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Urticaria, more commonly known as hives, is an allergic reaction to a substance or food, and can also be caused by stress. It results in red, itchy skin welts, which are an inflammatory reaction in the skin.
Urticaria is categorised as either acute or chronic and can be triggered by a number of factors.
Acute urticaria is caused by a release of histamine from under the skin. Histamine causes tiny blood vessels to dilate and leak fluid which then gathers causing a rash. While half of all urticaria cases have no known cause, common triggers include:
Infections – e.g. influenza, colds, glandular fever
Irritants – e.g. chemicals, insect bites, nettles
Physical factors – e.g. sunlight, exercise, heat, cold, pressure
Chronic urticaria isn't usually activated by these triggers but is an autoimmune response by the body. Autoimmune reactions are caused by the body releasing antibodies to fight infections which results in the release of histamine. The antibodies are released for no known reason, however the autoimmune reaction has been attributed to factors such as:
In some cases, chronic urticaria is caused by illness and infection such as thyroid problems or hepatitis.
The main symptom of urticaria is a pink or red rash on the skin. The rash appears as a number of wheals which are oval in shape and itchy. Wheals can appear anywhere on the body and in acute urticaria the rash can last for several days or even weeks. In the case of chronic urticaria, symptoms last for six weeks or more.
The appearance of urticaria can sometimes indicate an anaphylaxis reaction which is extremely serious. Other symptoms of anaphylaxis may include:
swollen lips, tongue, throat or mouth lining
increased heart rate
If you experience these symptoms along with urticaria then seek emergency medical attention immediately.
A GP will make a diagnosis of urticaria by examining the rash on your skin. What caused your urticaria may prove difficult given that half of all cases have no know cause however the GP may ask a few questions such as:
where you work
do you have pets
what you eat
do you take any medications
have you been on holiday recently
have you had any previous illnesses or infections
is there a family history of the condition
By identifying potential triggers you can avoid them in the future. Most cases of acute urticaria resolve themselves within a few days.
In the case of chronic urticaria (symptoms that last more than six weeks), the GP may refer you for further tests to identify any underlying cause of the condition.
blood test (for anaemia)
stool sample (for intestinal parasites)
ESR (erythrocyte sedimentation rate) test to check your immune system