Understanding Urticaria

New Delhi: If you tuned into the latest Bollywood-related show on a streaming service over the weekend, you must have come across various health-related issues the ladies face, from air sickness, to skin aging and a certain condition known as Urticaria.

Dr Smriti Naswa Singh, Consultant Dermatologist, Fortis Hospital, Mulund explains the definition of the condition, its causes, and treatment.

What is Urticaria?

Urticaria, commonly recognised as ‘hives’ is an outbreak of red and prickly bumps that suddenly appear on the skin. The reasons could be due to certain allergies, or at times for unknown reasons. The bumps or rash may vary in size and cause severe itching; it may also cause burning on the skin, causing discomfort as well as disturbing one’s daily routine. The bumps/ wheals may suddenly appear anyplace on the body – the face, hands or legs even the lips, tongue, ears, or throat.

The swelling of lips, eyelids, genitals can be painful, and swelling of throat/wind pipe can cause breathlessness which is an emergency and the patient has to be rushed to hospital. Depending on the severity of the condition, it may last for a few hours, or fade away after the reaction runs its course. Usually an Urticaria reaction lasts for less than 24hours and fades off only to recur at same or other area. If Urticaria lasts beyond 72hours, one has to find the causes beyond skin (involving inflammation of blood vessels), called as Urticarial Vasculitis.

What are its causes?

Urticaria is a type of skin allergy. Allergy means body’s hyperresponse to normal, common, harmless stimuli like dust, dirt, cat fur, pollen, change of weather etc. Urticaria ensues when the body reacts to the release of histamine which is found in the body’s cells or other chemicals into the bloodstream.

Inflammation is caused due to histamine, and fluid accumulates under the skin eventually causing ‘hives or welts’. It is said that “anything under the sun, including the sun can cause Urticaria”. Sometimes its very easy to find the cause, when Urticaria erupts immediately after ecposure to allergen, but sometimes it takes long history taking in OPD, or systematic diary entries for days & weeks to pin point the cause. However, the common triggers to this reaction are:

Reaction to medication such as antibiotics or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), or vaccines

Insect stings

Change in temperature or extreme temperatures

Food – shellfish, nuts, Wheat products, food additives, cow milk protein etc.

Secondary infections

Exposure to sunlight

Pollen/ dust mites

Stress

Animal-related allergies

Chronic illness – Thyroid

What is the treatment?

Hives are treated using anti-histamines, this nullifies the effect of histamine. It is to be used regularly for a few weeks, as prescribed. Chronic hives are generally treated using anti-histamines or a combination of medications.

To reduce the irritation caused by Urticaria, wear loose or light clothing

Avoid scratching and aggravating the condition

Avoid common triggers like dust, dirt, weeds, wool, sweating, dryness of skin, excessive protein in foods

Have bath with tepid water (neither too hot, nor too cold) with a bath oil, and stay away from harsh soap detergents

Compress the area with cold water or apply moisturizing lotion to soothe & moisten the area

Foods that are known to trigger histamine production include fish, dairy, fish, processed foods, chocolate, Spinach & Strawberries – avoid these

It is important to seek emergency medical care if you experience trouble breathing (breathlessness), dizziness, swelling in the lips/ tongue, or tightness in the chest

Hives & stress: Emotional stress may cause This is known as Stress-Induced Urticaria. Extreme stress at times may also be responsible for Chronic Urticaria. An example is a patient who had been Asthmatic for many years, started developing Urticaria recently; she would not have urticarial bouts on days when she was engrossed in her art, the day she got back to routine work and life without the one hobby that mentally relaxes her, the Urticaria would come back.

Skin is the mirror of internal body and mind. Hence, it is very important to find and treat the root cause (within the body and mind) to cure the skin problem.