What Is Urticaria (Hives)?

A skin condition characterised by the sudden appearance of itchy, red, swollen welts on the skin’s surface. These raised patches often vary in size, shape, and location and can last for a few hours to several days.

Symptoms

Urticaria or hives present as pink or red blotches or raised, swollen “wheals” or bumps on the skin which are very itchy. They can vary in size and may sometimes be mistaken for large mosquito bites.

These skin changes can emerge suddenly and either resolve within hours or persist for days. In some cases, hives may be accompanied by angioedema, which involves swelling beneath the skin and can affect the face (lips, eyelids), hands, or feet. Angioedema is harmless, but may become a potentially life-threatening emergency if it causes swelling in the mouth or throat or difficulty breathing.

What causes urticaria?

Urticaria occurs due to histamine release, which could be triggered by an allergic reaction to certain allergens such as medications, food, insect bites, latex etc. Non-allergic factors can also induce urticaria; such as physical pressure on the skin, stress, temperature changes or certain infections.

Diagnosis

This involves a physical examination and a thorough medical history. Your dermatologist may inquire about potential triggers, such as medications, infections, or allergens, to identify the underlying cause. In some cases, additional tests, such as blood work or allergy tests, may be recommended.

Can urticaria be cured?

The course of urticaria can be unpredictable; treatment aims to control the itch, prevent new episodes and to avoid any potential triggers (if identifiable).

Most cases of urticaria resolve within a few hours to a day spontaneously without any treatment.

As existing urticaria resolves, new ones can form in the same or other areas, and these episodes may persist for a few days to weeks.

If the urticaria resolves completely within 6 weeks, this is known as “acute urticaria”.

If a cause cannot be found and the urticaria persists for 6 weeks or more, this is known as “chronic spontaneous urticaria”.

Treatment

The symptoms of itch while the condition is active or persistent (e.g. in chronic urticaria) can be very bothersome in which case treatment is required, including:

  • Oral antihistamines: There are many different types, including non-sedating or sedating ones, and short or long-acting ones. The choice depends on each individual’s condition and treatment response.
  • Soothing creams or balms: these help to relieve the itch
  • Omalizumab: an injectable biologic medication that is used to treat chronic urticaria; often reserved for cases that are refractory to antihistamines
  • Immunosuppressants: Sometimes hives can be very challenging to treat despite all other conventional methods and may require other immune modulators such as cyclosporine.
  • Oral steroids: occasionally, these are given as rescue therapy but only for very severe, acute flares, and only given as a last resort as the risks usually outweigh the benefits.
  • Avoidance of triggers (if identifiable)

Types Of Urticaria (Hives)

Characterised by the sudden appearance of hives that usually resolve within six weeks. Common triggers include infections, insect bites, certain medications (such as antibiotics or NSAIDs), or food (like shellfish or peanuts).

Lasting longer than six weeks, chronic urticaria can significantly impact a person’s quality of life. In some cases, it’s associated with autoimmune disorders, such as lupus or thyroid disease. However, the exact cause often remains unknown.

Caused by physical stimuli on the skin, including pressure on the skin (dermographism), cold temperatures (cold urticaria), sunlight (solar urticaria). Managing physical urticaria requires identifying the specific trigger and taking measures to minimise exposure.

Associated with increased body temperature, cholinergic urticaria presents as small hives that usually appear after physical activity, exposure to heat, or emotional stress. Cooling the body, avoiding hot showers or baths, and managing stress can help mitigate symptoms.

This occurs when the skin comes into direct contact with an allergen. Potential triggers include rubber (latex), plants, cosmetics or chemicals.

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Urticaria (Hives) Risk Factors

Risk factors for developing urticaria include:

  • Personal or family history of allergies
  • History of autoimmune disorders
  • Exposure to certain medications or environmental triggers
  • Some individuals may be more genetically predisposed to developing hives.

Why Choose Us

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We are dedicated to your skin health and well-being. Our results-oriented approach is suitable for a wide range of hair, skin and nail conditions. Consult our MOH-accredited dermatologist for a personalised treatment plan.

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Billing & Insurance

Private and Corporate Insurance

You can use your Integrated Shield Plans to pay for certain procedures. Speak to us to learn more, and you’ll be surprised at how affordable private healthcare can be. 

Dr. Lee Hwee Chyen

Medical Director & Consultant Dermatologist

MBBS (S'pore) MRCP (UK) FAMS (Dermatology)


Special Interests In:
  • Paediatric Dermatology
  • Women’s Dermatology
  • Procedural Dermatology & Lasers

Dr. Lee Hwee Chyen is an accredited Adult & Paediatric dermatologist managing a wide range of skin, hair and nail conditions. The clinic provides services for medical, surgical, cosmetic, women’s and paediatric dermatology.

  • MBBS (National University of Singapore, Singapore)
  • MRCP (Royal College of Physicians, United Kingdom)
  • Specialist Accreditation Board, Dermatology (Singapore)
  • FAMS (Academy of Medicine of Singapore, Singapore)
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