Question: I have gotten hives all of my adult life. They seem to come and go for no apparent reason. I think it might be from stress from my job. None of my siblings get hives, but a couple of them have asthma and allergies. Could I have allergies? My doctor says my hives are from my nerves.
Answer: Although I addressed hives, or urticaria as we physicians call the condition, in a recent column, your question focuses on the problem of recurring hives.
Hives are officially caused by an allergic reaction in your body, but a lot of things can set them off. Just because you have had them for a long time doesn’t mean that you shouldn’t take the time now to investigate potential causes. Understanding the cause can help you manage and avoid recurrences.
A hive is a red, usually raised and very itchy lump that may come alone or in groups. Sometimes they spread out and cover most of your body. Other times they are isolated to only a few areas. Hives are the most common dermatological condition seen in emergency departments of hospitals in the United States.
About 20 percent of individuals will have an episode of hives at least once during their lifetime. Some people just get one outbreak; others, like you, will have a lifetime of recurring hives.
The cause of hives can be difficult to find as they may be caused by foods, food additives or chemicals. People who have only one episode of hives or very infrequent episodes may never find out the cause. But if you have hives all the time, it is well worth your time to get an allergy test.
Allergies do run in families, and since you have siblings with allergy-based conditions, you may share some of their allergies. Often there can be a bit of a delay between exposure to an allergen and the outbreak of hives, which makes the triggers for hives especially elusive.
The most common allergy test is the skin test. With the skin test, trace amounts of common environmental allergens, such as dust and pollen, and common food allergens are injected into the outer layer of the skin. The affected skin is then observed to see if it reveals any reactions and, if so, how severe they are.
The skin test is a generally painless procedure that can likely be done in a physician’s office. Sometimes blood tests for allergies are sent out. These are somewhat useful, but they are not as sensitive as the skin tests.
Although stress can aggravate hives, allergens are typically involved with this condition. With recurring hives, the most important approach is effective prevention. If allergens are behind your hives, this test can help you avoid those triggers. Prevention is the best treatment for urticaria or any allergy-based problem. It is never too late to have this testing done, even if you have had hives all of your adult life.
Thursday, May 13, 2010
WHITE SPOTS ON SKIN A COSMETIC NUISANCE
Question: I recently developed these little white areas on my fingers. My mother has them too, and she insists they are nothing to worry about. She says they’re called vitiligo and that she has had them as long as she can remember. Dangerous or not, I think they are ugly. What causes these? Are they anything to worry about? How can I make them go away?
Answer: Vitiligo is a relatively common skin condition that affects about 2 percent of all people in the world. It usually develops before the age of 20, and it seems to occur equally in both men and women and across all nationalities. Vitiligo results when melanocytes, the cells in the body that produce dark skin pigment, called melanin, stop working. When this occurs, the affected skin turns a pinkish white. If melanocytes stop producing melanin on the scalp, the hair in the affected area also turns white.
While there is no definitive cause for vitiligo, many theories exist. The most widely accepted theory is that it is an autoimmune disease, which occur when your immune system attacks your body’s healthy cells, destroying them. Although it is largely considered an autoimmune disease, most people with vitiligo do not have an underlying autoimmune disorder. Instead, vitiligo is more common in people with hyperthyroidism, adrenal insufficiency, pernicious anemia and alopecial areata. Also, vitiligo does seem to run in families, which might explain why both you and your mother experience the same symptoms.
The diagnosis of vitiligo involves a simple visual inspection of the affected skin by a trained physician. Sometimes the doctor will want to do a biopsy to confirm the diagnosis. She may also check your personal and family history for associated diseases like those mentioned above. If you or your family members do not have documentation of these conditions, your doctor may still want to test for them.
There are treatments for vitiligo. Topical steroid creams can help in restoring color to the de-pigmented areas, but it may take several months of regular use before you notice any improvements. Another treatment that works well is phototherapy with ultraviolet light, plus medication applied to the skin. These treatments are effective but they can be time-consuming, and the results are often delayed. For extreme cases –- people who have lost pigmentation on more than 50 percent of their skin surface, there are prescription cream treatments that fade the rest of the skin to match. Some people also choose skin grafts, which remove the affected areas of skin, but there can be complications from this treatment.
There is good news in all of this: interestingly, recent studies have shown that people with vitiligo may actually be at decreased risk for developing serious skin cancers.
Answer: Vitiligo is a relatively common skin condition that affects about 2 percent of all people in the world. It usually develops before the age of 20, and it seems to occur equally in both men and women and across all nationalities. Vitiligo results when melanocytes, the cells in the body that produce dark skin pigment, called melanin, stop working. When this occurs, the affected skin turns a pinkish white. If melanocytes stop producing melanin on the scalp, the hair in the affected area also turns white.
While there is no definitive cause for vitiligo, many theories exist. The most widely accepted theory is that it is an autoimmune disease, which occur when your immune system attacks your body’s healthy cells, destroying them. Although it is largely considered an autoimmune disease, most people with vitiligo do not have an underlying autoimmune disorder. Instead, vitiligo is more common in people with hyperthyroidism, adrenal insufficiency, pernicious anemia and alopecial areata. Also, vitiligo does seem to run in families, which might explain why both you and your mother experience the same symptoms.
The diagnosis of vitiligo involves a simple visual inspection of the affected skin by a trained physician. Sometimes the doctor will want to do a biopsy to confirm the diagnosis. She may also check your personal and family history for associated diseases like those mentioned above. If you or your family members do not have documentation of these conditions, your doctor may still want to test for them.
There are treatments for vitiligo. Topical steroid creams can help in restoring color to the de-pigmented areas, but it may take several months of regular use before you notice any improvements. Another treatment that works well is phototherapy with ultraviolet light, plus medication applied to the skin. These treatments are effective but they can be time-consuming, and the results are often delayed. For extreme cases –- people who have lost pigmentation on more than 50 percent of their skin surface, there are prescription cream treatments that fade the rest of the skin to match. Some people also choose skin grafts, which remove the affected areas of skin, but there can be complications from this treatment.
There is good news in all of this: interestingly, recent studies have shown that people with vitiligo may actually be at decreased risk for developing serious skin cancers.
Subscribe to:
Posts (Atom)
