Urticaria, also known as hives,
is an outbreak of swollen, pale
red bumps or plaques (wheals) on
the skin that appear suddenly --
either as a result of the body's
adverse reaction to certain
allergens, or for unknown
Hives usually cause itching, but
may also burn or sting. They can
appear anywhere on the body,
including the face, lips,
tongue, throat, or ears. Hives
vary in size (from a pencil
eraser to a dinner plate), and
may join together to form larger
areas known as plaques. They can
last for hours, or up to one day
Angioedema is similar to
urticaria, but the swelling
occurs beneath the skin instead
of on the surface. Angioedema is
characterized by deep swelling
around the eyes and lips and
sometimes of the genitals,
hands, and feet. It generally
lasts longer than urticaria, but
the swelling usually goes away
in less than 24 hours.
Rarely, angioedema of the
throat, tongue, or lungs can
block the airways, causing
difficulty breathing. This may
become life threatening.
What Causes Hives
Hives and angioedema form when, in response to
histamine, blood plasma leaks out of small blood
vessels in the skin. Histamine is a chemical released
from specialized cells along the skin's blood vessels.
Allergic reactions, chemicals in foods, insect stings,
sunlight exposure, or medicines can all cause histamine
release. Sometimes it's impossible to find out exactly
why hives have formed.
There are several different types of hives, including:
Hives lasting less than six weeks. The most
common causes are foods, medicines, or infections.
Insect bites and internal disease may also be
The most common foods that cause hives are nuts,
chocolate, fish, tomatoes, eggs, fresh berries, and
milk. Fresh foods cause hives more often than cooked
foods. Certain food additives and preservatives may
also be to blame.
Medicines that can cause hives and angioedema include
aspirin and other nonsteroidal anti-inflammatory
medications such as ibuprofen, high blood pressure
medications (ACE inhibitors), or painkillers such as
Chronic urticaria and angioedema:
Hives lasting more than six weeks. The cause of this
type of hives is usually more difficult to identify
than those causing acute urticaria. For more than 87%
of people with chronic urticaria, the cause is unknown.
Chronic urticaria and angioedema can affect other
internal organs such as the lungs, muscles and
gastrointestinal tract. Symptoms include muscle
soreness, shortness of breath, vomiting, and diarrhea.
Hives caused by direct physical stimulation of the skin
-- for example, cold, heat, sun exposure, vibration,
pressure, sweating, and exercise. The hives usually
occur right where the skin was stimulated and rarely
appear elsewhere. Most of the hives appear within one
hour after exposure.
Hives that form after firmly stroking or
scratching the skin. These hives can also occur along
with other forms of urticaria.
If hives or angioedema occur with any of the following
symptoms, contact your doctor right away:
To lower your likelihood of experiencing hives or
angioedema, take the following precautions:
Avoid known triggers.
These may include certain foods or medications, or
situations, such as temperature extremes, that have
triggered past allergic attacks.
Keep a diary.
If you suspect foods of causing the problem, keep a
food diary. Be aware that some foods may contain
ingredients that are listed by less common names on the
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