Hives come in many shapes, sizes and colors. This type of reaction can occur for a variety of reasons such as an allergic reaction, pressure placed on the skin, medications or changes in temperature. For many people, hives come on quickly, dissipate quickly and do not return. For others, hives become reoccurring due to factors like an unknown allergy, an infection or underlying health condition that the patient may not be aware of. If you suffer from reoccurring hives, it may be time to have a conversation with your provider about some treatment options or lifestyle changes that could help keep hives away for good.
We sat down with Kelsey Mauro, PA-C regarding her expertise on the subject of hives, the causes and treatment options available to patients who experience reoccurring hives.
When people come in for hives does it get mistaken for other skin disorders?
Many people tend to mistake it for a reaction to insect bites or a viral infection. Hives are transient, meaning they can appear in one place for several hours, go away and come back in another place the next day. This can lead people to believe it’s an environmental allergy or something else. A lot of people don’t know that hives can present in different sizes from very small to the size of a dinner plate so they often mistake it for something else.
What is the most common question you receive when a patient comes in to be treated for hives?
The most common question I get is “what caused this?” The unfortunate part about hives is that about 40% of the time it is idiopathic, meaning that we don’t really know why the person may have had this. This can be frustrating because a patient takes time to come into the office and we don’t have a very simple answer for them. The kicker is that sometimes stress can exacerbate hives so if the person is stressed, they may cause the hives to worsen.
We understand that hives can be idiopathic, however, what are some of the known causes?
Someone might break out in hives due to a food related or environmental allergy. Sometimes they could be experiencing a drug side effect or allergic reaction to a medication they’ve been newly prescribed. A more serious issue is that it could be an internal disease or an underlying health condition the patient might not be aware of. Unfortunately, there is a wide array of causes so it can be difficult to narrow down.
What is a common misconception about hives that you’d like to clear up?
Many people think that if you treat hives they are gone for good. And it’s possible, in many cases, that hives are a one-time thing for patients. In other cases, they can be more chronic and come back repeatedly. If that is the case, the patient usually requires patch testing or we may opt to send them to an allergist to see what is going on.
How can you ease the concerns of your patients given the illusive nature of hives?
I find it’s important to let patients know that we will do our best to find the cause. Finding the root issue is not a clear cut path and we understand how frustrating that can be for a patient. We like to employ a variety of steps to let the patient know we are trying to cover all the bases for them.
First, I prefer to give them an around the clock antihistamine when a topical steroid that they will apply 2 times a day for 2-4 weeks. I like to have them back into the office after a few days to see how they are improving. If we do not see any kind of improvement, we may choose to do a biopsy or further lab work and provide them with an additional antihistamine in the meantime. If there is not clear answer with their lab work and they are experiencing repeat instances or their hives are not improving, we like to consider prescribing them Zolaire to get the hives under control.
Everyone’s system is different so it’s important that we try a variety of things as some patients may respond well to one treatment while another doesn’t respond in the same way.
If you are concerned about underlying health conditions that could be causing your reoccurring hives, or if you would like more information about scheduling a consultation with one of our providers, please call a Skin Solutions location nearest you to schedule your appointment today! Our patients are part of the SSD Family and we love giving back in any way that we can! Do you have a skin care story that you would like to share with us? We would love to hear from you! Send your story or photos to: mcrooks@skinsolutionsderm.com