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Hives

Hives also known as urticaria appears as red, itchy, raised areas of skin with varying shapes and sizes. Its symptoms include its size from a few millimeters to several inches in diameter. It may appear as round, or they can form rings or large patches. Hives occurs anywhere on the body, like trunk, arms, and legs.

Generally all hives falls in two categories that is ordinary urticaria (ordinary hives) and physical urticaria (physical hives).

Ordinary Hives: Ordinary hives comes up suddenly and usually with no specific reason. It appears anywhere on the body. Its symptoms include a flare, itchy, and swelling of the skin. Ordinary hives goes off in a matter of minutes to hours and appear elsewhere on the body. Ordinary hives remains for days to weeks. Most of the hives lasts less than six weeks while hives that last more than six weeks are often called chronic hives.
The cause of ordinary hives is idiopathic meaning no cause is known. Some are caused due to viral infections, some are caused due to medications allergy - usually when they have been taken for the first time a few weeks before.

Chronic hives (long-lasting): Chronic hives are the hives which lasts more than six weeks, it can last from months to years. It is less common than acute hives. Allergy testing and laboratory tests are hardly ever useful in chronic hives.

Physical Hives: Physical urticaria are produced due to direct physical stimulation of the skin. There are two types of phisical urticaria as: dermographia and cholinergic.

• Dermographia: This is what happens to anyone when their skin is scratched or rubbed. Its symptoms look like a raised, itchy red welts with adjacent flares. It appears on the areas where your skin is scratched or at rubbed skin due to clothing or belts, which cause mast cells to leak histamine.
• Cholinergic: Its symoptoms look like as hundreds of small wheals 2-3 mm in diameter, surrounded by a flare. It occurs within 15 minutes of physical exertion, or a hot bath or shower. It is found generally in young people. Some other forms of physical hives are there which are much less common and are due to cold, water, and sun.

Causes
Hives are caused by histamine and other compounds released from cells called mast cells of skin. Histamine causes the leakage of fluid from the local blood vessels, which leads to swelling in the skin.

Hives are also caused due to allergies to such things like foods and medications, some caused by bee stings or drug allergy, but the large majority of cases are not allergic. Although the change in diet, soap, detergent, and makeup are usually not helpful in preventing hives and for the most part are not necessary.

In some cases, urticaria and angioedema are accompanied by shock and difficulty breathing which is called anaphylaxis. Usually hives may be widespread and disturbing to look at, but in majority of cases it do not lead to life-threatening complications.

Treatment

• Treatment for hives include the oral treatment of antihistamines which help oppose the effects of the histamine leaked by mast cells, while the main side-effect of antihistamines is drowsiness. Antihistamines available without prescription are diphenhydramine (Benadryl) - 25 milligrams and chlorpheniramine (Chlor-Trimeton) - 4 milligrams. It can be taken up to three times a day, but as it cause drowsiness they are often taken at bedtime. But be careful while using it, be sure that you are fully alert before driving or participating in other activities requiring mental concentration. Another medicene include loratadine (Claritin) - 10 milligrams and is less likely to cause drowsiness.
• Antihistamines which needs prescription are hydroxyzine and cyproheptadine. Sometimes it is combined with other types of antihistamines, such as ranitidine and cimetidine.
• Topical therapies include creams and lotions which help numb nerve endings and reduce itching. Ingredients included are camphor, menthol, diphenhydramine (Benadryl), and pramoxine.
• Oral steroids like prednisone, medrol can help severe cases of hives in the short-term.