Urticaria is a common skin condition. It is also known as hives. Acute urticaria usually lasts from a few days up to six weeks. Chronic urticaria, by definition, lasts for more than six weeks. Urticaria normally appears without obvious triggers (“spontaneous urticaria”). Some patients may observe a physical stimulus to their symptoms (“inducible urticaria”). Spontaneous and inducible urticaria may appear in the same patients. A third form of urticaria, urticarial vasculitis, is uncommon and related to inflammation of blood vessels.
What happens to the skin in urticaria?
The redness and swelling are due to changes in the small blood vessels of the skin. This leads to increased blood flow to the affected skin, and excessive fluid moves into the surrounding tissues. Histamine is the predominant chemical causing these changes and it causes the sensation of itch. Histamine is released by the mast cell, a special type of immune cell in the skin. Mast cells release histamine when stimulated.
Warts are contagious, and may spread from one part of the body to another or to other people. We do not know why some people get warts while others do not. There is no way to prevent coming into contact with the virus that causes warts.
Warts may disappear on their own and no treatment may be needed, especially in young children. This spontaneous healing is less common in older children and adults. Warts on the genitalia are usually sexually acquired.
Warts have a rough surface on which tiny, dark dots can often be seen. On pressure areas like the palms or the soles, they appear flat. Warts on the sole (called plantar warts) grow inward from the pressure of standing and walking and are often painful.
Treatment of urticaria
General measures include avoidance of known physical triggers, certain medications, alcohol, overtiredness, stress, maintenance of a cool environment, and light clothing.
Oral antihistamines are the main treatment for urticaria. They relieve itch and suppress hives. They do not affect the underlying cause of the rash. Antihistamines may need to be taken intermittently or continuously until the urticarial disappears. It is recommended that they be taken on a regular basis if frequent hives are experienced because regular dosing is more effective. The main side effect of anti-histamines is drowsiness. Non-sedating anti-histamines are available and these are frequently prescribed, especially during the day.
If patients do not respond to antihistamines, additional medications such as cyclosporin and omalizumab may be recommended by the doctor.
A short course of oral steroids may sometimes be prescribed in severe cases.
