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HIVES Or Urticaria


Urticaria, also known as hives, is an outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly - either as a result of the body's reaction to certain allergens, or for unknown reasons. 

When an allergic reaction occurs, the body releases a protein called histamine. When histamine is released, the tiny blood vessels known as capillaries leak fluid. The fluid accumulates in the skin and causes a rash.Hives are a red, raised, itchy skin rash that is sometimes triggered by an allergen. An allergen is something that produces an allergic reaction.It is also known as urticaria, welts, weals, or nettle rash.

Hives (urticaria) are red, itchy welts that result from a skin reaction. The welts vary in size and appear and fade repeatedly as the reaction runs its course.The condition is considered chronic hives if the welts appear for more than six weeks and recur frequently over months or years. Often, the cause of chronic hives is not clear.Chronic hives can be very uncomfortable and interfere with sleep and daily activities.


Signs and symptoms of chronic hives include :

  • Batches of red or skin-colored welts (wheals), which can appear anywhere on the body
  • Welts that vary in size, change shape, and appear and fade repeatedly as the reaction runs its course
  • Itching, which may be severe
  • Painful swelling (angioedema) of the lips, eyelids and inside the throat
  • A tendency for signs and symptoms to flare with triggers such as heat, exercise and stress
  • A tendency for signs and symptoms to persist for more than six weeks and to recur frequently and unpredictably, sometimes for months or years
  • Short-term (acute) hives appear suddenly and clear up within a few weeks.


  1. Acute urticaria and/or angioedema :

    Hives or swelling lasting less than six weeks. The most common causes are foods, medicines, latex, or infections. Insect bites and internal disease may also be responsible. The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame. Medicines that can cause hives and angioedema include aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs, such as ibuprofen), high blood pressure medications (ACE inhibitors), or painkillers such as codeine.

  2. Chronic urticaria and/or angioedema :

    Hives or swelling lasting more than six weeks. The cause of this type of hives is usually more difficult to identify than those causing acute urticaria and/or angioedema. The causes can be similar to those of acute urticaria but can also include autoimmunity, chronic infections, hormonal disorders, and malignancy.

  3. Physical urticarial :

    Hives caused by direct physical stimulation of the skin — for example, cold, heat, sun exposure, vibration, pressure, sweating, and exercise. The hives usually occur right where the skin was stimulated and rarely appear anywhere else. Most of the hives appear within one hour after exposure.

  4. Dermatographism :

    Hives that form after firmly stroking or scratching the skin. These hives can also occur along with other forms of urticaria.

  5. Hereditary angioedema :

    This is painful swelling of tissue. It is passed on through families.


Urticaria occurs when the body reacts to an allergen and releases histamine and other chemicals from under the surface of the skin.

The histamine and chemicals cause inflammation and fluid to accumulate under the skin, causing wheals. 

The welts that come with hives arise when certain cells release histamine and other chemicals into your bloodstream.

Examples of known triggers include :

  • medications, including some antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ACE inhibitors, used for high blood pressure
  • foods, such nuts, shellfish, food additives, eggs, strawberries, and wheat products
  • infections, including influenza, the common cold, glandular fever, and hepatitis B
  • bacterial infections, including urinary tract infections and strep throat
  • Intestinal parasites
  • Extreme temperatures or changes in temperature
  • High body temperature
  • Pet dander from dogs, cats, horses, and so on
  • Dust mites
  • Cockroaches and cockroach waste
  • Latex
  • Pollen
  • Some plants, including nettles, poison ivy, and poison oak
  • Insect bites and stings
  • Some chemicals
  • Chronic illness, such as thyroid disease or lupus
  • Sunlight exposure
  • Water on the skin
  • Scratching
  • Exercise
  • In over half of all cases, people never find the exact cause.
  • Chronic urticaria may start as an autoimmune response, but why it happens is unclear.


Doctor will do a physical exam and ask a number of questions to try to understand what might be causing signs and symptoms. He or she may also ask to keep a diary to keep track of :

  • Their activities
  • Any medications, herbal remedies or supplements they take
  • What they eat and drink
  • Where hives appear and how long it takes a welt to fade
  • Whether there hives come with painful swelling

If there physical exam and medical history suggest there hives are caused by an underlying problem, there doctor may have undergo testing, such as blood tests or skin tests.



    The characteristic of urticaria is the stinging & itching as if from bee stings. The itching is always worse at night. The urticaria may consist of isolated elevations which are quite painful & tender to touch; these later become purple or livid. There is slight fever & heat of skin, accompanying urticaria. There is burning pain. Thirstless is another striking feature.

    Generalized anasarca as a strong concomitant to the urticaria. Change of weather, warmth, & exercise cause troublesome itching & burning urticaria. The urticaria is worse during both chill as well as fever. The urticaria sometimes accompanies asthmatic troubles.

    Adapted to the strumous constitution; glands enlarged, indurated; scirrhous or open cancer. Women, especially widows; children and girls who, though generally careful, become awkward, and let things fall while handling them.


    Arsenic causes urticaria with burning and restlessness. It is also useful for persistence of complaints during recession of the urticaria. The urticaria may occur after eating shellfish. Urticaria gets worse at the sea-shore and due to sea bathing.

