What You Need to Know About Urticaria, Commonly Known as “Hives”
Urticaria, commonly referred to as “hives,” is a condition frequently encountered in the general population. Contrary to common belief, it is not a disease in itself but a clinical sign reflecting the body’s response to various triggers. Observational data indicate that approximately one in four people experiences at least one episode of urticaria at some point in their lives.
Urticaria is characterized by the sudden appearance of raised, well-demarcated, red wheals on the skin, accompanied by intense itching. A key distinguishing feature of these lesions is that they do not persist in the same location for longer than 24 hours; after resolving, they may reappear on different areas of the body. When pressure is applied to the lesions, they typically blanch.
How Does Urticaria Develop?
The underlying mechanism of urticaria involves the release of histamine from mast cells, which are part of the immune system. Histamine causes blood vessels to dilate and allows fluid to leak into surrounding tissues, leading to swelling and redness of the skin.
When this fluid leakage occurs in deeper layers of the skin, pronounced swelling may develop, particularly around the eyelids, lips, tongue, or genital area. This condition is known as angioedema and may accompany urticaria in some patients.
Types of Urticaria According to Duration
Based on the duration of symptoms, urticaria is classified into two main types:
Acute urticaria: Refers to symptoms lasting less than six weeks. The most common triggers include foods, medications, and infections. In most cases, symptoms resolve spontaneously within a few weeks.
Chronic urticaria: Defined by symptoms persisting for more than six weeks. In the majority of chronic cases, no clear underlying cause can be identified, although physical stimuli or immune-related mechanisms may play a role in some patients.
What Factors Can Trigger Urticaria?
Especially in individuals with chronic urticaria, various environmental and physical factors may exacerbate symptoms. Exposure to cold, sunlight, contact with water, vibration, scratching, or friction of the skin can provoke urticaria attacks.
In situations involving pressure—such as wearing tight clothing, tight socks, or carrying heavy bags—lesions may appear several hours after the pressure is applied.
Urticaria that develops as a result of increased body temperature due to exercise, hot showers, spicy foods, or emotional stress is referred to as cholinergic urticaria.
Impact on Daily Life
In many patients, urticaria symptoms become more pronounced at night, disrupting sleep. Persistent itching and recurrent outbreaks can significantly affect school life, work performance, and social activities. Therefore, early diagnosis and appropriate treatment are of great importance.
A detailed medical history is the cornerstone of diagnosis. Since skin lesions may not always be present during the clinical examination, photographs taken by patients during an attack can provide valuable diagnostic information.
Treatment Approach
The primary goal of treatment is to identify potential triggering factors, when possible, and to avoid them. First-line therapy for symptom control consists of antihistamine medications, which reduce itching and swelling by blocking the effects of histamine.
In chronic cases that do not respond adequately to standard treatment, dose adjustments under medical supervision or advanced treatment options may be considered for suitable patients.
Individuals experiencing symptoms of urticaria are advised to consult a specialist for accurate diagnosis and a personalized treatment plan in order to maintain quality of life.
Service Information
For the evaluation, diagnosis, and treatment of urticaria and other allergic diseases, patient care services have started at Immunology and Allergy Diseases Outpatient Clinic 2, available every Tuesday.