What are hives?

Quick Answer
Pink swellings called wheals that may occur in groups on any part of the skin.
Expert Answers
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Causes and Symptoms

Hives are produced by blood plasma leaking through tiny gaps between the cells lining small vessels in the skin. A natural chemical called histamine is released from mast cells, which lie along the blood vessels in the skin. Allergic reactions, foods, drugs, or other chemicals can cause histamine release.

Hives can vary in size from as small as a pencil eraser to as large as a dinner plate, and they may join together to form larger swellings. When hives are forming, they are usually very itchy; they may also burn or sting. In a July 2009 American Journal Of Clinical Dermatology article, researchers Evangelo Frigas and Miguel Park cited reports that nearly 20 percent of the general population will have at least one episode of hives in their lifetime. Acute hives may last for a few days to weeks. If they last for more than six weeks, they are called chronic hives.

The most common causes of acute hives are foods, drugs, infections, insect bites, and internal diseases. Other causes include physical stimuli, such as pressure, cold, and sunlight.

Treatment and Therapy

The best treatment for hives is to find the cause and then eliminate it. Unfortunately, this is not always an easy task. Even if a cause cannot be found, antihistamines are usually prescribed to provide some relief. Antihistamines work best if taken on a regular schedule. It may be necessary to try more than one or use different combinations of antihistamines to find out what works best. In severe cases of hives, an injection of epinephrine (adrenalin) or a cortisone preparation can bring dramatic relief.

Perspective and Prospects

In 1927, Sir Thomas Lewis reported the association between wheals and small blood vessel dilation, which later confirmed the importance of histamine as a cause of hives. Years of research showed that in addition to allergy, nonimmunological stimuli can cause hives as well. According to an October 2014 PLoS One article by Mey-Fann Lee et al., 30 to 50 percent of patients with idiopathic chronic hives have autoantibodies in their systems, suggesting that the causes of hives could be multifactorial.

Bibliography

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"Chronic Hives." Mayo Clinic, September 17, 2011.

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Hide, Michihiro, et al. "Autoantibodies against the High-Affinity IgE Receptor as a Cause of Histamine Release in Chronic Urticaria." New England Journal of Medicine 328, no. 22 (June 1993): 1599–1604.

"Hives." MedlinePlus, July 10, 2013.

Joneja, Janice M.V., and Leonard Bielory. Understanding Allergy, Sensitivity, and Immunity: A Comprehensive Guide. New Brunswick, N.J.: Rutgers University Press, 1990.

Lee, Mey-Fann, et al. "A Rapid Method of Detecting Autoantibody Against FcεRIα for Chronic Spontaneous Urticaria." PLos ONE 9, no. 10 (October, 2014): e109565.

Middlemiss, Prisca. What’s That Rash? How to Identify and Treat Childhood Rashes. London: Hamlyn, 2002.

Owen, Judith A., Jenni Punt, and Sharon A. Stranford. Kuby Immunology. 7th ed. New York: W. H. Freeman, 2013.

Young, Stuart H., Bruce S. Dobozin, and Margaret Miner. Allergies: The Complete Guide to Diagnosis, Treatment, and Daily Management. Rev. ed. New York: Plume, 1999.