    Great Prostration, with rapid sinking of the vital forces; fainting. The disposition is:

    1. Depression, melancholy, despairing, indifferent.
    2. Anxious, fearful, restless, full of anguish.
    3. Irritable, sensitive, peevish, easily vexed.

    The greater the suffering the greater the anguish, restlessness and fear of death. Mentally restless, but physically too weak to move. Indicated by its periodicity and time aggravation: after mid-night, and from 1-2 a.m. And by its intense restlessness, mental and physical: its anxiety and prostration.


    The urticaria of bovista covers nearly the whole body. There is burning, itching of a type which is not relieved by scratching and comes on more at night. Urticaria which is caused by tar: the itching is worse on getting warm. Urticaria with a disposition to diarrhea. Each stool is followed by tenesmus. The other concomitant symptoms of urticaria are scorbutic gums. Inflammation of the eyes, metrorrhagia and various mental symptoms.

    Persons who suffer from tettery eruptions, dry or moist. Adapted to old maids with palpitation. Stammering children. Discharge from nose and all mucous membranes very tough, stringy, tenacious. Usually deep impression on finger, from using blunt instruments, scissors, knife, etc. Intolerance of tight clothing around the waist. Sweat in axilla, smells like onions.


    Hives come on at night, especially when the nights are cool, with heavy dew, after a hot day or when weather changes from warm to cool and damp; urticaria with violent cough and oedema of glands; feverish urticaria, obliging one to scratch and burning after scratching, every eruption being preceded by sensation of pricking over whole body; eruption of white, irregular blotches raised upon the skin, surrounded with red areola, appearing in warmth, and disappearing in cold and extremities, face, chest and back, violently itching and burning after scratching, headache, want of appetite; nausea, bitter taste, vomiting, intense aching in pit of stomach and praecordial region, restlessness and sleeplessness, night-sweats turbid, dark urine, diarrhea, pains in limbs. Urticaria from gastric disorders.

    Aggravation of sufferings, chiefly in the evening or at night, an during repose, better by movement. Pains with coldness of the body.

  5. NAT. MUR.

    The skin of nat-mur is characteristically dirty, unhealthy and greasy, with a yellowish colour. There is great rawness and soreness of the skin, beginning at the feet and gradually ascending. Urticaria around joints with great itching, especially above the ankles. Eruptions itch, smart and burn after exposure to cold damp air, near the seashore and in intermitent fever. Itching is particularly worse from physical exercise. Urticaria may even be over the whole body with large red intensely itching blotches.

    For the anaemic and cachectic, whether from lots of vital fluids- profuse menses, seminal losses- or mental affections. Great emaciation; losing flesh while living well. Throat and neck of children emaciate rapidly during summer complaint. Great liability to take cold. Irritability: child cross when spoken to; crying from slightest cause; gets into a passion about trifles, especially when consoled with. Awkward , hasty, drops things from nervous weakness. Marked disposition to weep; sad weeping mood, without cause, but consolation from others <. her troubles.


    Hives of gastric or uterine origin. Urticaria from pastries or pork or delayed menses. Urticaria with diarrhea, itching is worse night. Patient is chilly all the time, even in a warm room.

    Adapted to persons of indecisive, slow, phlegmatic temperament; sandy hair, blue eyes, pale face, easily moved to laughter or tears; affectionate, mild, gentle, timid, yielding disposition- the woman’s remedy. Weeps easily: almost impossible to detail her ailments without weeping.


    Vesicular urticaria from getting wet, during rheumatism, with chills and fever, worse in cold air. Patient has itching all over; worse on hairy parts with burning after scratching.

    Adapted to persons of rheumatic diathesis; bad effects of getting wet, especially after being over-heated.

  8. SEPIA

    Chronic urticaria with burning, stitching and itching which gets worse on exposure to open air. The urticaria first appears on face, neck and forearms and then gradually spreads over the whole body. The attacks are preceded by nausea and pressing headache with face swollen as in erysipelas. Urticaria on upper body breaks out in cold air and disappears in a warm room. Eruption in the form of wheals as if due to blows with a whip or rod.

    Adapted to persons of dark hair, rigid fibre, but mild and easy decomposition.


    The urticaria of sulphur is found on the face, arms, on back of hands, neck and lower extremities. Urticaria with fever. Itching urticaria over the whole body, hands and feet. Eruptions alternate with other complaints. There is voluptuous itching which is worse at night, worse when in bed and worse after scratching and washing. Scratching is followed by burning.

    Adapted to persons of a scrofulous diathesis, subject to venous congestion; especially of portal system. Persons of nervous temperament, quick motioned, quick tempered, plethoric, skin excessively sensitive to atmospheric changes. For lean, stoop-shouldered persons who walk and sit stooping like old men. Standing is the worst position for sulphur patients; they cannot stand; every standing position is uncomfortable. Dirty, filthy people, prone to skin affections. Aversion to being washed; always after a bath.


    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 disappears as soon as she lies down and reappear immediately after rising. There is oedema of the face, chest and limbs without inflammation. Urticaria affects patient every year in the same season. Site of urticaria is face, arms, shoulders, scalp. Vomitting and diarrhea from suppression of urticaria.