HIVES NOT LIKELY THE RESULT OF WORK STRESS

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.