(also referred to as...) Urticaria
Description Hives are an allergic reaction on the surface of the skin in response to an allergen. The lesions are called "wheal and flare" lesions and are mainly caused by the release of histamine in the skin. Hives have affected 15 to 20 percent of the population at one time or another. Although they can occur at any age, hives most often affect young adults. In a typical allergic reaction, an allergic antibody (IgE) and an antigen or foreign molecule bind with certain white blood cells to stimulate the release of histamine. In the case of hives, however, other factors seem to play a greater role in histamine release. There are several types of urticaria that are grouped depending on the cause. The six main groupings are physical (most commonly dermographic, cholinergic, and cold), drug-related (most commonly penicillin and aspirin), food allergies, food additives (most commonly benzoates, salicylates, sulfites, and tartrazine,), infections, and stress.
Symptoms and Signs: Generally, hives appear as white or pink welts or large bumps surrounded by redness. Other signs or symptoms that may occur include headache, malaise, nausea, vomiting, wheezing, difficulty breathing, salivation, watering, swelling, or burning eyes, fainting, fever, joint or muscle pain, gastrointestinal upset, fatigue, flushing, disorientation, glottis edema, increased white blood cell count, tremour, collapse, abdominal cramps, diarrhea, low blood pressure, asthma attack, chills and rapid heart beat.
Causes: Causes listed below are organized by groupings.
Physical Aquagenic urticaria: Caused by contact with water. Cholinergic urticaria (or "prickly heat rash"): Caused by physical exercise, overheating, and mental stress. Can be brought on by a warm bath/sauna, eating hot spices, and alcohol consumption. Cold urticaria: Caused by contact with cold breezes, temperatures, and surfaces. This type may be associated with viral/parasitic infection, syphilis, multiple insect bites, penicillin injections, dietary changes, and stress. Dermatographic urticaria: Caused by pressure, stroking, scratching, and rubbing and may be brought on by contact with another person, furniture, bracelets, watch bands, towels, and bedding. This type may be associated with parasite infection, insect bites, hormonal changes, thyroid disorders, pregnancy, menopause, diabetes, immuological alterations, other urticarias, drug therapy, chronic candidiasis, angioedema, and increased blood levels of the white blood cell eosinophils. Exercise-induced anaphylaxis: Caused by exercising after a heavy meal. Familial cold urticaria: Caused by cold wind and change from cold to warm air. Heat urticaria: Caused by heat. Pressure urticaria: Caused by pressure. Solar urticaria: Caused by light of varying wavelengths. Vibratory angioedema: Caused by vibration.
Drug-Related Drugs are the leading cause of hives in adults. The two most common culprits are penicillin and acetylsalicylic acid (aspirin). Penicillin can exist undetected in food, yet the extent of its contribution to the development of hives it is not known. Penicillin in the food supply has most commonly been found in milk, soft drinks, frozen food, and meat. This type of urticaria can also be caused by allopurinol, antimony, antipyrines, barbiturates, bismuth, chlorhydrate, chlorpromazine, corticotropin (ACTH), eucalyptus, flourides, gold, griseofulvin, insulin, iodines, liver extract, menthol, meprobamate, mercury, morphine (opium), para-aminosalicylic acid, phenacetin, phenobarbital, pilocarpine, poliomyelitis vaccine, potassium sulfocyamate, procaine, promethazine, quinine, reserpine, saccharin, thiamine chloride, and thiouracil.
Food Allergies Any food can cause such a reaction in a susceptible individual, but the most common food allergies are those to milk, fish meat, eggs, beans, and nuts. It is interesting to note that the underlying cause for food allergies and sensitivities in some individuals may be increased gut permeability, alterations in gastric acidity, intestinal motility, and other functions of the gastrointestinal tract. Many patients with food allergies are found to have little or no hydrochloric acid output. Increased gut permeability can be caused by vasoactive amines in food, bacteria, non-steroidal anti-inflammatory drugs (NSAIDs), or alcohol.
Food Additives Again, this could be a reaction to anything, but the most common additives are colourants, e.g., tartrazine, flavouring agents, e.g. salicylates, food preservatives, e.g., benzoates, BHT, BHA, and food emulsifiers and stabilizers, e.g., polysorbate, acasia, gum arabic, tragacanth, quince, and carrageenan. Tartrazine is present in almost all processed foods and many drugs and is banned for use in Sweden as adverse reactions are so common. Consumption is higher in children than in adults. Salicylates are aspirin-like compounds and may be a factor in aspirin sensitive individuals. Salicylates are naturally occurring in many foods, especially berries, dried fruits (especially raisins and prunes), candy made of licorice or peppermint nuts, seeds, curry powder, paprika, thyme, dill, oregano, and turmeric. Fish and shrimp often contain very high amounts of added benzoates, which may be why many people are sensitive to these foods. Sulfites are added to processed foods and many drugs and are also found in wine and beer. Sulfites are also often sprayed on fresh foods such as shrimp, fruits, and vegetables. Its use of fruits and vegetables has been banned in the United States. Hives could also be caused by cinnamon, vanilla, or menthol.
Infections Infections are the major cause of acute urticaria in children, but are also a cause of hives in adults. Bacteria: Typically, acute stretptococcal tonsilitis is the culprit in children, whereas chronic dental infection is the usual cause for adults. Viruses: Most commonly hepatitis B, but it has also been linked to infectious mononucleosis (EBV). Yeast: Candida albicans is implicated as an important factor in the development of hives in at least 25% of patient's whose hives are chronic. Chronic Trichomonas infections are also known to induce hives.
