Urticaria (Hives): When the Skin Talks in Red Whispers

It comes out of nowhere—a red, raised rash that itches like crazy. Maybe it disappears in hours, maybe it lingers. You try to pinpoint a cause, but the mystery continues. This is the world of urticaria, commonly known as hives.

At SkinWise Clinic, we know how frustrating, unpredictable, and disruptive hives can be—and we’re here to help your skin find peace again.

What Is Urticaria?

Urticaria is a skin condition marked by sudden, itchy, raised welts or bumps—called wheals—that appear and fade within hours. These welts can vary in size and location and are usually red or skin-colored.

Sometimes hives are a one-time event. Sometimes, they return daily. That’s when they need deeper attention.

What Does It Look Like?

  • Raised, red or pale welts (can look like mosquito bites)

  • Itching or burning sensation

  • Can appear anywhere: face, arms, legs, trunk—even lips or eyelids

  • Lesions often change shape, size, and position rapidly

  • Each bump usually lasts less than 24 hours but new ones may appear

Types of Urticaria

⏱ Acute Urticaria

  • Lasts less than 6 weeks

  • Often due to infections, medications, or food triggers

📆 Chronic Urticaria

  • Persists beyond 6 weeks

  • May have no clear cause (called chronic spontaneous urticaria)

  • Triggered by pressure, cold, heat, exercise, or stress (chronic inducible urticaria)

⚠️ Angioedema

  • Swelling of deeper layers, often in lips, eyelids, or throat

  • Can occur with or without hives

  • Needs urgent care if breathing is affected

What Causes Urticaria?

It occurs when mast cells in the skin release histamine, causing swelling and itch. Triggers can include:

  • Certain foods (nuts, seafood, eggs)

  • Medications (NSAIDs, antibiotics)

  • Infections (viral, bacterial, parasitic)

  • Insect bites or stings

  • Pressure, temperature change, sun exposure

  • Stress

  • Autoimmune causes (especially in chronic urticaria)

Is It Dangerous?

Most hives are not life-threatening, but angioedema or anaphylaxis (severe allergy) can be medical emergencies.

Even when not dangerous, chronic urticaria can affect sleep, concentration, and quality of life—which is why proper diagnosis and care are crucial.

Treatment at SkinWise Clinic

We treat hives with a layered approach, focusing on control, comfort, and clarity:

✅ First-Line Relief

  • Non-sedating antihistamines (cetirizine, fexofenadine, loratadine)

  • Doubling or tripling dose in chronic cases (under supervision)

🧴 Topical Comfort

  • Soothing moisturisers or calamine lotions (for mild episodes)

💊 Second-Line Options

  • Montelukast (for added control)

  • Short-term steroids (for severe flares)

💉 Advanced Therapy

  • Omalizumab (anti-IgE biologic) for chronic, treatment-resistant urticaria

🧪 Investigations (if needed)

  • Autoimmune screening

  • Allergy testing

  • Thyroid or infection panels in persistent or atypical cases

Living with Urticaria

  • Avoid known triggers if identified

  • Wear loose, breathable clothing

  • Keep a symptom diary

  • Don’t self-medicate with frequent steroids

  • Seek medical help early—especially if swelling affects breathing or the tongue

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Alopecia Areata: When Hair Loss Becomes a Whisper from Within