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Symptoms, Their Causes & Cures: Hives

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Hives

WHEN TO SEE YOUR DOCTOR

* Your face, eyes or throat begins to swell.

* You have frequent or persistent hives.

* Your symptom lasts for more than one day and is accompanied by a fever or other ill feeling.

* Your hives turn to blisters.

What Your Symptom Is Telling You

Who named this obnoxious type of rash? It must have been someone who felt as if a colony of bees had swarmed under their skin.

You know you have hives if you otherwise feel well but your skin seems to be having a raucous party that moves from one place to another. Hives are bumpy, red, itchy patches that go away in less than a day (more likely hours). But the bumps, called wheals, often reappear elsewhere, explains Glenn Kline, M.D., allergist and assistant clinical professor of pediatrics at the University of Texas at Houston. They're raised because histamine, a chemical in the body, squeezes fluid out of blood vessels and it collects under the skin.

Hives can be acute (a one-shot deal) or chronic (they last for weeks on end or sometimes needle a person for years), Dr. Kline explains. Anyone can get hives, but they often run in families and are likely to prickle allergy-prone people who have hay fever, dust mite allergies and eczema.

Acute hives often are allergic reactions to things you eat or touch. Artificial flavorings, colorings and preservatives, for example, are a common cause of hives, says Ivor Caro, M.D., a dermatologist and associate professor of medicine at the University of Washington School of Medicine in Seattle. Hives caused by bee stings are also acute; they usually go away in a few hours.

Some people's hands erupt in hives when they handle certain foods—tomatoes and some meats, for example. Remarkably, they often can eat those foods with no problem, says Arthur Daily, M.D., associate clinical professor of dermatology at Brown University in Providence, Rhode Island.

Occasionally, hives are even caused by "nerves" or stressful situations. "For example, during finals, I see a lot of students with hives," says Dr. Kline.

Other major causes: Viruses and certain diseases, such as lupus; medications, such as antibiotics and aspirin; sunlight; heat; cold; pressure (as in the pressure of a chairback when you sit, or a tight waistband); exercise and sweating. But virtually anything can cause hives.

Symptom Relief

Often the cause of acute hives is very clear: You eat strawberries and soon you look like one. Chronic hives are usually more mysterious. Their causes are rarely uncovered, even by expert investigators, says Dr. Daily. Fortunately, both kinds of hives respond to a variety of treatments.

Be cool. When hives begin to blossom, you often can save your body from becoming a bouquet of red lumps by taking a cool shower, says Dr. Daily. That's a cool shower. Hot water stimulates histamine release and can turn you into a giant, walking wheal.

Have hives, will travel (to a pharmacy). Hives and histamines go hand in hand, so it makes sense to lull those red bumps into submission with oral antihistamines, such as Benadryl or Chlor-Trimeton. But if you don't want to be lulled to sleep as well, see a dermatologist for a prescription antihistamine that won't make you sleepy, such as Hismanal and Seldane. Only use prescription antihistamines if your hives are chronic, says Dr. Kline.

Or perhaps you want to sleep through your symptoms. In that case, Dr. Kline says to take the common drowsiness-causing antihistamines before going to bed, which will both help you sleep and probably take care of tomorrow's hives.

For stress-caused hives, Dr. Caro often prescribes Doxepin, a combination antihistamine and antidepressant medication. "It's often a tremendous benefit both to treat the hives and to help people relax," he says.

Taste no evil, touch no evil. If you break out in hives after eating specific foods or using various products, stay away from them. If the troublemaker is unknown, do a little hive hunting: Avoid diet drinks and foods with lots of additives. Avoid dusty places (and dust mites). And stop putting chemicals that you might be allergic to on your skin. Possible culprits include makeup, cologne, shampoo and soaps. Reintroduce them one at a time and see if they cause hives.

Use care with clothes. Avoid hive-raising chemicals in fabrics by washing new clothes before you wear them. Also, use mild, unscented detergents, and stop using softener sheets in the dryer, says Dr. Caro.

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