Urticaria or hives is an allergic condition characterized by itchy, red, raised patches on skin. These patches disappear in a few hours but reappear at the same or a new area. Generally, Urticaria can be easily treated and doesn't cause much trouble to the person but in some cases it can get severe and chronic if it takes more than 6 weeks. Urticaria can be a manifestation of many conditions and illnesses, rather than one illness. The effectiveness of treatment depends on the diagnostic expertise, experience and attention they extend towards you.

MECHANISM:

Mast cell degranulation is the mechanism behind hives. If we put it in simple words, some white blood cells go berserk and cause the dismissal of histamine. And in response to antigens (intruders, real or seeming) which may come into contact through touch, breathing or digestion, the Mast cells fire back to resist them. There can be various reasons that your body produces antigens including factors like thyroid or lupus, inflammation or cancer like chronic diseases.

There are little receptors for immunoglobulin e antibody (IgE) on the surface of the Mast Cells and these stick to any antigens that come into  contact with your body. When the mast cell gets loaded it starts firing its weapons and it encourages other mast cells as well as other inflammatory cells to fire also. As the mast cells fire, they release histamine. Blood vessels seep out fluid due to vasodilation (where the capillaries increase in diameter) into the surrounding tissues by histamine and other mast cell by-products. The production of Hives occurs as a result of the infusion of histamine.

If you have frequent episodes of Urticaria, here are some tips suggested by Dr. Nivedita Dadu.

• Can you take aspirin or other nsaids (non-steroidal anti-inflammatory drugs)? If not, you may be salicylate sensitive. If you don't know already what salicylate is, let us tell you that it is an active ingredient in aspirin. This is also present in plants such as herbal supplements, vegetables and fruits. So, if you're allergic to salicylate your hives may worsen when you take an aspirin.
• This is also true if you cannot tolerate other nsaids such as ibuprofen, because they are cross-reactive with salicylates.
• A few people have found that a yeast-elimination program (diet and medications) has helped reduce their flares.
• You may be sensitive to additives or dyes or preservatives. Pay attention to what is happening, and your body may give you clues.
• Do you have any other possible sources of infection? Potential culprits are kidney infections, sinus infections, gallbladder infection, liver infections, Dental caries, thyroid disorder, urine infection.
• Have you been tested for other autoimmune conditions? While the majority of autoimmune Urticaria is a primary illness, hives can also be a symptom of some other autoimmune diseases. Some things many people with autoimmune disease have in common:
• for women, a worsening of symptoms during periods
• remissions during pregnancy
• development of other autoimmune diseases
• family history of various autoimmune problems (one family member may have rheumatoid arthritis, another may have thyroid disease, still another may have endometriosis)
• onset of symptoms with an event or trauma such as accident, illness, surgery, or infection within approximately 6 months- something that kicks the immune system into high gear.

If you've experienced any of these, you may indeed have autoimmune Urticaria, and this warrants further investigation.

TREATMENT:

• For patient with chronic Urticaria, Dr. Nivedita Dadu suggests a battery of tests to rule out the common causes. You need to know that even minor infection that remains undiagnosed can cause Urticaria.
• Treatment includes - Identifying and eliminating the trigger and treating the symptoms with the latest treatment options available in modern day medicine.

What's new in Urticaria treatment?

BIOLOGICALS - Monoclonal antibody to IgE is a recombinant biologic molecule effective for chronic Urticaria is currently F.D.A. approved for treatment of chronic Urticaria. It is given as injections, to adults and children above 12 yrs of age.

If you have tried a lot of treatment and are still not relieved of the symptoms, we suggest you book an appointment with Dr. Nivedita Dadu and we will be happy to help you.