Urticaria (Hives)

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 Urticaria, also known as hives, is a skin condition characterized by the sudden appearance of raised, itchy welts on the skin. These welts may vary in size, shape, and location, often merging to form larger patches. 

The hallmark symptom is intense itching, which may become worse at night or with heat.  Symptoms can be short-lived, lasting less than 24 hours per lesion, but new lesions may continue to appear, making the condition feel persistent. 

 Diagnosing urticaria is primarily based on clinical evaluation. Doctors usually ask about the onset, duration, and possible triggers such as food, medications, infections, insect stings, or environmental exposures. 

Physical examination reveals the characteristic welts, which are typically red or skin-colored and blanch when pressed. In cases of chronic urticaria (lasting more than 6 weeks), additional tests may be ordered to rule out underlying autoimmune disorders, allergies, or infections. However, in many cases, the exact cause remains idiopathic (unknown). 

 The mainstay of urticaria treatment are antihistamines. Non-sedating antihistamines are generally preferred for daily use.  For patients with chronic spontaneous urticaria who do not respond well to antihistamines, biologic therapy such as omalizumab (Xolair) may be recommended. Xolair is an injectable monoclonal antibody that helps reduce immune system activity and can significantly improve quality of life in resistant cases. In severe flares, short courses of corticosteroids may also be prescribed. 

• Is urticaria contagious? No, it cannot spread from person to person.
   
• Can urticaria be cured? Acute urticaria often resolves on its own, but chronic urticaria may last for months or years, though it can go into remission.
   
• What triggers urticaria? Common triggers include allergies, infections, stress, heat, pressure, and sometimes no identifiable cause.
   
• Is urticaria dangerous? Most cases are not life-threatening, but angioedema involving the throat can cause breathing difficulty and requires emergency attention.
   
• When should I see a doctor? If hives last longer than 6 weeks, recur frequently, or are accompanied by difficulty breathing, swelling of the face or throat, or severe discomfort, medical care should be sought promptly.