Urticaria
(Hives)
What is it?
It
can take many forms. It usually causes itchy crops of reddish blotches on the
skin, rather like nettle rash. Occasionally some joints might ache. There are
other forms, however. Attacks generally last two to four days, often up to ten
days, but very occasionally far longer.
Possible causes
For
some reason, if you have an attack of urticaria, the cells in your skin release
a variety of irritant chemicals into the skin. One of the most likely of these
is called histamine.
Some possible reasons
why this release might happen.
Cause not identifiable
Often
no cause can be found- we use anti-histamines by and large to treat the itchy
rash when it flares up.
Infection
Even
a mild virus in the throat triggers
off your immune system to fight it. If your body gets confused, it can end up
unintentionly fighting your skin, and trigger off an attack of hives.
Started by:-
-
virtually any drug- especially
aspirin, codeine, ACE inhibitors (used to treat blood pressure and fluid), some
anti-inflammatory drugs and anti-biotics
-some
foods-especially shellfish- crab, prawns etc.,
strawberries, orange juice
-foods that contain naturally occurring aspirin-
like chemicals- salicylates
-food
colourings
especially tartarazine yellow, in fruit juices and
yellow orange processed foods generally
-food
preservatives- the “E Numbers” on the labels of packaged foods
Thyroid Problems
Extremes of Heat &
Cold
Exercise
Emotional upset
Any combination of the
above
However,
in a lot of people, we simply
never manage to put our finger on what is causing the problem. Though it
usually lasts just a few days, it can continue for weeks or, I’m afraid,
months.
What can you do about
it?
Try to identify causes- write down what eaten and drunk (record brands-
remember, they may have changed ingredients without you realising) over
the 48 hours before rash starts. Do the same next time it starts. Are
there any things common to both lists that MAY be the cause?
Drugs
General
Anti- histamines (“histamine 1 blockers”)
$e.g. cetirizine (Zirtek), loratidine (Clarityn),
desloratadine (NeoClarityn)
chlorpheniramine
(Piriton) This may make you more tired, - available over the counter at the
chemists for less than the cost of a prescription charge. Possibly the safest to
use in pregnancy.
Other
anti-histamines
(“histamine 2 blockers”) e.g. surprisingly certain types of stomach ulcer
drugs, and even doxepin, which is also used to treat depression!
steroid
tablets very
occasionally, these are necessary to control urticaria, though your doctor will
try to avoid this if at all possible.
The
doctor may try to get rid of a bacteria in the throat by prescribing anti-biotics,
if he thinks that may be the trigger.
Avoidance of what triggered it off- if you can work it out!!
What can I do if it
keeps coming back and I don’t know why?
·
Avoid foods
and drugs which encourage histamine
release, as above.
·
Long term
use of anti-histamines keeps you comfortable, and is safe.
·
Very
occasionally, we use powerful and potentially dangerous drugs that alter the
immune system.
·
You could
try a faffy possible answer- a fresh, non-processed diet- temporarily avoiding
ALL processed foods.
The foods
the LEAST likely to trigger it are lamb and rice. You could try eating these for
a week, then reintroducing other foods one by one, every couple of days, to try
to identify a trigger.
You could try a LOW SALICYLATE DIET
Salicylates
are found in ASPIRIN and also in a wide range of foods where they may be used as
a food flavouring- though it doesn’t always say so on the label!
Some foods
which contain significant quantities of salicylates are:-
|
Fruit
|
Apples,
apricots, blackberries, blueberries, cherries, gooseberries, grapes and
dried fruit, melon, nectarines, oranges, pineapple, plums, prunes,
raspberries, rhubarb.
Jams prepared from these fruits.
|
|
Vegetables
|
Carrots,
cucumber, onion, peas,
tomatoes.
|
|
Nuts
|
All
nuts, especially peanuts and almonds.
|
|
Cereals
|
Maize
|
|
Beverages
|
Tea,
coffee, wine, sherry, beer and cider.
|
|
Miscellaneous
|
Many
manufactured foods, especially ice-cream,
sweets
- peppermints, liquorice, soft drinks and cake mixes.
|
But
sometimes, there simply isn’t an answer, and taking anti-histamines if it
flares up is all you can do.
