Doctor 24/7: Itchy hives, need testing to find the cause?

'Sometimes I get hives, I take medicine for a few days and it goes away, but it keeps coming back. Do I need to get tested to find the cause? Please advise me on how to prevent the disease' (Q.Thai, in Ho Chi Minh City).

Dr. Nguyen Thi Ngoc Loan, Internal Medicine, Diag Medical Center (HCMC), answers: Urticaria is a skin reaction characterized by the transient appearance of wheals or angioedema. This condition occurs due to mast cells releasing histamine and mediators that cause vasodilation, increased vascular permeability and interstitial edema.

The wheals are usually raised, pink or white, very itchy, vary in size, disappear within 24 hours and leave no trace. Angioedema may accompany it, appear deeper under the skin, less itchy but cause a feeling of tension and usually last 24-72 hours.

Not all cases of hives require testing. About 50% of chronic hives have no known cause.

Photo: QT

Classification of hives

• Acute urticaria. Lasts about 6 weeks. Usually associated with infection, food, medication, or acute allergic reaction.
• Chronic urticaria. Lasts about 6 weeks, includes 2 groups: chronic spontaneous urticaria (CSU) and chronic urticaria caused by triggering factors (CIndU) such as heat, cold, pressure, light, vibration, cholinergic...

How to limit recurrence

Depending on the patient's condition, they should limit factors that can trigger symptoms such as alcohol, seafood, weather that is too hot or too cold, stress, certain medications, or physical pressure on the skin.

About testing

Not all cases of hives require testing. About 50% of chronic hives have no known cause and are classified as idiopathic chronic hives.

With your condition, recurring, episodic, self-healing and without warning signs such as tongue swelling, difficulty breathing, it can be considered chronic spontaneous urticaria. You should see a dermatologist or allergist for evaluation and consider testing when necessary, avoid prolonged self-medication

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