Upending Urticaria
Your skin is incredibly itchy. When you scratch your skin, you get raised welts. It only lasts for 24 hours. You could have urticaria.
Urticaria in general is characterized by itchy, sometimes weeping, red swellings (wheals or hives) of various sizes on the skin. The swelling can affect your face, lips, throat, hands, feet and genitals. It is usually a short-term allergic response or immune reaction to external chemicals. It also may be part of an abnormal immune response of the body against itself. Physical factors such as heat, cold, sunlight, injury and pressure can also cause hives on occasion.
It is estimated that 20 percent of people in the United States will develop hives at some point in their lives.
Ordinarily, the acute or short-term urticaria is often easy to pinpoint (e.g. allergy to strawberries). This form of the disease usually goes away by itself once the cause is removed.
That is easier said than done when the cause is sensitivity (but not allergy) to sunlight or cold.
Chronic urticaria, usually defined as having episodes lasting more than six weeks, is quite another matter. Half of those whose episodes of urticaria last that long will have recurrences for years.
Some people may suffer from cold urticaria, where you get those telltale hives in cold weather. Doctors perform an ice cube test against the skin to see if you will react with welts. Air conditioning, ice cold drinks, even ice cream may result in a head to toe outbreak.
Cold urticaria sufferers can have problems with New England winters, but they can limit time in the cold, cover exposed skin and be treated with medications to help the symptoms.
It’s in the hot summer when there’s more danger. If you have a bad case, and you do a cannonball into a pool or lake, you can have such a reaction that you can cause anaphylaxis.
And much like someone allergic to bee stings, without immediate medical treatment a person could die.
Cold urticaria occurs most frequently in young adults—though not exclusively—and it doesn’t seem to favor a gender.
Things like intravenous fluids or anesthetics that can cool a body’s temperature can also be dangerous.
There are certain autoimmune diseases that can cause chronic hives such as celiac disease, dermatomyositis, diabetes, lupus, polymyositis, rheumatoid arthritis, thyroid disease and vitiligo.
Other diseases that may cause urticaria are asthma; H. pylori bacterial infections and sinus infections; liver disease; lymphomas including Hodgkin’s lymphoma and non-Hodgkin's lymphoma; and vasculitis.
To diagnose urticaria, your health care provider will run tests like blood tests, allergy tests, urine tests and skin biopsy procedure.
Most physicians suggest an antihistamine like Zyrtec or Benadryl to treat the itchiness and the hives. Other treatments include allergy shots, steroids like prednisone, hydroxychloroquine and cyclosporine.
Even in the midst of an outbreak, sometimes hives can appear within 30 minutes of exposure and disappear after 24 hours.
But there may be an end in sight. Those diagnosed with urticaria may stop suffering after five or six years.
