Hive way to hell

Dr Manish K Shah on a common skin allergy.
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Updated on Feb 23, 2009 03:27 PM IST
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Hindustan Times | By, Mumbai

Because It Had Hives! Saw this funny cartoon on the internet. Hives or urticaria is a common allergic condition. One gets red, raised areas, often large and shaped like maps on various parts of the skin. These are called wheals and are often hot to touch.

Patients sometimes think they have fever, but it doesn’t show up on the thermometer. The characteristic thing about urticaria is that individual hives last for a few hours, never more than a day. Of course a succession of new hives is on its way and itching can really be maddening at times.

Those triggers
Urticaria is often triggered off by certain foods and drugs. Common offenders include fish, sea food, eggs, lemon, tomatoes, chocolates, cheese, strawberries, nuts and a pain killer like aspirin.

Preservatives, colouring and flavouring materials used in packaged foods and beverages can be culprits too. Various infections can precipitate hives, more so in children. There is a large group who suffer from chronic urticaria and get wheals daily for over six weeks. Even after a battery of tests, no cause is identifiable.

Neem helps
The manner of presentation of urticaria will often give clues to the cause. Investigations to exclude infections or hormonal causes may sometimes be necessary. Allergy tests provide relevant information only in a handful of cases. Your dermatologist may sometimes ask you to maintain a food diary. If urticaria is unremitting, special tests for ‘autoimmune urticaria’ may provide insights for specific therapy.

Urticaria is considered a type of pitta due to ‘heat in the body’ and ‘hyperacidity’. I am not sure how much ‘cooling the body from within needs’ but using neem in various forms helps hives.

That healing touch
Foods are often considered the do- all and be-all of hives. Patients often stop various foods randomly for prolonged periods to ease the assault of hives. Family and friends have their own two bit to add to the confusion.

I had a Jain patient who undertook a week -long fast during which, only boiled water was permitted. Throughout that week, she continued to get hives. So food is not the only cause of urticaria.

The first and most important treatment for relieving hives is oral, anti-allergic medications, called anti-histamines. They are of various kinds. The newer versions require to be taken just once or twice a day and do not affect your alertness.

This is in contrast to the older anti-histamines which had to be taken three-four times daily and used to produce drowsiness. Anti-histamines may be required for prolonged periods but the good news is they are safe for long-term use. Special medications may be considered for non-responders. Calamine lotion can soothe the skin until the effect of anti-histamines kicks in.

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