Urticaria is a skin condition characterized by itchy, red or white blisters or nodules that can appear anywhere on the body. These symptoms are caused by the body releasing a chemical called histamine in response to various external or internal causes, including food allergies, medications, infections, physical stress, heat or cold. The symptoms of urticaria can appear suddenly and vary greatly in both appearance and duration - from a few hours to a few days, and sometimes even longer when we talk about chronic urticaria, which lasts more than six weeks, sometimes even a year or more.

How does urticaria affect daily life?

One of the most disturbing aspects of urticaria is the itching, which can range from mild to very intense, sometimes even interfering with sleep and daytime activities. Itching and characteristic skin changes can cause symptoms of discomfort, reduce the quality of life, causing psychological stress, anxiety and depression. In addition, the constant urge to scratch can damage the skin, causing inflammation, infection or scarring.

The impact of urticaria on daily life can be significant; for example, nocturnal itching can interfere with the normal sleep cycle, resulting in daytime fatigue and reduced concentration levels. This can affect work performance, learning abilities and overall social functioning. In addition, the aesthetic side of skin changes can lead to low self-esteem and social isolation, as individuals may feel ashamed of their appearance.

Urticaria treatment strategies

The treatment of urticaria is a complex process that depends on the form of the disease (episodic, chronic), the severity of the symptoms and the individual characteristics of the patient. The main goal of treatment is to reduce or eliminate symptoms such as itching, redness and swelling of the skin, and to prevent the condition from recurring. It is important to emphasize that treatment often requires an integrated approach, including both lifestyle changes and pharmacological treatment.

  • The first step in treating hives is to avoid known or suspected triggers. Patients may be advised to avoid certain foods, medications, physical factors (such as cold, heat, sun exposure), or stressful situations that may cause or exacerbate symptoms. However, since it is not always possible to determine the specific cause of urticaria, pharmacological treatment often becomes necessary.
  • Antihistamines are the first-line treatment choice and are effective in reducing itching, redness and swelling. Modern antihistamines (eg, cetirizine, loratadine, fexafenadine) have fewer side effects and are safe for long-term use. In some cases, with severe symptoms, the doctor may recommend higher than usual doses of antihistamines.
  • If antihistamines do not provide sufficient relief, treatment with corticosteroids (glucocorticoids) may be started, which are used in short-term courses to reduce inflammation and skin reactions. Although these drugs are effective, their long-term use can cause serious side effects, so it is necessary to carefully monitor the patient's condition.
  • Another treatment option is leukotriene receptor antagonists, such as montelukast, which are sometimes given together with antihistamines to increase the effectiveness of the treatment, especially in the chronic form of urticaria.
  • For patients with severe chronic urticaria unresponsive to standard treatment, newer therapies such as monoclonal antibodies (for example, omalizumab) can be used to target immune system molecules involved in the development of allergic reactions. This treatment can significantly improve quality of life in patients for whom other treatments have failed.
  • In addition to pharmacologic treatment, patient education about disease management, including prevention of exacerbations, adequate response to symptoms, and lifestyle changes that can help reduce recurrence of symptoms, play an important role. These include dietary regulation, stress management techniques, and regular health monitoring.

It is important to note that each patient's urticaria is unique and the treatment plan must be tailored to the individual based on the severity of symptoms, lifestyle and other health issues. Working with a qualified healthcare professional is essential to ensure effective and safe urticaria treatment.


Reasons

Hives is a skin reaction where one or more red bumps appear on the skin that are itchy and may look like nettle marks. This condition can be caused by a variety of factors, and its symptoms can come on suddenly and be uncomfortable or even painful. The causes of urticaria can be divided into several categories: allergens, physical factors, infections, autoimmune reactions and other unclear factors.

Allergens

Allergens are one of the most common causes of hives. These can include foods (such as nuts, eggs, seafood), medications (antibiotics, nonsteroidal anti-inflammatory drugs), insect bites or stings, and even some chemicals. Allergen-induced urticaria usually occurs soon after exposure to the allergen.

Physical factors

Physical factors can also cause hives, including changes in temperature (cold, heat), physical pressure, sweating, sunlight, and even water contact. This form is called physical urticaria and it occurs as a skin reaction to some physical irritation.

Infections

Infections, especially viral, bacterial, or fungal infections, can also trigger urticaria symptoms. Infection-induced urticaria often occurs in children and may be accompanied by other symptoms such as fever.

Autoimmune reactions

Autoimmune reactions, where the immune system mistakenly attacks the body's tissues, can also be a cause of hives. In this case, urticaria may be chronic in nature, and its symptoms may be more severe and last longer.

Sometimes the exact cause of urticaria cannot be determined and in this case it is called idiopathic urticaria. This means that despite a thorough medical examination, the factors that caused the skin reaction remain unknown.

Factors that can cause an exacerbation of urticaria symptoms

Recognizing factors that may cause exacerbation of symptoms requires a careful analysis of personal and family medical history, as well as a detailed review of the patient's lifestyle and habits.

An important step is to keep a diary of foods, medications, activities, and when symptoms occur. This helps reveal possible connections between a specific factor and an exacerbation of urticaria. Allergy tests can help identify allergens. In addition, when physical urticaria is suspected, special tests, such as cold or heat tests, may be performed to determine the skin's reaction to the physical agent.

Once potential triggers are assessed and identified, preventative measures can be taken, such as avoiding exposure to known allergens or modifying certain aspects of lifestyle to reduce the likelihood of symptom flare-ups. Such an individualized approach to the management of urticaria helps to reduce the occurrence of symptoms and improves the quality of life of patients.


Why does urticaria recur?

Recurrence of urticaria is a complex phenomenon caused by multiple factors, including immunological, genetic, environmental, and even psychological causes.

One of the main reasons for the recurrence of urticaria is the hyperreactivity of the immune system. There may be specific allergens or other substances in the body that trigger an immune system reaction that causes the release of inflammatory substances such as histamine, causing skin rashes and itching. In some people, this reaction can be caused even without the clear presence of allergens, due to autoimmune processes, where the body's immune system mistakenly attacks its own tissues.

Genetic factors also play an important role. Research shows that people with certain genetic traits are more likely to develop chronic urticaria, suggesting that family members may have a higher risk of developing the condition.

Environmental factors, including certain foods, medications, chemicals, as well as physical factors such as cold, heat, sweating, and physical stress, can cause hives to recur in those who are sensitive to these irritants. Even stress and psychological strain can trigger or exacerbate symptoms, as stress affects the immune system and can increase the inflammatory response in the body.

In addition, in some cases, the recurrence of urticaria can be caused by infections. Studies have shown that certain bacterial infections, particularly those associated with Helicobacter pylori, as well as viral and parasitic infections, may be associated with chronic urticaria.

Information sources

  1. National Institute of Allergy and Infectious Diseases (NIAID)
  2. British Association of Dermatologists (BAD)
  3. American Academy of Allergy, Asthma & Immunology (AAAAI)

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