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What Are Hives and Why Do They Itch?
Although the exact cause of hives is unknown, they generally occur when mast cells within the body release histamine in response to some type of outside stimuli, usually an allergen. Histamine activates the inflammatory response as part of the immune system to fight unknown pathogens within the body. The histamine that is discharged causes blood vessels and capillaries to leak blood plasma into the surrounding tissues. This leakage and pooling of the blood plasma under the skin causes the main visual symptom of hives – raised red or pink bumps, patches or welts over different parts of the body. Histamine is also responsible for the itchiness associated with hives.
Allergic reactions are the main cause of hives, but they can also be caused by food, medications, insect bites or stings, viral infections and latex products. Direct physical stimulation to the skin, such as exposure to cold, heat, sun; vibration or pressure; sweating; and physical exertion and/or exercise can result in hives. Hives due to direct physical stimulation generally last about an hour and only occur where the skin was specifically stimulated.
Twenty percent of people will experience hives at least once in their lives and women are affected more often than men. An outbreak of hives generally lasts 24 hours and is prone to appear and disappear rapidly in different areas of the body over the course of the outbreak.
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OTC and Prescription Medications
Treatment options primarily focus on how to relieve hives symptoms while the outbreak resolves itself. Many medications are available, including:
- OTC antihistamines such as diphenhydramine (brand name, Benadryl), chlorpheniramine (brand name, Chlor-Trimeton), loratadine (brand name, Claritin), hydroxyzine (brand names, Atarax, Vistaril) and cetirizine (brand name, Zyrtec). Antihistamines are very successful at counteracting the effects of histamine, but they can cause various degrees of drowsiness.
- Prescription antihistamines such as cyproheptadine (brand name, Periactin), fexofenadine (brand name, Allegra) and levocetirizine (brand name, Xyzal). These medications can be combined with other antihistamines called H2 blockers such as ranitidine (brand name, Zantac) and cimetidine (brand name, Tagamet). These also can cause various degrees of drowsiness.
- Prescription oral steroids such as prednisone (brand name, Medrol) can be used short-term for chronic cases of hives but generally cannot be used for the duration of the hives outbreak due to the harmful side effects of long-term steroid use.
- OTC topical creams and lotions that contain ingredients such as camphor, menthol, diphenhydramine and pramoxine to dull nerve endings can be used but are generally unsuccessful at treating the itchiness associated with hives.
- Prescription and OTC cortisone creams containing steroids can be used, but are also generally ineffective at reducing itchiness.
Some antihistamines and other medications can be taken on a regular, proactive basis to avoid hives and swelling before they occur. Always consult a health care professional before taking any medication on a regular basis.
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Currently, there is much interest in controlling various illnesses with natural and herbal remedies instead of with traditional medicine. Below are some herbal supplements that can be used to treat the itchiness of a hives outbreak:
- Jewelweed is an herb that contains lawsone, a compound that can instantly relieve itching. Best if used fresh; the leaves can be crushed and applied directly to the skin. The leaves can also be boiled in water, strained and then cooled or frozen for use.
- Chamomile in a lotion or oil form can ease itching as it contains antihistamines and anti-inflammatory properties. However, do not use chamomile if there is an existing allergy to ragweed.
- Stinging Nettle is a plant that produces its own histamine that can counteract the histamine produced by the body that is causing the hives outbreak. It is generally taken in capsule form or as a tea.
- Quercetin is a natural antihistamine that is found in foods such as onions, apple and leafy green vegetables that can diminish or eradicate hives altogether. It is available in capsule form.
- Other “cooling" herbs such as sandalwood oil, mint and aloe vera can be use to lessen itchiness during a hives outbreak.
Always consult a health care professional before using any herbal remedies as they are not regulated by the FDA, may contain unknown ingredients, have unintended side effects and may react unpredictably with other prescribed or OTC medications.
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There are many things that can be done to lessen hive itchiness with items from around the house or from a local grocery store. Below are other suggestions on how to relieve hives itchiness at home:
- Identify the cause of the hives outbreak and try to avoid it.
- Use lukewarm or cool water instead of hot for bathing or showering.
- Use gentle, mild soap.
- Use cool compresses on the affected areas.
- Sleep and/or work in a cool room.
- Wear loose-fitting, lightweight clothes.
- Apply milk of magnesia or calamine lotion directly to affected areas.
- Apply a paste of cornstarch or oatmeal directly to affected areas.