Hives and angioedema are skin conditions caused by an allergy. Hives, also called urticaria, are raised, red, warm, itchy bumps on the skin. Usually, hives will last about 24 hours. About 20 percent of the United States population develops hives sometime during their life.

Angioedema is a condition similar to hives, but the swelling occurs in deeper tissue – under the skin, in the dermis and underlying tissue. The swelling caused by angioedema most commonly occurs in the lips, face and tongue. Other symptoms may include abdominal cramping, difficulty breathing, and swollen eyes. Seldom, in very severe cases, swelling can occur inside the throat. Up to 50 percent of patients with hives also have angioedema.

What causes hives and angioedema?

Allergies, irritants, your genetic makeup, and certain diseases and immune system problems can cause hives. Hives are commonly caused by an allergic reaction to medicines, foods, insect stings or bites, and skin contact reactions to certain materials such as latex, but oftentimes the cause is undetermined, and the hives may never happen again.

Similar to hives, angioedema can be caused by an allergic reaction to insect stings, food, animal dander, and skin contact allergens. Medications like aspirin, non-steroidal anti-inflammatory drugs like ibuprofen, blood pressure medications (ACE inhibitors), and antibiotics can also cause angioedema.

How does Ohio State diagnose hives and angioedema?

Because hives and angioedema can be caused by many different things, it’s important to figure out what condition you have before you treat it. Our physicians will examine your skin and ask if you’ve been exposed to any irritating substances. Be prepared to list any medications and supplements you’ve been taking. Blood or allergy tests may be ordered.

How does Ohio State treat hives and angioedema?

Hives are very common and usually go away on their own, but if you have a serious case, you might need medicine or a shot, including antihistamines. Some hives sufferers continue to have problems over a larger time period. When hives occur daily for six weeks or more, it is called chronic idiopathic urticarial (CIU). When CIU is diagnosed, a diligent search is performed to try to identify a trigger or cause. When the trigger is identified, it can often be changed or avoided. For those with severe hives, Xolair (an anti-IgE) is a medication that is injected twice a month.

Depending on the severity of the angioedema diagnosis, your doctor may prescribe over-the-counter antihistamines, anti-inflammatory medicines, epinephrine shots, inhaler medicines, or ranitidine. In addition, people with angioedema should avoid any known allergens or triggers that cause their symptoms and avoid any medicines, herbs, or supplements that are not prescribed by their Ohio State Wexner Medical Center physician.

Suffering from breathing difficulties is a medical emergency. Seek immediate medical attention if you are having trouble breathing. A severe, life-threatening airway blockage may occur if the throat swells.

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