If you’re experiencing or have ever experienced hives, chances are you’ve got a good idea of what caused them. Hives are most commonly a result of an allergic reaction, but there are a number of other exposures and factors that can cause them.
Hives go by many names including welts, wheals and their scientific name: urticaria. Hives are often itchy and can crop up anywhere. They appear as red, blotchy welts and can range in size from small spots the size of freckles, to large areas the size of a dinner plate. Hives can appear in a spreading network of welts in varying sizes, or in very small areas and never grow. Hives can appear almost instantly after contact with an irritant or up to around two hours after exposure. This can make the cause of hives difficult to determine since we generally come into contact with many things in the span of two hours. Because of this, we can say that around half of all hives cases are never figured out. Thankfully, hives are usually little more than harmless irritation that lasts around 24 hours. However, if you experience extreme swelling or difficulty breathing or swallowing, you should seek emergency attention.
Regardless of their cause, treatment generally entails a course of antihistamines or antibiotics depending on severity. Your dermatologist can perform different screenings such as blood work, allergy tests, or a skin biopsy to determine the cause of your hives and rule out an illness or infection if the cause is not evident.
An allergic reaction is the single most common cause for an outbreak of hives. It can happen to anyone at any time. Some children with allergies seemingly outgrow them, and adults can develop them almost out of nowhere. Food allergies (most commonly an allergy to citrus fruits) will cause hives. Other foods that can cause hives include milk, eggs, shellfish and peanuts (and tree nuts). An allergy to medications will also result in hives, so your doctor will ask if you have started taking any new drugs or assess whether your hives may be the result of an ongoing medicinal treatment.
Bites and stings by insects like bees, mosquitoes, or wasps can cause hives. This reaction is called papular urticaria and can result from the bites and stings of almost any insect, including fleas and bedbugs. These hives may last longer than other types of hives. Contact with animals, most commonly domestic ones like cats or dogs, can cause an allergic reaction and hives. However, the exposure to the dander, saliva, or urine of many animals can trigger a reaction.
Pollen is another common allergy, and unsurprisingly a reaction to a pollen allergy can manifest as hives. Physical exposure to or touching allergens like latex can cause hives as well. Even allergy shots (treatments designed to reduce allergy symptoms) can cause hives, since these shots expose you to allergens in order to strengthen your immunity.
As with any allergic reaction, if hives are accompanied by difficulty breathing or swallowing, this can be a sign of a much more severe and serious anaphylactic reaction. This requires immediate emergency medical attention to treat. If the allergy is known, an administration of a personal automatic epinephrine injector will be required.
Second to allergies, stress is a big creator or enabler of hives. Stress won’t have physical symptoms in small bouts, but prolonged emotional stress can cause chemical and hormonal changes that can lead to hives. Stress also leaves us more susceptible to illness and exposure to hives.
Illnesses ranging from the common cold to lupus can cause hives. Fungal and bacterial infections can give you hives too. Since medicines used to treat infections or illnesses can also cause hives, determining the source can be complicated.
Sweat from exercise can cause hives in some individuals, and in others exercise itself can cause hives. We don’t know much about why hives are caused by exercise. Sweat, which can also result from heat or nervousness, can cause hives if you’re allergic to a particular antibody produced in the sweat glands.
Sunlight can be harmful to your skin for a number of reasons, and hives can result from sun exposure. This is called solar urticaria and while it is rare, there are steps to avoid it. Use sunscreen with a high SPF, wear clothing with at least 40 UP and limit exposure during the most intense bouts of sun (from mid-morning to mid-afternoon). Hives from contact with water, or aquagenic urticaria, are more likely in women, especially during and after puberty. Exposure to heat, cold, or water can cause hives as well.
While any of these exposures can cause hives, they are incredibly rare and little is known about why hives result from them. These differ from true allergies, however, as they don’t trigger the same immunoglobulin antibodies.
Topical treatments prescribed by your doctor can alleviate hives. While hives itch, scratching them too much can lead to skin infections. Exercise caution when dealing with itchy skin.
If you are dealing with hives or often suffer from them, contact your dermatologist today.
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