Treatment for Hives in Charlotte
Hives can be a frustrating and difficult condition for many individuals. At Carolina Asthma & Allergy Center, we understand the impact that hives can have on your lifestyle and well-being, and we are committed to providing comprehensive care to help manage and treat this condition.
Our team of board-certified allergists and experienced healthcare professionals is dedicated to providing personalized treatment plans and ongoing support to help you live your life to the fullest. Whether you are seeking a diagnosis, treatment, or ongoing management of your hives so you can find relief from your symptoms, we are here to help you every step of the way.
How to Request an Appointment
At Carolina Asthma and Allergy Center, we offer comprehensive evaluation and treatment for your hives. If you suspect you may have hives or have noticed a skin condition that may be hives, you can request an appointment with our team of board-certified allergists and experienced healthcare professionals.
To schedule an appointment, you can call our office or fill out the online appointment request form on our website. Our friendly staff will work with you to find a convenient date and time for your visit.
During your appointment, our allergists will review your medical history, perform a physical exam, and conduct any necessary tests to determine if you have hives. Based on your evaluation, our team will develop a personalized treatment plan to help manage your symptoms.
What are Hives?
True hives are red, itchy, usually raised lesions that look very much like mosquito bites. They are often round or oval but can be irregularly shaped. Their size may vary from ¼ inch to several inches in diameter. They may blend together. Each spot lasts anywhere from 4-36 hours and is surrounded by normal looking skin. As they resolve the skin looks normal, not flaky or rough. While the hives are present one spot will be resolving while another nearby is developing. In about 40% of cases localized swelling (angioedema) of the lips, eyelids, hands, feet or tongue also occurs.
What Causes Hives?
Hives that have been present intermittently or daily for less than 6 weeks are called acute hives, and if longer, chronic hives. Amongst the many possible causes of acute hives those due to allergic reactions get the most attention. In allergic patients the mast cells are coated with an allergy antibody, called IgE, that recognizes a very specific target (peanut, penicillin, yellow jacket, etc.). When that substance, such as peanut, becomes attached to that allergy antibody a chain reaction occurs that activates the mast cell which results in the release of histamine and other inflammatory substances.
For food allergy reactions, there are 3 useful rules to consider:
- First, the reaction begins quickly, within 5-30 minutes of eating the food; on rare occasions up to an hour but almost never longer.
- Second, it goes away within a few hours or at the most within a day or two. Therefore, you never get hives for a week from one serving of peanut butter.
- Third, the reaction is reproducible, meaning that if hives were caused by eating 4 peanuts on a Monday, eating 4 peanuts the following week will almost always cause the same problem. Despite popular belief, artificial food colorings and food additives almost NEVER cause hives.
Hives from antibiotics is a different situation. The hive reaction can begin anywhere from a few minutes after the first dose to 10 days after finishing the course. Antibiotic related hives can persist for up to approximately 2 weeks.
Allergic hives from stinging insects are usually obvious but occasionally they can be sneaky by occurring while you’re asleep or distracted. They begin quickly after the sting and resolve in a few hours to a few days. In the U.S. spiders, flies and mosquitoes almost never cause hives although rare cases have been reported.
Almost any medicine or herbal product can potentially cause hives but one of the most common medicines implicated is the aspirin family (aspirin, ibuprofen, naproxen, etc.). Isolated swelling without hives is a unique side effect of the ACE inhibitor blood pressure medicines. Soaps, detergents, fabric softeners almost never cause hives but if they do, the hives occur only where the skin is touched. Airborne allergy to pollen, dust, etc. almost never causes hives unless the person is in the midst of a massive hay fever attack. In an allergic person, direct skin contact with a potent allergic substance like animal saliva or latex can cause hives at the site. All categories of allergic hives are potentially dangerous while chronic hives are usually not.
Acute vs. Chronic Hives
One of the more common presumed causes of acute hives, especially in children, is post-infectious hives. During or within a week of viral, strep or other infections hives may occur through poorly understood mechanisms. This often leads to confusion when antibiotics have been given for the infection. Were the hives from the antibiotic or from the underlying illness? Post-infectious hives can recur for up to 6 weeks. At times, even without infection or any obvious trigger a few hours to a few days of hives occur. These are called acute idiopathic hives. We assume that the immune system is inappropriately activating the skin mast cells but we don’t know why. We don’t think that stress is a common cause.
Unlike acute urticaria, less than 5% of chronic hives cases are due to some external cause. Also, unlike acute urticaria, the hives and /or swelling are rarely dangerous. In this form of hive problem various quirks and idiosyncrasies of the immune system, as they relate to mast cells, are the primary cause.
Triggers for Hives
Some forms of chronic hives have to do with the immune system’s reaction to physical triggers. Hives produced by stroking of the skin is called dermographism. Some people’s hives are triggered just by cold, heat, skin pressure, vibration, exercise, sun or even water. These conditions are fairly rare. Some exercise induced patients can either react just to exercise while others react only if their exercise follows the consumption of a food to which they are mildly allergic, most commonly wheat, celery and shellfish. These exercise reactions can produce anaphylaxis and may be dangerous. Another dangerous condition, this one involving angioedema and never hives, is called hereditary angioedema. In these patients swelling of the upper airway can be fatal. Such patients also usually have pronounced abdominal pain from swelling of their intestines.
Treatment for Hives in Charlotte
For acute hives and rare cases of chronic hives avoidance of triggers is the key. If the acute hives are already present antihistamines and if severe, a short course of oral steroid is used. For chronic hives daily preventative antihistamines are essential. Doses higher than those used for nasal allergy treatment are often needed. If maximum antihistamine dosing has been reached without control, addition of an H2 blocker (e.g. Tagamet) and/or a leukotriene blocker (e.g. Singulair) may be tried. Maximizing the above therapy should minimize the need for oral steroid. Relying on recurrent courses of oral steroids (prednisone) especially without full antihistamine, H2 blocker and anti-leukotriene support is to be discouraged. In rare cases cyclosporin or other immunomodulatory medicines may be added. Once control has been achieved medicines should be continued for several weeks or longer past the last symptoms. Slow tapering can then be attempted.
Summary
At Carolina Asthma and Allergy Center, we are dedicated to providing compassionate care and ongoing support to help you live your life to the fullest. Contact us today to request an appointment and take the first step towards managing your hives.
Hives FAQs
How long do hives last?
Antibiotic-related hives can persist for up to approximately 2 weeks, while acute hives can last for up to 6 weeks. Any longer than that is considered chronic hives.
Can hives be caused by something other than an allergic reaction?
In the U.S., spiders, flies and mosquitoes almost never cause hives, although rare cases have been reported.
