Urticaria (Hives)

Urticaria (hives) is a common skin condition characterised by itchy, raised, red and well-defined eruptions that appear suddenly on the skin. These eruptions usually disappear within a few hours but can reappear on different parts of the body during the day. In some patients, deeper swellings (angioedema) developing on the lips, tongue, eyelids or face may accompany the picture.

Although urticaria is often thought of simply as an allergy, not every case is due to allergy. Acute urticaria lasting less than 6 weeks in particular may be linked to triggers such as infections, medications or certain foods. Chronic urticaria lasting more than 6 weeks, on the other hand, does not stem from allergy in most patients; mechanisms involving the immune system are to the fore, and often no clear cause can be found.

In some patients, physical stimuli such as heat, cold, sunlight, exercise, sweating, contact with water, pressure or vibration can also trigger urticaria. Stress, too, can contribute to a flare of the existing condition.

The diagnosis of urticaria is usually made from the patient's history and dermatological examination. Where needed, laboratory tests or additional investigations may be planned to look for underlying causes; however, extensive testing is not necessary in every patient, and the assessment should be tailored to the patient's clinical features.

Treatment is planned individually according to the type, duration and severity of the urticaria and its possible triggers. Identifying triggers and avoiding them as far as possible is important. Thanks to the modern treatment options in use today, itching and eruptions can be brought successfully under control in the great majority of patients. In cases of chronic urticaria that cannot be controlled despite standard treatments, biologic treatments (such as anti-IgE therapy) can now achieve very successful results.