What Are Hives?
Hives or welts, also known as urticaria, are itchy, raised, reddish areas on the skin. About a quarter of the general population can have hives during their life. Hives often appear without warning and may start at any age. Hives can occur anywhere on the body including the face, extremities, chest, back or face. They may range in size from just a few millimeters to several centimeters. An individual hive usually fades within a 24-hour period and the skin returns to normal without leaving any marks or bruising.
Hives are sometimes associated with swelling, also termed angioedema, which is a swelling below the surface of the skin and fatty tissue. Angioedema usually affects the face, throat, hands, and feet but can also occur in other areas of the body. Throat swelling can be life threatening and requires immediate medical attention.
Diagnosing The Cause Of Hives
Our doctors will do a very thorough evaluation to find the cause of the hives. This will include a detailed history, and often skin tests and blood tests to rule out both internal and external cause. Frequent causes of hives are foods, drugs, infection and autoimmunity. Sometimes no cause can be found, in which case they are called “idiopathic hives.”
How Are Hives Treated?
The right combination of medications will usually control your hives so that you can stop suffering. Antihistamines are the first line of treatment. Sometimes, a combination of several antihistamines or an increased dose of one antihistamine may be recommended. Sometimes we use other medications like H2 blockers and leukotriene antagonists as well.
Biologics For Severe Hives
For the person who has not responded to usual medications, treatment with biologic agents is now available. Xolair (omalizumab) is an injectable monoclonal antibody given by injection once a month. This is extraordinarily effective and can be a life-changing medication for patients who had been miserable and unable to function previously. (Read more about biologics for hives.)
Our doctors will find an individualized treatment that will bring your hives under control.