Hives (urticaria) is a widespread hypersensitivity reaction of the skin in Germany. The condition causes typical symptoms such as skin redness, wheals (red swellings), and severe itching. The causes and triggers of hives are varied: it can be triggered by certain medications and foods, among other things, but also by heat, cold and pressure. In the treatment of hives, the search for the cause is the first priority. Until this is found, therapy focuses on relieving the symptoms.
Hives – a common skin rash.
Hives – also known as nettle rash – is one of the most widespread skin diseases in Central Europe, along with atopic dermatitis and psoriasis. According to estimates, between 20 and 25 percent of Germans suffer from hives at least once in their lives. The name is derived from the Latin term for stinging nettle (urtica), as the symptoms resemble skin reactions that occur after contact with a stinging nettle. The symptoms that occur in hives are caused by the neurotransmitter histamine. This is released in large quantities by a faulty reaction of the immune system to a trigger that is actually harmless. Histamine increases the permeability of the blood vessels of the skin in the body and water retention occurs in the dermis – the wheals.
Hives: Causes and triggers
The causes for the release of histamine are varied, in about ten percent of cases, an allergy is behind the symptoms. This can exist, for example, against certain foods or against drugs. In addition, viral diseases, infections with parasites, internal diseases, autoimmune diseases and infections in the ear, nose and throat area can also be possible causes of hives. Besides, hives can also be triggered by the following external stimuli:
- Cold
- Heat
- Light
- Friction
- Pressure
Likewise, psychological factors are said to be able to influence hives. It is considered relatively certain that stress can have a negative effect on an already existing hives. Whether stress can be considered as the sole cause of the skin disease, however, is still uncertain. Incidentally, hives are not contagious or hereditary. Only a special form of cold hives can be passed on to the next generation. However, this form occurs only extremely rarely.
Hives: typical symptoms
The typical symptom of hives is a red rash that is usually very itchy. The itching is often very stressful for those affected, as they find it difficult to concentrate on other things and consequently sleep poorly. Characteristically, sufferers feel they can counteract the itching by pinching or applying pressure with their fingernails. This distinguishes hives from other skin conditions such as atopic dermatitis, where sufferers are more likely to try to relieve itching by scratching. In addition to itching, red swellings on the skin – known as wheals – are another typical symptom of hives. The wheals are sometimes distressing for those affected, as they can be disfiguring. They often appear initially as pale pink to red small bumps that become larger over time. The wheals can appear only on certain parts of the body or on the entire body. Particularly typical of hives is the wandering of these wheals: they disappear in one place and reappear in another.
Swelling in revenge as a life-threatening symptom
Often, hives also cause swelling and water retention in the subcutaneous tissue, called angioedema. In rare cases, mucous membranes in the mouth, throat, and larynx may also be affected by the swelling. This can lead to life-threatening breathing problems. Affected persons should therefore always carry an allergy emergency kit with them. This should contain a liquid antihistamine, a liquid cortisone preparation and a syringe with adrenaline. The individual symptoms of hives may appear very quickly – within minutes of contact with the trigger – or may take several hours to appear. As a rule, the symptoms subside after 24 hours at the latest, and in some cases the wheals regress after just half an hour.However, during a hives flare-up, the symptoms may recur after a short break. A hives flare can last for several days or even weeks.
Hives in children
Not only adults, but also children can be affected by hives. However, the skin disease tends to occur less frequently in children. Chronic hives, in particular, primarily affect adults. In children, too, hives show the typical symptoms such as red wheals and severe itching. In babies and small children, an episode of hives often lasts only a few days, after which the disease disappears on its own. Otherwise, a pediatrician or dermatologist should be consulted to determine the cause of the symptoms. In young children, an expired viral infection is particularly often behind the hives. But also an allergy to certain foods or medications as well as great heat can trigger the unpleasant symptoms.
Hives and pregnancy
During pregnancy, hives symptoms often improve as the immune system is dampened. However, some women report worsening of the condition. In addition, the severe hormonal changes during pregnancy can also trigger hives for the first time. More severe courses of the disease in pregnant women can be problematic, as the use of many medications for hives is not allowed during pregnancy.
Different types of hives
Because hives are an extremely complex condition, several subtypes are distinguished:
- Spontaneous hives
- Physical hives
- Cholinergic hives
- Contact urticaria
In these subtypes, hives are divided either by their duration in time or by the trigger of the disease. You can learn more about each type of hives on the next page of the book.