This skin disease is therefore quite common, and in the majority of cases, not serious.
The word “urticaria” has the same origin as the word “ortie”, Because the rashes characteristic of hives closely resemble those caused by a nettle sting. Urticaria is characterized by the presence of red or pinkish patches or papules, rounded, well defined and raised. As in the case of a nettle sting, these lesions are usually associated with itching, or pruritus, sometimes very important.
Urticaria is similar to a kind of allergic reaction of the skin: at the microscopic level, urticaria results from the activation of certain immune cells in the superficial layers of the skin, mast cells (belonging to the family of white blood cells) , which free from l’histamine, an immune substance. It is the latter which causes dilation of the blood vessels and these famous patches of urticaria.
These plaques can be few or multiple, and the rash can evolve or move in just a few hours. When they are superficial, hives usually end in disappear on their own after a few days.
There are thus two main types of urticaria:
- acute urticaria: it manifests as one or more flare-ups, each lasting a few hours to just a few days.
- chronic urticaria: it is accepted that this skin condition becomes chronic when the outbreaks are repeated daily or every 2 to 3 days, over a period of at least six weeks. The hives may then be accompanied by other symptoms (see “when to see”).
What is the cause of hives?
The hives may be due to several factors, and it sometimes happens that no specific factor is highlighted. This is called chronic spontaneous urticaria.
We distinguish the so-called immunological or allergic causess, when the body reacts to substances to which it is exposed; the physical causes, and as pathological causes, that is, when the urticaria occurs as part of another disease.
Here are some of the factors that can explain a hives attack:
- taking some pharmaceuticals (antibiotics, anti-inflammatories, etc.);
- certains foodstuffs rich in histamine (fish, crustaceans, tomatoes, nuts, peanuts, kiwi, milk, etc.), we sometimes speak of allergic urticaria;
- the friction ;
- some plants (including nettles of course);
- some materials and products (latex, cleaning products, etc.);
- a pressure important (bicycle saddle, etc.);
- le froid, or on the contrary the heat ;
- vibrations;
- infections of the ENT sphere (otitis, nasopharyngitis, angina, bronchitis…);
- the autoimmune diseases thyroid;
- le stress and overwork.
Urticaria: when to consult?
Whether urticaria patches occur in an adult, a child, or a baby, it is generally recommended to consult when urticaria becomes chronic (several relapses lasting more than six weeks), and / or that she is accompanied by other symptoms : fever, painful or swollen joints, abdominal pain, digestive disorders, severe cough … These symptoms require consultation with your doctor during the week, or even during the day, in particular in case of fever and spread of hives patches on all the body.
In addition, if the attack of urticaria is most of the time not serious, it can extend deep or reach the mucous membranes. We then speak ofangioedema, orangioedema. This occurs on the face (eyelids, lips, tongue, throat) and is characterized by significant swelling deforming the affected area. We quickly understand the need to consult urgently : If the tongue or throat is affected, the swelling may cause difficulty in breathing.
Urticaria crisis: what treatment?
The main treatment for hives is to takeantihistamines, orally or by injection. They are effective in the vast majority of cases. This treatment is said to be symptomatic since it aims to treat the symptoms, and not the cause of the disease.
Generally, the duration of an antihistamine treatment does not exceed 15 days, as regards theacute hives. Treatment can be extended for several months in chronic urticaria. The general practitioner often prescribes a “rescue” prescription for antihistamines in the event of a recurrence.
In the case of angioedema, or angioedema, the treatment, which will be done urgently, is based on adrenaline administration, injected or inhaled, such as during a anaphylactic shock.
As for the removal of the cause of urticaria, it requires identifying it. It will be advisable to note the various elements preceding an outbreak of urticaria (friction, household products, drugs…), in order to see what is the common cause of the various attacks of urticaria. For his part, the attending physician will also try to identify the cause of the urticaria, through questioning and possibly physical tests (reaction to pressure, cold, heat, etc.). If an immunological cause is suspected (drug, autoimmune disease, allergy), it may be useful to perform a blood test and / or an allergic test.
Once the cause of the urticaria has been discovered, it will suffice, in principle, to eliminate it, for example via avoidance of the trigger food, so that the symptoms disappear. Obviously, when the urticaria is due to stress or overwork, the task is not so easy …