Urticaria also known as hives, is a fancy medical name given to red or skin-colored bumps and plaques of various sizes, ranging from as small as the tip of a pencil to larger than a supper plate, on the skin surface. They are either flat-topped or round. They can present singly, or in groups. They are usually itchy, very uncomfortable and most of the time is the result of an allergic reaction to something - be it food or medicine, which then causes the skin to react in such a way that it collects fluid in and around the skin cells, in a process called edema. When deeper layers of the skin are involved, for instance around the face, especially the lips and eyes, hands, feet, and throat, this form of swelling is called Angioedema. Some flares can last a few hours and other flares can last up to days, appearing and disappearing over several weeks. Urticaria is a skin condition that is common and can happen to anyone from infants to the elderly. Sometimes it occurs in the same area of skin, and other times it presents at a different site.
Some common things or foods that can cause an allergic reaction to present, leading to the formation of hives are fruits that contain Vitamin C, like oranges, strawberries, grapefruit and peaches etc; products with lactose such as milk or milk products; eggs, peanuts and peanut products and shellfish. Medications that may have traces of peanut, sulfur or shellfish can also be problematic in addition to insect bites, animals (cats and dogs) and their dander, as well as, pollen. Oddly enough, some people can break out with hives with extreme exercise, various degrees of stress and exposure to sun, heat, cold, water, pressure, vibration or scratching. A lot of times when a flare is about to occur, the area may become itchy and if scratched begins to turn red, swells and rises with defined edges of its size. These swellings, if more than one presents, can become bigger, spread, and join together to form larger areas of flat, raised skin.
Recognition and diagnosis
Normally a patient that has hives on the skin, be it on the face or elsewhere, presents with the previously mentioned symptoms and invariably by the time a visit to the dermatologist is made, the hives are gone and the history that is given at time of consultation can be enough to make a diagnosis of Urticaria. It can be difficult to pinpoint the cause for the flare, but with a process of exclusion and recording of daily activities, food eaten, medication taken or things applied to the skin, most of the time a cause can be identified provided the problem hasn't been more than six weeks prior.
Treatment for hives can be a bit tricky because a lot of times it is related to food consumed and the consumer is none the wiser. It can either be the obvious, such as seafood or poultry, or unrecognized seasonings like garlic, curry, season-all or cumin powders to name a few. But like always, the severity of the problem has to be assessed as mild, moderate or severe so when treatment is given it can either be administered as single or as a combination therapy. Generally, antihistamines are prescribed to help eliminate and decrease itching. Steroids, whether oral, topical or both, may also be prescribed to help eliminate or significantly decrease the swelling and redness that is seen and felt, during this ordeal.
If it is found the problem is not caused by food consumed, then the daily monitoring of exposure to pets, extremes of hot and cold, water, vibrations, extreme exercise and various degrees of stress should be noted, then allergy testing should be done to give an idea of the possible agent(s) that need to be avoided in order to prevent flares. Once treatment is in place and avoidance of the agent(s) is adhered to then the hive generally disappears with no traces of ever being present.
oDr. Rokeisha Clare-Kleinbussink studied at Cosmetology Cosmetic Training for Dermal Filler in London, UK and attended the Academy of Beauty Training for Laser and Microdermabrasion in Nottinghamshire, UK. She also attended the University of the West Indies School of Medicine and Cardiff University School of Medicine. She has a private practice at Roseona House of General and Cosmetic Dermatology and can be reached at www.roseonahouse.com or 422-2022.
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