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ives is a very common disorder. At least 20 percent of the general population will develop some form of hive-like eruption in the course of a lifetime. Fortunately, most episodes last for a few days to a couple of weeks and the cause, in these cases, is often readily identified.
What are hives? Contrary to popular opinion, it is not a disease. Caused by the release of a chemical called histamine, hives – physicians call it urticaria – is a symptom of some disorder or allergic mechanism going on in the body. Hives appear on the skin and mucous membranes in the form of itching, stinging, and burning wheals (welts), surrounded by a zone of redness. They resemble big mosquito bites. New areas develop as old areas fade away. Hives come in a variety of sizes and shapes and can appear just about anywhere on your body, but mostly on pressure points: where you sit or lean.
When the wheals are very large and the loose tissue of the eyelids, lips and tongue swell up to form actual disfigurement, the condition is called angioedema, or “bull hives.” Hives may involve the mucous membranes of the mouth and throat, and in rare cases may even obstruct breathing so severely that one requires heroic medical methods to prevent suffocation.
Like coughing or sneezing, which may signal a response to an upper respiratory infection or hay fever, hives are a clue, which alerts us to abnormal goings-on in our system. For example, it may be a response to an infection, an allergic reaction to some strange food or drug, or the result of emotional tension. It is extremely difficult to pinpoint the specific cause of a case of hives, mainly because the possibilities are endless. In the acute type of hives – where the itching and wheals appear quickly and fade in a few minutes or hours – it is somewhat easier to uncover the culprit: a strange food, an emotional upset, a penicillin injection, a new medication, or some recent infection such as chicken pox, mononucleosis, or an upper respiratory ailment.
Unfortunately, in the chronic form – which occurs most commonly in middle-aged women, and which may last for months or even years – the culprit is much more difficult to determine.
The most common causes of hives are certain foods and drugs. Strawberries, nuts, chocolate, fish and shellfish, milk, eggs, pork, oranges, bananas, and many other edibles, such as the artificial sweeteners saccharin and aspartame, can cause hives. Hives can appear within minutes or up to two hours after eating a responsible food.
Of the various drugs and medications, penicillin is probably the most common cause. If you are allergic to penicillin and suffer from hives, you should avoid milk and certain cheeses, such as blue cheese and Roquefort. Milk and other dairy products may contain enough penicillin to prolong hives for years. A woman who is allergic to penicillin may develop hives after having intercourse with a man who has been taking the drug. This phenomenon occurs because penicillin levels in semen can be as high as those in the blood, causing the allergic reaction. The systematic use of other antibiotics, such as tetracycline, in cattle feed also can cause hives.
Sulfa drugs (sulfonamides) are notorious for causing hives. If you are allergic to sulfa (not sulfur), you should know that many common compounds contain sulfa. Saccharin and the “thiazide” diuretics – Lasix, hydrochlorothiazide, Prinizide and others – as well as the antibacterial drugs - Bactrim and Septra - can cause hives in those sensitive to sulfa. In addition, many vaginal creams, eyedrops (Ocusulf, Trusoft), acne medications (Sufacet-R, Novacet, Klaron Lotion, Plexion Cleanser), burn preparations such as Silvadine, cyclamates (Sucaryl, Sweeta, etc.), and most anti-diabetic drugs, such as Diabinese, Orinase and Glucotrol, all contain sulfa!
Other classes of medication that commonly cause hives are antibiotics, sedatives, tranquilizers, vitamins, laxatives, and dozens more.
Another common cause is aspirin. When you realize that Americans consume more than 25 million pounds of aspirin each year, it’s little wonder that we see so many reactions from it.
Related to aspirin are other hive-producing chemicals known as salicylates. Salicylates appear in such products as root beer, wintergreen and mint flavorings, commercial bakery products, and mixes. Certain food dyes and preservatives (such as sodium benzoate), insulin, and various vaccines to protect against measles and polio may also be common offenders. So is menthol, found in such diverse products as cigarettes, toothpastes, candies, jellies, Noxzema, room deodorants, lozenges, and shaving creams.
Some people get hives from inhaling substances such as animal dander (from cats, dogs, or horses), house dust, pollen, molds, certain plants, and flour in bakeries. Others break out in hives when they touch something cold or when they touch something hot and still others when they are exposed to sunlight. Some even get hives when pressure is applied to their skin, as in the shower.
There are certain types of hives that are of psychogenic origin. Fear, anger, and stress are the primary psychological factors responsible.
Underlying infections of the teeth, sinuses, gastrointestinal, respiratory, and genitourinary tracts all can cause hives. Hives is also associated with untreated athlete’s foot and viral diseases such as hepatitis and infectious mononucleosis.
The treatment of hives consists of identifying and eliminating the cause of the condition. You – the patient – must be the detective. What food did you eat? What medication did you take? Anything new? Anything different? Have you been in some strange place? What different inhalants or sprays have you been exposed to lately? Are you painting around the house? Have you mown the lawn? Any recent emotional tensions?
See your doctor if your hives are persistent, recurring, or severe. It is important that you provide as much information as you can to your physician. Only a physician can unearth the origin and nature of your hives, and only a physician can eradicate them. You may need a thorough physical examination, blood tests, X-rays, allergy testing, and other laboratory analyses to rule out any internal infection such as hepatitis.
For acute, temporary hives, over-the-counter antihistamines, such as Benadryl, taken orally usually relieve the symptoms promptly – at least until your next exposure to the culprit. If these don’t work – or if they make you drowsy – prescription medications, such as Allegra, Claritin, or Zyrtec, might do the job. If the hives are severe and acute, see your doctor with all deliberate speed. He or she may have to give you an injection of adrenaline or a cortisone-like drug.
Finding the cause of chronic, recurrent hives is often a difficult, frustrating, and lengthy process, and requires patience and extensive detective work. Only when you are able to discover the cause, can you prevent your hives from recurring.
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For more information on hives, log on to: www.aad.org 1-888-462-DERM x22 |
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| TREATING HIVES |
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Until you've identified and eliminated the culprit that's causing your hives, you can try to ease its annoying symptoms.
To soothe the itching of generalized hives, take lukewarm baths in either of the following bath oils:
Aveeno Bath
Directions for use are on the labels.
Apply any of the following anti-itch preparations every 3 or 4 hours:
Cort-Aid Cream
Sarna Lotion
Directions for use are on the labels.
If you need extra relief from itching, try either of the following antihistamines:
Benadryl (25 mg)
Chlor-Trimeton
Directions for use and cautions are on the labels.
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