What is Urticaria?

Itchy, swollen and red rashes that appear suddenly on the skin are one of the most common skin problems in society. The medical name of this condition, popularly known as urticaria, is urticaria. Urticaria, which can be seen in all age groups, from children to elderly individuals, often resolves spontaneously in a short time, but in some people it may recur over weeks, months or even years.

Urticaria is a reaction that develops as a result of the release of histamine and similar chemicals from mast cells in the skin. As a result of this reaction, itching, redness and blisters occur on the skin. Although many people associate urticaria only with allergies, infections, medications, physical stimuli, stress and some chronic diseases can also cause this condition.

Although urticaria does not pose a serious health problem in most cases, frequent recurrent attacks or situations accompanied by symptoms such as shortness of breath and swelling of the lips should be evaluated by a healthcare professional.

In brief

Urticaria (hives) is a skin disease characterized by itchy, swollen and red rashes that develop suddenly on the skin. It usually develops due to histamine release and can be triggered by many different factors such as allergies, infections, medications, physical stimuli or stress. With appropriate diagnosis and treatment, symptoms can be successfully controlled in most patients.

How Does Urticaria Occur?

The basis of urticaria is the biological process created by the immune system and mast cells in the skin. Mast cells normally help protect the body against infections and foreign substances. However, in some cases, it is stimulated too much and secretes various chemicals, especially histamine.

As a result of histamine release:

• Small vessels in the skin expand.
• Vascular permeability increases.
• Fluid leaks under the skin.
• Itching sensation occurs.
• Hives-like bumps occur.

Therefore, urticarial rashes can usually develop within a few minutes and disappear just as quickly. A rash that disappears in one area may reappear in another area of the body after a short time.

What are the symptoms of urticaria?

Urticaria symptoms may vary from person to person. While some people experience only mild itching, some patients may develop rashes affecting large areas of skin.

The most common symptoms are:

• Intense itching
• Red or skin-colored raised plaques
• Hives-like rash
• Displaceable bulges
• Redness that fades with pressure
• Burning or stinging sensation
• Rashes that can appear in any part of the body

One of the most important features of urticarial rashes is that a single lesion usually disappears without leaving a trace within 24 hours. However, new rashes may develop in different parts of the body during this period.

In some patients, urticaria may also be accompanied by swelling of deeper tissues called angioedema. Swelling on the lips, eyelids, tongue, or throat requires immediate medical evaluation as it may make breathing difficult.

What are the Types of Urticaria?

Urticaria is divided into two main groups according to its duration.

Acute Urticaria

The condition in which symptoms last less than 6 weeks is called acute urticaria. It is the most common type of urticaria and is often associated with infections, medications or foods. In most patients, it recovers completely with appropriate treatment.

Chronic Urticaria

Symptoms persisting for more than 6 weeks are defined as chronic urticaria. Attacks may recur over weeks or months. The exact cause may not be determined in a significant portion of chronic urticaria. In some cases, autoimmune diseases, chronic infections, or physical triggers may play a role.

What is the Difference Between Urticaria and Angioedema?

While urticaria affects the superficial layers of the skin, angioedema is characterized by swelling that develops in deeper tissues.

Angioedema is the most common:

• On the lips
• On the eyelids
• In Language
• On the cheeks
• On hands and feet

is seen.

Angioedema developing in the throat area may require urgent intervention as it may make breathing difficult.

What Causes Urticaria?

Urticaria is a skin disease that does not develop due to a single cause and many different triggers may play a role. While a clear cause can be identified in some people, the exact trigger may not be determined, especially in a significant portion of chronic urticaria cases. Therefore, detailed patient history is of great importance in the evaluation of urticaria.

The most common causes are:

1. Allergic Reactions

Some foods, medications or insect stings can stimulate the immune system and cause the release of histamine. In particular, the following situations may trigger acute urticaria:

• Shellfish
• Peanuts and some nuts
• Egg
• Milk
• Some antibiotics
• Painkillers (especially NSAID group)
• Bee and insect stings

However, not every urticaria attack is due to allergies. For this reason, allergic urticaria cannot be diagnosed just by looking at the symptoms.

2. Infections

One of the most common causes of acute urticaria in children is viral infections. Flu, upper respiratory tract infections and some bacterial infections can activate the immune system and cause temporary urticaria.

Some chronic infections may also be associated with prolonged urticaria attacks. Therefore, it is important to investigate underlying infections in patients deemed necessary.

3. Physical Triggers

In some people, urticaria may develop due to environmental physical stimuli.

These include:

• Hot air
• Cold weather
• Sunlight
• Pressure
• Exercise
• Sweating
• Water theme
• Vibration

may take place.

For example, cholinergic urticaria that occurs in hot weather or cold urticaria that develops after contact with cold water are evaluated in the physical urticaria group.

4. Stress

Although intense stress, anxiety and emotional load do not directly cause urticaria, they can contribute to the exacerbation of existing symptoms.

It is known that attacks are more common, especially in people with chronic urticaria, due to the effects of stress hormones on the immune system.

Therefore, not only medication but also stress management is an important part of the treatment plan.

5. Autoimmune Diseases

In some patients with chronic urticaria, the immune system may develop a reaction against its own cells.

It can be seen especially with the following diseases:

• Hashimoto thyroiditis
• Graves disease
• Celiac disease
• Rheumatoid arthritis
• Systemic lupus erythematosus

For this reason, in cases of long-lasting urticaria, the doctor may request additional tests when deemed necessary.

In Whom Is It More Common?

Although urticaria can be seen in all age groups, it is more likely to be seen in some people.

