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Hives (urticaria) are more common than you think and affect 1 in 5 people at some point in their lives. They appear suddenly as red raised itchy welts of varying sizes on the skin. They are not contagious and in most cases, the reaction will last only a few hours (in most cases less than 24 hours), but as the hives progress and move around in the same area due to scratching, the lesions can last a couple of days before disappearing.

Hives can be a sign of an allergic reaction to food, insect stings, medication, infections, autoimmune disease, pets, or even stress. But in most cases, there is no obvious cause of hives and in that case they are called “idiopathic urticaria”.

It is important to check your liver and thyroid function, complement studies, inflammatory markers, check for infections such HIV and hepatitis, autoimmune disorders, as well as malignancy work up (many cancers can present as hives) when assessing the cause of hives.

Hives can be either acute or chronic (lasting longer than 6 weeks); they can also be classified as hereditary or acquired. Around 40% of urticaria patients have associated “angioedema”, swelling of lips and tongue.

When hives are acute, the reaction is usually immediate and lasts only for a few hours. Perhaps, it is the first time you were exposed to an allergen. When hives are chronic, the symptoms usually last a few hours as well but recur more frequently, over a period of weeks, months and even years, but the lesions always shift around, with individual spots never lasting more than 24 hours.

It is always recommended to see an allergist to pinpoint possible triggers, which could be causing hives.

These tips may help you relieve mild hives:

  • Put cool compresses or wet cloths over affected areas.

  • Keep your body cool.

  • Wear loose-fitting cotton clothes.

  • Use over-the-counter oral antihistamine on a daily basis (as opposed to as needed) to relieve itching.

If you are experiencing unusual or ongoing symptoms, it is always best to talk to a specialist about an accurate diagnosis and treatment.

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