Urticaria

What is urticaria?

Urticaria, also known as “hives”, is a common skin condition which appear as itchy red patches or swellings on the skin. These are usually temporary, each lesion lasting less than 24 hours. Occasionally in more serious cases, the swelling may involve the eyelids and lips (angioedema).

What causes urticaria?

Urticaria is caused by the release of histamine from mast cells, a type of skin cells.  This may be triggered by various causes e.g. food, drugs, infection, stress, environmental factors.

Urticaria may be acute, following a viral infection or from an allergic reaction to foods or drugs. The acute form usually lasts about a few days up to 6 weeks. If allergy is suspected, allergy tests may be performed. Urticaria may be chronic, lasting more than 6 weeks, sometimes months or years.  In this chronic form, the cause is mostly unknown and is thought to be autoimmune in nature. Food allergy is rarely the cause. Possible triggers are heat, cold, sweating, baths, pressure and sunlight. Sometimes, there may be underlying infection or a medical condition like thyroid disease. Your dermatologist may do investigations to exclude any underlying condition.

What is the treatment of urticaria?

The management of urticaria is to identify and avoid any triggering factors, treat any underlying condition and suppression with anti-histamines.

Anti-histamines suppress the release of histamine and help to control the appearance of rashes. There are many types of anti-histamines and your dermatologist will usually prescribe a combination for you. This may sometimes be combined with other medication like famotidine or colchicine.  In  severe acute urticaria, a short course of oral steroids may be prescribed. But this is not recommended for chronic urticaria.

For refractory cases of chronic urticaria, a biologic Xolair® (omalizumab) which is an approved injectable medicine can be prescribed under supervision.

Most cases of urticaria will usually resolve by itself in a matter of time.