Hives Treatment in Manassas, McLean and Washington, DC
In the Washington, DC area, every year, thousands of people of all ages consult their physicians and hundreds of people report to emergency rooms and urgent care centers, seeking treatment for hives.
What are hives?
Hives (medically known as urticaria) are itchy, red skin eruptions of various shapes and sizes over different parts of the body. They are slightly raised above the surface of the skin and blanch with pressure, though they can sometimes be flush with the skin. Their borders can either be sharply demarcated or they can blend with the surrounding normal skin. They are usually described as blotches or welts.
Individual lesions usually subside in less than 24 hours, though one can have multiple crops of lesions in a day. The frequency of the eruptions can range from daily to several times a month. If the whole episode resolves itself in less than 6 weeks, it is called “acute urticaria” and if it lasts longer than 6 weeks, it is labeled as “chronic urticaria.” It should be noted that hives are fairly common as they affect about 20% to 25% of the population.
What causes hives?
In some instances, the cause of hives is straight forward and obvious. For example, if hives begin within a few minutes or hours of taking a new medication or eating a new food, it is usually, but not always, a result of an allergic sensitivity to that drug or food. However, in a vast majority (over 80%) of instances of chronic hives, the cause is not immediately evident.
A variety of conditions like infections (viral, bacterial, fungal, or parasitic), autoimmune disorders (where the immune system fights our own tissues and organs instead of defending us against outside invaders), and rarely even cancers can play a role in causing hives. If the lesions persist longer than 24 hours and/or they leave residual marks on the skin, it may signify inflammation of the small blood vessels.
Is it dangerous?
Severe hives can result in misery due to intractable itching and disfigurement leading to sleeplessness, impaired school performance in children, and difficulty in focusing on work in adults. Sometimes the hives are also associated with swelling episodes of soft tissues like the eyelids, lips, and tongue. If the swellings involve the throat, it can lead to difficulty in swallowing and breathing, requiring emergency intervention. The swelling is medically known as “angioedema.”
Are any tests needed?
Physicians specializing in Allergy and Immunology receive special training in the diagnosis and management of hives and tissue swellings. The evaluation involves taking a thorough history, a detailed physical examination, and focused laboratory tests in an attempt to identify the possible causes. Allergy skin testing may be helpful in some cases. In many instances, the cause can remain a mystery even after all the tests are completed, however, this does not mean that we cannot help control or eliminate your hives.
What hives treatments are available?
Histamine is the predominant chemical substance that is involved in the causation of hives. The majority of cases of hives respond to some combination of medications that block the action of histamine on the skin. In persistent cases, in spite of antihistamines, medications that control inflammation may be needed. Some patients also require higher than normal doses of these medications to obtain adequate relief. For resistant cases, the FDA recently approved a monthly injection of a medication called Xolair (omalizumab) which was previously used only to treat allergic asthma. Xolair reduces the concentration of the IgE antibody which has been found to decrease the frequency and severity of hives.
Black and Kletz Allergy’s board certified allergists have expertise in the diagnosis and management of difficult to treat hives. Over the past several years, thousands of patients in northern Virginia, Washington, DC, and Maryland have come to us and have experienced effective relief from this very annoying and frustrating malady.