Stress Stress has been pegged as the most frequent primary cause of chronic hives. It is believed to cause hives due to its role in decreasing intestinal IgA secretions.
What to Expect: Acute hives are described as recurrent episodes that last less than six weeks. Hives lasting longer than this period are termed chronic. Approximately 50% of people with hives also develop angioedema -- a more serious form that involves deeper layers of the skin, mucous membranes, and sometimes the viscera (internal organs). The lesions are larger and much more swollen. This is also known as angioneurotic edema, giant urticaria, Quincke's disease or Quincke's edema. Some people may also experience anaphylaxis if particularly sensitive. Anaphylactic shock is a MEDICAL EMERGENCY. Symptoms include difficulty breathing, itching, hives, a drop in blood pressure, and fainting. If this occurs, seek medical attention immediately.
Remedies
Food Supplements Acidophilus and Bifidus supplementation can help reduce allergic reactions and will restore beneficial bacteria counts in the digestive tract, promoting proper function. Supplementation is particularly important for people with impaired gastric functioning or C. albicans infection. Look for a dairy-free formulation with at least 2.5 billion viable cultures per capsule and keep refrigerated. Take 2 or 3 capsules daily before meals, preferably in the morning. Supplements with Fructooligosaccharides (FOS) provide a beneficial "bed" and initial food source for the bacteria. If dairy allergies have been ruled out, you can also eat yogurt that has had either bacterial culture added.
Herbs Aloe vera gel applied to the affected area can be quite soothing. Use as often as necessary.
Homeopathy Certain remedies can be used in acute situations if your symptoms fit the symptom picture of the remedy. For dosages, see the dedicated section on Homeopathy. Consult your homeopath or naturopath to determine your constitutional remedy: the remedy that best fits you as a whole person. Your homeopath or naturopath will take a complete case history considering all of your mental and physical ailments and match these symptoms with the symptom picture of the remedy. Hives is an acute disorder characterized by red swellings that are itchy and appear suddenly anywhere on the skin. Apis: Symptoms occur suddenly. Skin is inflamed, pinkish red, with a burning, prickling sensation. Condition improves with cold applications. Rhus Tox.: Hives are red, burning, itchy. Inflammation and blisters present. Symptoms are relieved by the application of hot water. Urtica Urens: Irritated area is itchy and burns. Hives are pinkish red. Symptoms made worse from cold applications and from bathing or washing.
Lifestyle It is most important to identify and eliminate or avoid the factors that are causing the hives. Avoid allergenic foods and eliminate food additives from your diet. Also eliminate foods with vasoactive amines such as cured meats, alcohol, cheese, chocolate, citrus, and shellfish. Get tested for C. albicans. If you test positive, eliminate yeast from your diet. This will include avoiding bread, buns, sausage, wine, beer, cider, grapes, raisins, vinegar, tomatoes, ketchup, pickles, and prepared foods containing yeast. Decrease stress. You can accomplish this goal in a number of ways. Try exercising (as long as this is not the cause of your hives), massage therapy, hypnosis, meditation, yoga, and other methods of reducing stress. Some people with chronic hives have benefited from UV light therapy, which appears to work best for people with cold, cholinergic, or dermographic hives. Sunbathe or use a UVA solarium 15 to 20 minutes daily. For obvious reasons, this treatment is contra-indicated for people with solar urticaria. Quercetin inhibits the manufacture and release of histamine and other inflammatory mediators by certain white blood cells. Take 200 to 400mg 20 minutes before each meal. Some people find relief with thyroid hormone replacement therapy even though they have seemingly normal thyroid function. A variety of topical applications can sooth symptoms and promote skin healing. Try mixing calamine lotion or unflavoured yogurt with a beta-carotene liquid and apply it directly to the affected area. Vitamin A mixed with a zinc oxide ointment may also prove useful. Fresh coriander juice can relieve itch and inflammation when applied externally. See your naturopath or other health care practitioner to determine if you have poor hydrochloric acid secretion. If so, supplementation with pancreatic enzymes may be beneficial. Take 4 capsules/tablets 4 times daily on an empty stomach. You may also supplement with bromelain, a protein-digesting enzyme found in pineapples. Take 3 to 4 times daily between meals.
Minerals It has been suggested that sulfite sensitivities may be due to a molybdenum deficiency. This mineral plays and important role in the conversion of sulfites to less harmful sulfates in the body. Take 200mcg daily. Zinc promotes healing of skin tissue and aids in maintaining proper concentrations of vitamin E in the blood stream. Take 50mg per day.
Vitamins If your hydrochloric acid secretions are low, you are likely deficient in B vitamins and supplementation would prove beneficial. Take 1 50mg capsule twice daily with plenty of water. B12 promotes proper nervous system function and healthy skin and some sources state that supplementation proves beneficial. Take 1,000 to 2,000mcg daily, in sublingual form. High doses of vitamin C help lower histamine levels by preventing the release of histamine by white blood cells and promote histamine breakdown. Take 1,000mg 3 times daily (do not take less than 2,000mg daily). Vitamin D supplementation can help reduce the occurrence or severity of hives. Take 400 IU daily. Vitamin E helps improve circulation to the skin. Take 400 to 800 IU daily.
Actions and Remedy Listings
See also Candidiasis, Food Allergies, Stress
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