People in the risk group are:

• People with allergic diseases
• Individuals with asthma
• People with allergic rhinitis
• Those with atopic dermatitis
• Women
• Young adults
• People with autoimmune diseases
• People living under intense stress
• Individuals who use certain medications regularly

Research shows that approximately 20% of individuals in society may experience at least one urticaria attack at some point in their lives.

Is Urticaria Contagious?

No.

Urticaria is not a contagious disease.

It is not transmitted from person to person through contact, sharing the same environment or using common items.

However, some viral or bacterial infections that cause urticaria can be contagious. In such cases, the disease transmitted is infection; It is not urticaria.

How Long Does Urticaria Last?

The duration of the disease may vary depending on the underlying cause.

• Acute urticaria usually resolves within a few hours to a few weeks.
• Chronic urticaria lasts longer than six weeks and may recur for months or even years.

A single urticarial wheal often disappears within 24 hours. However, the disease may appear to continue because new rashes may form.

How is Urticaria Diagnosed?

The diagnosis of urticaria can often be made by the patient's history and dermatological examination. When the rash starts, how long it lasts, in which situations it occurs and accompanying symptoms are of great importance for diagnosis.

Your doctor may ask the following questions during the evaluation:

• When did the rash start?
• How long does each rash last?
• Have you used any new medication recently?
• Do symptoms increase after certain foods?
• Do heat, cold, exercise or stress trigger symptoms?
• Do you have a family history of urticaria or allergic disease?

Most cases of acute urticaria do not require additional testing. However, if the symptoms last longer than six weeks, recur frequently, or a different underlying disease is suspected, the doctor may request blood tests or other examinations that he deems necessary.

Important Note: Comprehensive allergy tests are not necessary for every urticaria patient. Testing should only be planned based on clinical judgment.

How to Treat Urticaria?

The main purpose of urticaria treatment is to reduce itching, control rashes and improve quality of life. Treatment plan; It is determined individually according to the duration, severity of symptoms and the underlying cause.

1. Identifying Triggers

Identifying the factors that increase symptoms is one of the most important steps of treatment.

For example;

• Some medicines
• Certain foods
• Hot or cold environments
• Intense exercise
• Alcohol
• Stress

It may cause attacks to occur more frequently.

2. Antihistamine Treatment

The first preferred drug group in the treatment of urticaria is antihistamines. These medications help control itching and rashes by reducing the effect of histamine.

Drugs should be used in accordance with the doctor's recommendation.

3. Advanced Treatment Options

In some chronic urticaria patients whose symptoms persist despite standard treatment, different treatment options may be evaluated by an allergy and immunology or dermatology specialist. Which treatment is appropriate is decided according to the clinical condition of the patient.

Things to Consider at Home

The following suggestions may be useful to support urticaria treatment and reduce the risk of new attacks:

• Take care of keeping your skin cool.
• Avoid very hot showers.
• Choose cotton and breathable clothes.
• Avoid scratching.
• Use perfumed or irritating skin products with caution.
• Try to sleep regularly and manage stress.
• Do not use medication without a doctor's advice.
• Note the situations that trigger your symptoms and share them with your doctor.

When Should You Consult a Doctor?

It is recommended that you consult a healthcare institution in the following cases:

• If the rash lasts longer than six weeks
• If attacks recur frequently
• If itching affects your daily life
• If swelling develops on the lips, tongue or eyelids
• If you experience shortness of breath or a feeling of swelling in the throat
• If you feel dizzy or faint

Symptoms such as shortness of breath, swelling of the throat, or altered consciousness require immediate evaluation.

Frequently Asked Questions

Are urticaria and allergies the same thing?

No. Allergy may be one of the causes of urticaria, but not all urticaria develops due to allergies.

Is urticaria contagious?

No. Urticaria is not transmitted from person to person.

Does urticaria go away on its own?

A significant portion of acute urticaria cases may resolve within a few days or a few weeks. Chronic urticaria may last longer and require treatment.

Can urticaria be caused by stress?

Stress may not be the direct cause but may contribute to the exacerbation of existing symptoms.

Which doctor to see for urticaria?

You can consult a dermatology or allergy and immunology specialist for the diagnosis and treatment of urticaria.

Is urticaria dangerous?

In most cases it is not serious. However, development of shortness of breath, throat swelling, or generalized angioedema requires urgent medical evaluation.

Result

Urticaria (hives) is a skin disease that is common in society and can affect the quality of life. Although it is usually short-lived, it can become chronic in some people. Not every case of urticaria is caused by allergies; Many factors such as infections, medications, physical stimuli and stress can trigger this picture.

With correct diagnosis, appropriate treatment and avoiding triggers, symptoms can be largely controlled. In cases of long-lasting or frequently recurring complaints, it is important to be evaluated by a dermatologist or allergy and immunologist.

Expert Support from e-Health

If you are experiencing symptoms of urticaria and your daily life is affected by recurrent itching or hive attacks, you can safely reach expert opinion by making an online appointment with Dermatology or Allergy and Immunology specialists via e-Health.

Scientific Resources

• EAACI – European Academy of Allergy and Clinical Immunology. Guideline for the Definition, Classification, Diagnosis and Management of Urticaria.
• World Allergy Organization (WAO). Guidelines for the Assessment and Management of Urticaria.
• Zuberbier T, Abdul Latiff AH, Abuzakouk M, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI Guideline for Urticaria.
• American Academy of Allergy, Asthma & Immunology (AAAAI). Chronic Urticaria Resources.
• UpToDate. Evaluation and management of urticaria in adults and children.

This content has been prepared by the e-Health editorial team based on current scientific sources. The content is for informational purposes only and is not a substitute for diagnosis or treatment. For your health problems, it is recommended that you consult a physician in the relevant specialty.