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Breaking Out In Hives Doesn't Always Involve Bees

“I am a 31 year old guy, and I’m dealing with this strange onslaught of hives. I have never had allergies and I can’t recall ever getting hives before,” wrote a man named Jacob on a health forum. “It started on my scalp and back of my neck, then it stopped for a few days. But it came back with a vengeance.
“Benadryl (an antihistamine) helps, but if I stop taking it they come back. Nothing in my life has changed; my diet, detergent, etc. I guess I just have to chalk this up to my body going through a freak-out stage or something. It’s frustrating.”
And, Jacob isn’t alone, neither in getting hives or being frustrated at not knowing the cause. Hives, also known as urticarial, affect about 20 percent of the population at some time in their lives.
They can be caused be an allergic reaction to chemicals in some foods, insect bites, sunlight or medications. WebMD tells us that “it’s often impossible to find out exactly why hives have formed.”
So what are they? The American Academy of Dermatology explains: “Hives are welts on the skin that often itch. These welts can appear on any part of the skin. Hives vary in size from as small as a pen tip to as large as a dinner plate. They may connect to form even larger welts.”
Hives sometimes go away in hours. If they hang around for less than six weeks they’re called acute hives and if they last longer than that they’re called chronic hives.
“When large welts occur deeper under the skin, the medical term is angioedema. This can occur with hives, and often causes the eyelids and lips to swell. If this occurs, the person needs emergency care right away,” AAD says.
If you get hives it’s good to know what triggered the allergic reaction so you can stop exposing yourself to it. Common triggers in food include fruit (particularly citrus fruit), milk, eggs, peanuts, tree nuts and shellfish. Other triggers may be a reaction to animals or pollen. Sometimes it’s by touching something you’re allergic to like latex.
Other causes of hives can include infections, including colds and infections caused by some bacteria or fungi; some illnesses such as vasculitis, lupus or thyroid disease; exposure to the sun, heat, cold or water; exercise; stress; pressure on the skin such as sitting too long; contact with chemicals, or scratching the skin.
Okay. We have to back up here for a second. No. You can’t say that you’ll break out in hives if you exercise. That’s not an allowable excuse. Well, unless you actually do break out in hives, but remember there’s a difference between hives and a heat rash. We can talk about heat rash another day.
“Hives can happen within minutes of exposure to the trigger, or you can have a delayed reaction of more than two hours,” AAD says.
For a mild or moderate case of hives you should take an over-the-counter antihistamine. Jacob chose Benadryl, there are several others. You may choose one that doesn’t cause drowsiness. The antihistamine should stop the itching.
You might also try applying a cool cloth on the hives or taking a cool shower to relieve the symptoms. You should make every effort not to scratch your skin, so some calamine or aloe lotion might be helpful.
If the hives don’t go away after several weeks or if the symptoms aren’t relieved by the home treatment, you should see your healthcare professional. There are other medications that may be prescribed for you.
“For some cases of hives or angioedema, you may need an injection of epinephrine,” AAD explains. “If the hives remain or become severe, it’s important to get medical care. Hives can be a sign of an internal disease. Some people develop severe swelling. If you have hives and trouble breathing or swallowing, get emergency care right away.”
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at 264-4029 or kathyleehubbard@yahoo.com.

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