Saturday, July 07, 2012

Hives


Hives (medically known as urticaria) appear on the skin as wheals which are red, very itchy, smoothly elevated areas of skin often with a blanched center. They appear in varying shapes and sizes, from a few millimeters to several inches in diameter anywhere on the body.

It is estimated that 20% of all people will develop urticaria at some point in their lives. Hives are more common in women than in men

causes:
Hives are produced when histamine and other compounds are released from cells called mast cells, which are normally found in the skin. Histamine causes fluid to leak from the local blood vessels, leading to swelling in the skin.
Some hives are caused by allergies to such things as foods, medications, and insect stings, but in the majority of cases, no specific cause for them is ever found.

What is the treatment for hives?

The goal of treating most cases of ordinary urticaria is to relieve symptoms while the condition goes away by itself. The most commonly used oral treatments are antihistamines, which help oppose the effects of the histamine leaked by mast cells. The main side effect of antihistamines is drowsiness. Many antihistamines are available without prescription, such as diphenhydramine (Benadryl), taken in doses of 25 milligrams and chlorpheniramine (Chlor- Trimeton), taken in a dose of 4 milligrams. These can be taken up to three times a day, but because these medications can cause drowsiness, they are often taken at bedtime. Those who take them should be especially careful and be sure they are fully alert before driving or participating in other activities requiring mental concentration.
cetirizine (Zyrtec, 10 milligrams), which is mildly sedating. Antihistamines that require a prescription include cyproheptadine (Periactin), which tends to cause drowsiness. Prescription antihistamines that cause little sedaton are fexofenadine (Allegra) and levocetirizine (Xyzal). Sometimes physicians combine these with other types of antihistamines called H2 blockers, such as ranitidine (Zantac) and cimetidine (Tagamet). This antihistamine list is not exhaustive. Physicians individualize treatment plans to suit specific patients and modify them depending on the clinical response. Oral steroids (prednisone, [Medrol]) can help severe cases of hives in the short term, but their usefulness is limited by the fact that many cases of hives last too long for steroid use to be continued safely. Other treatments have been used for urticaria as well, including montelukast (Singulair), ultraviolet radiation, antifungal antibiotics, agents that suppress the immune system, and tricyclic antidepressants (amitriptyline [Elavil, Endep], nortriptyline [Pamelor, Aventyl], doxepin [Sinequan, Adapin]). Evidence to support the benefit of such treatments is sparse. In ordinary cases, they are rarely needed. Topical therapies for hives are available but are generally ineffective. They include creams and lotions which help numb nerve endings and reduce itching. Some ingredients which can accomplish this are camphor, menthol, diphenhydramine , and pramoxine. Many of these topical preparations require no prescription. Cortisone- containing creams (steroids), even strong ones requiring a prescription, are not very helpful in controlling the itch of hives.

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