Urticaria (or hives) is a skin condition, commonly caused by an allergic reaction, that is characterized by raised red skin wheals (welts). It is also known as nettle rash or uredo. Wheals from urticaria can appear anywhere on the body, including the face, lips, tongue, throat, and ears. The wheals may vary in size from about 5 mm (0.2 inches) in diameter to the size of a dinner plate; they typically itch severely, sting, or burn, and often have a pale border.
Causes
Urticaria is thought to be a hypersensitivity reaction of the immunity of the body. However, the exact cause of urticaria is unknown.
Urticaria occurs in response to an allergen. In response to the allergens, a chemical released from specialized cells along the blood vessels of the skin called histamine. As a result, the process of inflammation of the affected area starts to appear along with the fluid accumulation to form wheals.
Other commonly known triggers for skin hypersensitivity or urticaria:
- Medications, including antibiotics and NSAIDs like aspirin and ACE inhibitors, commonly used for high blood pressure.
- Foods, like nuts, shellfish, eggs, strawberries, and wheat products
- Food additives
- Infections, (common cold, strep throat, glandular fever, UTI and hepatitis B)
- Intestinal parasites
- Extremes of temperatures
- High body temperature
- Drinking alcohol or caffeine
- Emotional stress
- Pet dander (dogs, cats, horses, mice)
- Dust mites
- Cockroaches and it’s waste
- Latex
- Pollen
- Some plants, (nettles, poison ivy, and poison oak)
- Insect bites and stings
- Chemicals toxins
- Chronic illness, (thyroid disease or lupus)
- Exposure to sunlight
- Scratching
- Exercise
Types of urticaria
- Acute urticaria: The symptoms last for less than 4- 6 weeks. It is the most common type that affects people. The hives can appear on any part of the body but usually, it appears on the face, neck, fingers, toes, and the genitalia.
- Chronic urticaria: The symptoms continue for 6 weeks and more.
- Physical urticaria: The symptoms of urticaria which get triggered by any direct stimulation of the skin may be due to extremes of temperature, sun exposure, vibration, pressure, sweating, and exercise. The hives appear on the skin and rarely appear anywhere else. Most of the papules appear in continuation within one hour after exposure.
- Dermatographism: It is a type of physical urticaria where papules of urticaria appear after firm scratching of the skin.
- Angioedema: It is a similar condition to urticaria, but it has an influence on the deeper layers of the skin. It is characterized by deep swelling around the affected part (eyes, lips, hands, feet, and genitals). Angioedema lasts longer than urticaria, but the swelling may subside within one day.
Symptoms
- Eruptions:Raised, irregular or round-shaped, pale pink to red-colored hives is the prominent symptom of urticaria. Sometimes, hives present with local warmth and intense burning.
- Itching: The most troublesome symptom for most of the patients is intense uncontrollable itching which makes the patient restless and impatient. At times, the eruptions and itching may lead to a disturbance at work, daily routine, and can cause sleeplessness. The size of eruptions ranges from a few millimetres to several centimetres, and they may coalesce to form giant urticaria. Hives may last from a few seconds to 24 hours or more and may reoccur intermittently on various sites on the body.
- Dermatographism: When pressed with an object or fingernail, the skin shows raised eruptions of urticaria, which may remain on the skin for some time. Drawing a line and writing a word on the skin leading to urticaria is called dermatographism.
- Angioedema: Angioedema is a reaction similar to hives that affects deeper layers of the skin. It most commonly appears around the eyes, cheeks or lips, feet, hands, or genitals, etc. Sometimes angioedema may affect the throat, windpipe, or lungs and cause difficulty in breathing. Angioedema may become life-threatening in some cases and needs immediate medical attention.
- Urticaria pigmentosa: Urticaria pigmentation is a form of urticaria as well as mastocytosis, in which you find brown, intensely itching patches on the skin. On rubbing the spots, one gets hives or urticaria rash.
Diagnosis
In the case of urticaria, a doctor can diagnose by examining the rash on the skin. The doctor will take a complete history and probably ask a few direct questions like:
- About the first occurrence of an episode
- The site where the hive first appeared
- Any related modality
- Insect bite if any
- Whether the patient lives or works in a place where potential aggravating factors may exist, like animals, latex gloves, chemicals
- If the patient is under the influence of any medications, including herbal supplements
- Any family history of urticaria
After inspecting imposed reasons, the doctor will advise the following test to form a diagnosis:
- Blood test with ESR (erythrocyte sedimentation rate): To rule out wide illness is present.
