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Among the majority of CIU (Chronic idiopathic urticaria) patients have antibodies that have the immunoglobulin (Ig)E receptors on the surface of mast cells hence CIU is an autoimmune disorder. Different studies estimate that between 40% and 60% of CIU are definitely associated with IgG anti-IgE receptor antibodies.

For some reason, the skin mast cells are triggered by the auto-antibodies to release histamine to cause both urticaria and angioedema at different times; mostly late at night, or early in the morning. Intensive investigations are being conducted through skin tests involving patients’ plasma, to detect the auto-antibodies with the capacity of the plasma to cause wheals and flaring reaction. Unfortunately the validity of this test has not being confirmed.

Some tests done on urticaria patients

1. Food skin testing; this is how the skin reacts to different dietary composition after ingestion or coming into contact.
2. Safely stopping all concomitant medications to see the response of the body; whether there is a reduction of the attacks.
3. Measuring the thyroid functions; this includes the presence of anti-thyroid peroxidase and thyroglobulin anti-body titers. NB// Over 22% of CIUs cases are associated with Hashimoto’s thyroiditis disorders.
4. Obtaining a Complete Blood Cell count and Erythrocyte Sedimentation Rate; CBC and ESR.
5. Chest x-ray; this is done to examine the interior of the body

These entire tests ensure that 90% of the condition recurring within six months period is drastically reduced.

The combination of H1 and H2 antihistamines resulting to double the ordinary dose; taken in the morning and the evening is very effective for hives treatment. To achieve better results in good time a limited diet consisting of unprocessed rice, chicken, lamb, and turkey-white meats and avoiding any form of additives, fast foods/fatty foods, and beverages as sodas.

Treatment process after correct diagnosis

1. To start treatment, the causes’ ascertaining is crucial. This starts with identification of the triggering elements as conditions (cold/ heat/pressure), urticaria can recreated through making available the stimuli hence the diagnosis is correctly concluded.
2. Psycho-somatic urticaria caused by stress can be dealt with through the location of the underlying stressors; stress-busting techniques and patient counseling is employed.
3. Precautionary measures on food, dressing and cosmetics must be taken as they can easily promote the onset or recurrence of the condition.
4. Elimination of processed or ready-to-eat foods packages as tinned or canned foods, foods with preservatives included, coloring agents and other food additives can preventurticaria. Also always check condition of the food and the packaging, the date of manufacture and expected date of expiry. These measures will definitely allay the onset or an attack.
5. The avoidance synthetic materials coming into with the body as latex and cosmetics.
6. Improved diet comprising of large portions of fruits as mango, papaya, oranges, limes, melons, goose berries assist to strengthen your skin.
7. Always take at least 1 glass of cold milk daily reduce body acidity hence you maintain the require pH.
8. Hygiene is also required especially after directing your body to strenuous tasks where you profusely sweat.

If correctly practiced the above will keep of hives and also treat it if you already suffer from it. Patience is demanded in diagnosis and treatment of this condition.

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Urticaria is a skin rash that can be noted in any part of the body. It is described as a raised, maculopapular pruritic lesions that is often times caused by allergic reaction, although there are a number of non-allergic conditions that can cause it. It could be a chronic condition that will immensely affect the daily lives of people who is suffering from it.

Types of Hives

1. Acute- this often lasts for hours to a few weeks. It is often triggered by food or insect bites
2. Chronic- this type lasts for more than 6 weeks. There is no visual difference between acute and chronic forms. Most of the patients who have chronic form’s rash have unknown causes.
3. Drug induced- this is the most deadly type of urticaria/hives which is often caused by an anti-diabetic drug called sulfonylurea.
4. Physical- this type can be attributed to a direct skin contact with a specific antigen like a wristwatch or even a fake ring. The friction often causes local irritation.

Management of Urticaria

A person who suffers from this ailment more often than not finds it very hard to function every time they have an attack. The medical management is straightforward and it is not affected by its etiology. Being able to know what generally causes the rash is very helpful for a patient since the mainstay of treatment is avoidance of the triggering factor.

The first line of treatment is the antihistamines. The antihistamine drugs that generally block the H1 receptors are the primary therapeutic approach to a patient suffering from acute form. H1 receptor blockers like Diphenhydramine and Hydroxizine are the most commonly used medicine for acute form onset. They act rapidly and improve the itch in just a few minutes.

The minimally sedating types of antihistamines are the one used for attacks that lasts more than 24 hours. It is also the preferred drug to give for chronic form. The two most common drugs are Loratadine and Citirizine.

For refractory cases of chronic attacks, significant improvement can be seen with the use of glucocorticoids. It may even improve with certain anti-depressant medications with potent antihistamine properties. Topical creams like 5% doxepin (Zonalon) or capsaicin can also be used.

Consultation with a dermatologist, allergist or an immunologist is advisable if a particular case becomes chronic or recurrent. Consultation with or referral to a dermatologist, allergist, rheumatologist should be appropriate in some cases, More in cases of recurrent, complicated, severe, refractoryor chronic form. Mandatory dermatology referral if suspected of urticaria

Needless to say, the most effective way of managing a nagging disease like hives is to get to know what causes it so that it can be avoided. Certain triggers can be hard to evade so having an antihistamine tablet ready in your purse or wallet always comes in handy. People who suffer from chronic urticaria should also know that avoidance of stress and a good outlook in life would greatly improve this ailment and minimize its attacks. Rashes can be concealed by wearing clothes that covers most of the affected part or wearing hypoallergenic make ups to conceal rashes in the face. Choosing the right soft and hypoallergenic fabric is also important considering urticaria is mostly triggered by an allergic reaction.

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