Contagious or not? How dangerous is hives
Hives or fever (technical term: urticaria from
Latin urere = burn) describes various pathological skin reactions that are
accompanied by swelling (wheals), redness and itching. The name comes from
the fact that the apparitions usually look like you've fallen into stinging
nettles. The trigger can be an intolerance, for example due to food, an
infection or external stimuli such as light or cold. Hives are neither
contagious nor hereditary.
Hives are uncomfortable because they can be very
itchy and affect the quality of life if they appear on the face, lips or throat. In
most cases, however, the hives are harmless. Usually healing occurs by
itself after a few days or weeks. However, caution is sometimes required
in children if allergic reactions are causing the wheals on the skin.
Experts differentiate between several
forms of hives. In the acute form, the symptoms disappear after six
weeks at the latest, often after a few hours or days. In the chronic form,
they last longer than six weeks. The chronic form also differs into an
inducible form, i.e. those in which the symptoms occur due to an external
trigger. Opposed to them are the chronic-spontaneous forms that appear by
themselves, therefore without any recognizable reason. Every fourth person
suffers from it at least once in a lifetime. Hives are chronic in around ten
percent of those affected.
Causes and triggers of inducible hives
Wheals can have a number of causes and triggers -
and often make the life of those affected very complicated. If they
develop a rash (cold urticaria) due to the cold, they can often no longer go
for a bath or hold a chilled drink in their hand. In other patients
(urticaria factitia) even slight contact with clothing or skin leads to
excruciating itching.
Doctors differentiate possible triggers of
inducible hives according to physical and non-physical causes.
The following physical stimuli can trigger hives:
- Heat or cold (e.g. via objects, air, water)
- UV light
- Static pressure
- Friction, scratching, rubbing
- Vibrations (e.g. from a jackhammer)
The following non-physical stimuli can also trigger
hives:
- water
- Increase in body temperature (e.g. when exercising, if you have
a fever , eating spicy foods, often also due
to stress )
- Skin contact with certain substances (e.g. a nettle or certain
foods)
Possible causes of chronic hives
If spontaneous urticaria becomes chronic, 80
percent of patients are caused by one of the following triggers:
- Intolerance to endogenous substances
- chronic infections, e.g. in the stomach or intestines
- Hypersensitivity to food additives or an intolerance to certain
foods
Treatment of hives
For the treatment of hives, it is important to
first track down the cause. A symptom diary can help in this, in which the
person concerned precisely notes the type, time and circumstances of the
symptoms (e.g. food eaten, medication taken, activities throughout the
day). This allows the doctor to uncover possible triggers inside and
outside the body (see above). If, for example, an infection or intolerance
is the cause of the hives, it can be enough to treat them.
If treatment of the cause is unsuccessful, the
doctor will try to at least treat the symptoms so that the rash on the skin and
the associated itching or a possible aesthetic problem (with rash on the face)
disappear.
For this purpose, the doctor can prescribe antihistamines . These are agents that dampen the
allergic reaction in the skin by blocking the body's own histamine. If
this is unsuccessful, the doctor can prescribe active substances that activate
the immune system. These include omalizumab (also used in severe asthma ), which is approved for chronic spontaneous
hives, but has also shown good results in inducible urticaria.
Ciclosporin is also available, a substance often
used in transplants that suppresses the immune system. Finally, montelukast,
which is taken orally and used in moderate asthma, and allergic rhinitis, can
help. In the case of severe flare-ups, taking cortisone for a short time
can also be useful.
The doctor has to adjust the drug therapy
individually again and again. Especially during pregnancy, patients must
speak to their doctor before continuing to take medication.
Some doctors report good experiences with
alternative therapies such as autologous therapy. In general, however,
doctors advise caution when using homeopathy and the like against hives - there
is no proof of their effectiveness.