Hives: When the skin overreacts

Hives: When the skin overreacts

Hives (urticaria) are a widespread skin hypersensitivity reaction in Germany. The disease causes reddening skin, wheals (red swellings) and severe itching. The causes and triggers of hives are diverse: They can be triggered by certain medications and foods, as well as by heat, cold, and pressure. When treating hives, finding the cause is paramount. Until this is found, therapy focuses on relieving the symptoms.

Hives – a common skin rash

Hives – also known as hives – are one of Central Europe’s most widespread skin diseases, along with neurodermatitis and psoriasis. It is estimated that between 20 and 25 per cent of Germans suffer from hives at least once in their lives. The name derives from the Latin term for stinging nettle (Urtica), as the symptoms resemble skin reactions that occur after contact with stinging nettle.

The neurotransmitter histamine causes the symptoms of hives. This is released in significant quantities by a faulty immune system reaction to an actually harmless trigger. In the body, histamine increases the permeability of the blood vessels in the skin, and water retention occurs in the dermis, which is the wheals.


Hives: causes and triggers

The causes for the release of histamine are varied; in about ten per cent of the cases, an allergy is behind the symptoms. This can exist, for example, against certain foods or medications. In addition, viral diseases, parasitic infections, internal diseases, autoimmune diseases, and infections in the ear, nose, and throat areas can also be possible causes of hives.

In addition, hives can also be triggered by the following external stimuli:

  • cold
  • warmth
  • light
  • friction
  • Print

Psychological factors are also said to be able to influence hives. It is considered relatively confident that stress can hurt existing hives. However, it is still uncertain whether stress is the sole cause of the skin disease.

Incidentally, hives are not contagious or hereditary. Only a particular form of cold hives can be passed on to the next generation. However, this form could be more consistent.

Hives: typical symptoms

A typical symptom of hives is a red rash that is usually very itchy. The itching is often very distressing for those affected, as they find it difficult to concentrate on other things and consequently sleep poorly. The feeling of being able to counteract the itching by pinching or pressure with the fingernails is characteristic of those affected. This distinguishes hives from other skin conditions, such as eczema, where sufferers tend to try to relieve the itching by scratching.

In addition to itching, red swellings on the skin – the so-called wheals – are another typical symptom of hives. The wheels are sometimes stressful for those affected because they can be disfiguring. They often appear as pale pink to red small bumps that grow larger over time.

The wheels can only appear on specific body parts or the entire body. The wandering of these wheels is particularly typical of hives: they disappear in one place and reappear in another.


Swelling in the throat is a life-threatening symptom.

Hives often also cause swelling and water retention in the subcutaneous tissue, the so-called angioedema. In rare cases, the mucous membranes in the mouth, throat and larynx can also be affected by the swelling. This can lead to life-threatening breathing problems. Those affected should, therefore, always carry an allergy emergency kit with them. It should contain a liquid antihistamine, cortisone preparation, and adrenaline syringe.

The individual symptoms of hives can appear very quickly – within a few minutes after contact with the trigger – or after a few hours. As a rule, the symptoms subside after 24 hours at the latest; sometimes, the wheals recede after half an hour. However, during a flare-up of hives, the symptoms can reappear after a short break. A flare-up of hives can last for days or even weeks.

hives in children

Not only adults but also children can be affected by hives. However, the skin disease is less common in children. Adults are primarily affected by chronic hives.

Hives also show the typical symptoms such as red wheals and severe itching in children. In babies and small children, an episode of hives often only lasts a few days, and then the disease disappears. Otherwise, a paediatrician or dermatologist should be consulted to determine the cause of the symptoms.

It is widespread in young children to have a previous viral infection behind the hives. However, allergies to certain foods or medicines and extreme heat can also trigger unpleasant symptoms.

hives and pregnancy

During pregnancy, hives symptoms often improve as the immune system is suppressed. However, some women also report a worsening of the disease. In addition, solid hormonal changes during pregnancy can trigger hives for the first time.

More robust courses of the disease in pregnant women can be problematic since many medications for hives are not allowed to be taken during pregnancy.


Different types of hives

Since urticaria is a highly complex disease, different sub-forms are distinguished:

  • Spontaneous hives
  • Physical hives
  • Cholinergic hives
  • contact hives

In these sub-forms, hives are divided according to their duration or according to the trigger of the disease. You can learn more about the individual types of hives on the next page of the book.

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