Hives (urticaria) is an allergic reaction in the skin characterized by white or pink welts or large bumps surrounded by redness.
These welts are known as wheal and flare lesions and are caused primarily by the release of histamine (an allergy mediator) in the skin. About 50% of people with chronic hives develop angioedema—a deeper, more serious form of hives involving the tissue below the surface of the skin.
While the basic cause of hives involves the release of histamine from white blood cells, what actually triggers this release can be a variety of factors, such as physical contact or pressure, heat (prickly heat rash), cold, water, autoimmune reactions, infectious organisms (e.g., hepatitis B virus, Candida albicans, and streptococcal bacteria), and allergies or sensitivities to drugs (especially antibiotics and aspirin), foods, and food additives.
Symptoms include an itchy skin rash with red bumps that can appear on the face, trunk of the body, and, sometimes, on the scalp, hands, or feet. Individual lesions usually last less than 24 hours and can change shape, fade, and then rapidly reappear. People with hives may also have wheezing, or swelling of the eyelids, lips, tongue, or throat.
Psychological stress is often reported as a triggering factor in people with chronic hives.1 Stress may play an important role by decreasing the effectiveness of immune system mechanisms that would otherwise block allergic reactions. In a small preliminary trial of people with chronic hives, relaxation therapy and hypnosis were shown to provide significant benefit.2 People were given an audio tape and asked to use the relaxation techniques described on the tape at home. At a follow-up examination 5 to 14 months after the initial session, six people were free of hives and an additional seven reported improvement.
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