- Stool sample: To identify any parasites.
- Allergy tests: To find a specific substance or trigger such as chemicals, dust mites, or some food for the urticaria. Pinpointing the trigger can help prevent recurrences by avoiding the specific substance.
- Thyroid function test: To assess for an overactive thyroid, or, an under-active thyroid.
- Liver function tests: To test in case of any liver problems.
Homeopathic management
Homeopathy medicines for urticaria treat the condition very effectively. Homeopathy heals skin diseases effectively, following a mild and safe approach. These medicines follow a curative rather than a suppressive approach while treating urticaria. Homeopathy treats urticaria in two phases. In the first phase, the acute episode of urticaria is treated. In the second phase, these medicines treat the chronic tendency towards urticaria.
Homeopathic medicines
Apis Mellifica
Apis Mellifica is one of the top-grade medicines for treating urticaria. Apis Mellifica is best prescribed for urticaria when symptoms include marked itching and burning. A characteristic stinging pain in the urticarial eruptions is also observed. The skin is extremely sensitive to the touch. Apis Mellifica is one of the best medicines for urticaria that gets triggered in heat. Going out in the open air or cold applications bring some relief. Apis Mellifica is also a top-rated medicine for urticaria that arises following an insect bite.
Natrum Mur
For treating urticaria triggered by exercise, Natrum Mur is a great option. The person who needs Natrum Mur will get large hives on the skin from exertion. This is attended with violent itching and burning. Natrum Mur is also one of the most effective medicines for solar urticaria that arises from exposure to the sun.
Astacus Fluviatilis
Urtica Urens and Astacus Fluviatilis work wonders in treating urticaria. The choice between the two is made based on unique symptoms. Urticaria that appears every year, in the same season, is best treated with Urtica Urens. Another key symptom associated with Urtica Urens is urticaria with intense burning and formication on the skin. Urtica Urens also shows great results in urticaria that alternates with rheumatism. Apart from this, Urtica Urens is also the ideal medicine for treating urticaria from eating shellfish. Astacus Fluviatilis is well indicated where urticaria is attended with liver complaints. The person prescribed Astacus Fluviatilis will have itching over his entire body, with a marked stinging sensation on the skin.
Rhus Tox
Key symptoms that will decide in favor of medicine Rhus Tox is urticaria from cold exposure with itching and smarting sensation. Warm applications provide some relief from itching. Rubbing worsens the symptoms in this case. Rhus Tox is also well indicated for urticaria resulting from getting wet.
Sepia Succus
The characteristic symptom to look out for while prescribing Sepia Succus is urticaria from going in cool open air. Being in a warm room brings relief. Urticarial eruptions with itching, which is not relieved by scratching, is another guiding feature for use of Homeopathic medicine Sepia Succus.
Sulphur
Sulphur is selected for urticarial eruptions arising from heat exposure and attended with itching and burning. Scratching worsens the itching. In some cases, even washing may worsen the itching. Most persons prescribed Sulphur will notice a worsening of itching towards the evening. Sulphur is also the best solution for urticaria cases that have been suppressed with ointments in the past.
Bovista Lycoperdon
Some features unique to Bovista Lycoperdon are urticaria on waking in the morning time and attended with diarrhea.
Calcarea Phosphorica
Homeopathic medicine Calcarea Phosphorica is suggested where contact with cold water leads to urticarial eruptions.
Dulcamara
Homeopathic medicine Dulcamara is the best choice in case of violent itching in the urticarial eruptions. Use of Dulcamara is also suggested for urticaria arising from exposure to cold and that which gets triggered in wet weather.
Urtica urens
Itching and burning of the skin as if scorched, raised red blotches, fine stinging points; pale rash requiring constant rubbing; consequences of suppressed Urticaria. Eruption and itching disappear as soon as patient lies down and reappear immediately after rising. There is oedema of the face, chest and limbs without inflammation.
Belladonna
The person has a red-hot face, with red eruptions. Eruptions appear on the entire body with more on the inner side of limbs and less on the face. Itching aggravated in morning and evening and is better by scratching.
Arsenicum album
The Urticaria caused by eating shellfish which causes burning and itching with restlessness. Eruptions are worse at night.
Calcarea fluorica
This homeopathic medicine work wonders in treating urticaria. It is best indicated for suppuration with a callous hard edge, hard raised border of ulcers, chaps, fissures, crack and swellings.