Expert insight | Urticaria symptoms and solutions

Dr Alan Twomey, Telehealth Clinical Lead, gives expert insight into Urticaria symptoms and solutions


What is Urticaria?

  • Urticaria or “hives” arise when triggered by something you come into contact with. This usually causes a blotchy red raised rash that can be itchy or even feel like it burns.  Some people also get swollen eyelids, lips, or tongue and this is called angioedema.
  • Urticaria and angioedema can occur separately, but some people get both – if you ever get s suddenly swollen tongue, or your breathing is affected by swelling, call 999.
  • Hives fade within 24 hours in most cases whereas angioedema is a deeper swelling and typically lasts up to 3 days.
  • Urticaria affects about 20% of people – many more women than men. It’s also common in children where the most common cause is infection such as a sore throat.
  • Other common causes include medications, bee, and wasp stings, and in some cases, foods. Foods are not a common trigger, but they can aggravate urticaria – a phenomenon known as pseudoallergy.



Do I need tests?

  • Most people don’t need tests – your GP can usually tell from the description and appearance of the rash (many people keep photos)
  • Some forms of urticaria are caused by physical stimulation such as contact with heat, water, cold, or event sweating – if you think that’s happening to you, tell your GP.
  • There are some rare forms of urticaria that affect other organs and cause painful bruises and if this is happening to you, you need to tell your GP and tests will be needed.
  • If you think food is aggravating your hives, keep a diary and talk to your GP about psudoallergy.


Things that can help with Urticaria

  • You may not be able to identify or avoid the trigger, but we know that drugs such as Ibuprofen and codeine can be triggers.
  • Keep your skin cool and if you think a physical stimulus is involved, try to avoid it as much as possible.
  • Keep a food diary if you suspect a food is causing your hives.


When to speak with your GP

  • The mainstay of treatment is antihistamine use and you can buy several of these over the counter. However, there are others that need to be prescribed and your GP can talk you through how to use them properly as the doses you need for urticaria may be well above what you’re used to.
  • Some people get hives that continue for many weeks and become a chronic problem. Treatment is the same but needs to continue for months.  This can be a real burden and affect lots of parts of your life – don’t be afraid to call your GP and get help!
  • If antihistamines aren’t working, there are other options, and you’d need to see a specialist to start these. One of the best is called Xolair – an injection that’s given once a month for at least 6 months.


Online – where to get more information on Urticaria?

Author: Dr Alan Twomey


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