READER’S HIVES LIKELY CAUSED BY ALLERGIC REACTION

Question: I broke out with a rash around my neck a few weeks ago. I figured it was from my necklace, but now I am getting hives on my arms, too. What can be causing these hives? What can I do to get rid of them?

Answer: Hives, known clinically as “urticaria,” are generally an acute allergic reaction to a substance, although sometimes the source of the rash can be hard to determine. While allergies most commonly appear during childhood, they can develop at any age.

Hives can last for a few minutes or up to several days. An individual hive usually only lasts for less than 24 hours, but hives can spread. Acute urticaria is defined as an episode lasting less than six weeks.

Although sometimes an illness like mono can cause hives, they usual form through allergic reactions to foods, medications or insect stings. The usual suspects include nuts, shellfish, fresh berries, chocolate and tomatoes, as well as penicillin-based antibiotics, aspirin, high-blood-pressure medications, and painkillers such as codeine. These cases usually resolve quickly once you stop consuming the offending food or medication.

Chronic urticaria is defined as hives that last more than six weeks. Their cause can be difficult to identify. Up to 50 percent of the time, the cause is never understood, and these are called chronic idiopathic urticaria.

Regardless of the cause, hives occur when your body releases a chemical called histamine, and in response, blood platelets leak out of small blood vessels. Hives appear as swollen red or white bumps on the skin. They usually itch, but they can also burn and sting. Scratching will make the itching and swelling worse, as can exercise, sweating and emotional stress.

Identifying the cause of a single episode of hives is probably not worth the time. However, when hives appear frequently, you should have testing done to determine the cause. Your family physician can often diagnose an allergy based on a medical history. It’s important to note what foods and/or medications you consumed before each hive outbreak.

If the cause is known, treatment for urticaria is aimed at prevention and avoidance. If the cause is not known, short-term steroid pills and creams and/or oral antihistamines may be prescribed by your physician to stop the itching.

You can find over-the-counter oral antihistamines to treat hives as well as topical creams such as Benadryl. You may also be able to gain some relief through colloidal oatmeal treatments or simply by applying cold compresses or damp, cool cloths to the affected area. I would also suggest wearing light, loose-fitting cloths.

Lastly, and most importantly, if your hives are ever accompanied by difficulty breathing, tightness in the chest, dizziness or swelling in the face, seek emergency medical care.