Hives
Hives
Unless you’re a bee, you want to avoid hives. Unfortunately, evasion is nearly impossible because hives tend to erupt for no apparent reason.
These red, intensely itchy bumps, which may also burn or sting, crop up by themselves or in clusters and afflict 10 to 20 percent of the population at least once in a lifetime. Usually, hives go away within a few days to a few weeks, but occasionally, a person will continue to have hives for many years.
Hives form when a trigger—often something you’re allergic to, but not always—sends a flood of immune substances known as mast cells coursing through your blood vessels, squirting an inflammatory substance called histamine into your cells. Histamine makes blood vessels leak fluid, forming the red, itchy bump that you see and feel as a hive.
Medications are the number one cause of hives, says Jonathan Weiss, M.D., dermatologist and assistant clinical professor of dermatology at Emory University School of Medicine in Atlanta. Anti-inflammatory agents like aspirin, ibuprofen, and naprosyn (Aleve)—the sort of over-the-counter drugs commonly taken for muscle strains and headaches—are leading triggers, says Dr. Weiss. In the prescription drug category, antibiotics are another class of medications that can trigger hives.
According to the American Academy of Allergy, Asthma, and Immunology, food is often a trigger. Even exercise or a hot shower can bring on a case of hives.
Unless they cause you to have trouble breathing, form around your eyes, are in or on your mouth, remain for more than 24 hours, or leave bruises, hives aren’t serious, but they surely are annoying. Here’s how you can avoid getting stung by your hives in the future.
Try This First
Alleviate with an antihistamine. An over-the-counter antihistamine, like di phenhydramine (Benadryl), can reduce the itch and inflammation of hives and keep them from getting worse, says Dr. Weiss. If this method does not control symptoms, a visit to your der matologist or primary-care physician is necessary.
Dr. Weiss recommends 25 milligrams of Ben adryl up to four times per day. Since Ben adryl tends to make you sleepy, he suggests taking a dose at bedtime so you can get the medication’s full therapeutic effects without daytime drowsiness.
Other Wise Ways
Keep cool. Heat of any kind makes hives worse. So until your hives subside, you’ll be more comfortable if you keep as cool as possible, says Helen Hollingsworth, M.D., associate professor of medicine at Boston University School of Medicine and director of allergy and asthma services at Boston University Medical Center Hospital.
Chill the area. If you get hives from cold weather or cold water, you’ll want to skip this next tip. But for most people with hives, ice and cold compresses are about the best things you can put on your hives, says Paul Greenberger, M.D., professor of medicine in the division of allergy and immunology at Northwestern University Medical School in Chicago.
Track the cause. The best long-term treatment for hives is to find and remove the cause of these annoying, itchy bumps, says Dr. Greenberger. But this isn’t always an easy task.
Because so many different things can trigger hives, Dr. Greenberger suggests compiling a list of every medication and food item you swallowed in the four hours before an outbreak. Jot down any temperature extremes and anything that may have put physical pressure on your body (like a tight waistband), and note whether or not you exercised.
Rule it out. Once you think you’ve spotted a cause, try to eliminate it. If you’re not sure what caused your hives, you should see a doctor, recommends Dr. Greenberger. If you think a type of food is the culprit, stop eating it and see if the hives clear. Herbs and food additives may also bring on hives, so unless you’re sure you won’t have a reaction to them, make sure that they are on your suspect list. Once you’ve pinpointed the offending food, you should refrain from eating even a small portion, he says. A tiny amount can cause a flare-up. If the hives started just after you took a new medication, talk to your doctor about a substitute. You may be able to determine the cause this way and put an end to the misery, says Dr. Greenberger.
Watch your diet. Be cautious about eating tomato sauce, citrus, strawberries, and shellfish while you have hives, advises Dr. Hollingsworth. No one knows why, but these foods frequently aggravate hives.
| Managing Your Meds If you’re allergic to it, almost any prescription or over-the-counter medication can trigger hives, says Jonathan Weiss, M.D., dermatologist and assistant clinical professor of dermatology at Emory University School of Medicine in Atlanta. If an outbreak occurs, cast a suspicious eye on any new drugs that you’ve just started taking. Although any drug can potentially cause hives, Dr. Weiss lists the following medications as likely triggers. • Antibiotics such as erythromycin (Erycette) • Oral products for ear infections such as amoxicillin (Amoxil) • Sedatives such as benzodiazepines (Alprazolam) • Tranquilizers such as flurazepam (Dalmane) • Antihypertensives such as ACE inhibitors (Accupril) • Diuretics such as bumetanide (Bumex) Nonprescription items can also be potential causes of hives, including these triggers. • Pain medications such as salicylates (Anacin) • Vitamins • Eyedrops such as tetrahydrozoline (Visine) • Laxatives such as phenolphthalein (Medilax) • Vaginal douches (Massengill) If you have an attack of hives, it’s important to tell your doctor about all of the preparations that you use. The more he knows, the faster he’ll be able to find the cause, says Dr. Weiss. |
Cow’s milk, eggs, fish, shellfish, peanuts, soy protein, legumes, wheat, and tree nuts such as walnuts and hazelnuts can worsen hives, too, says Dr. Greenberger.
Wear loose clothes. Pressure generated by tight shoes and tight clothes are known to cause hives, and that pressure may aggravate and worsen a case of hives that has already started. So be particularly careful to wear loose clothing and properly fitted shoes when you have hives, warns Dr. Hollingsworth.
Moisturize your skin. Dry skin tends to cause itching, which can irritate hives and make them worse. If your skin tends to be dry, apply a moisturizer to the area around the hives, says Dr. Hollingsworth.
