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Hives (Urticaria)

Hives are raised, red depending on skin tone, and very itchy on the skin that can last minutes to hours. The term "urticaria' is often used in medical literature.  They can suddenly appear anywhere on the body and last a few hours or as long as 48 hours, with new hives popping up frequently.  Lesions that are painful/tender and last for greater than 48 hours should be thought of as separate from hives. Approximately one in five people will develop hives in their lifetime.   It is important to recognize that hives appear differently on various skin tones. For darker skin tones, the skin will appear inflamed but may not be red. Instead, the hives may be the same color as the surrounding skin. Also, due to differences in pigmentation, hives can vary on brown and black skin from person to person. 

Hives can be divided into two groups, acute vs. chronic:

Acute - less than 6 weeks in duration

  • causes include infection, allergy (like new drug, food, insect sting)

  • daily until resolve spontaneously

  • can be accompanied by swelling of lips, eyes, hands or feet (angioedema)

  • treat with antihistamines, if severe may need prednisone (steroids)

Chronic - greater than 6 weeks

  • causes are usually unknown, but medial conditions such as thyroid disease or autoimmune process is possible.

  • can be daily or intermittent

  • about 50% of patients will also have facial, hands, or feet swelling (angioedema)

  • rarely due to allergies

  • treat with high dose antihistamines, try to avoid steroids, prolonged cases may require injectable drug, Xolair

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If you feel you are suffering from hives (urticaria), call 313-871-7572 to schedule an appointment today.

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