Physical hives are an allergic reaction to environmental stimuli that cause a red, itchy rash and bruising on the skin. Treatment is aimed at relieving itching and can be oral or topical, over-the-counter or by prescription. Different types of physical hives include aquagenic, solar, delayed pressure, cold-induced, cholinergic, and dermatological urticaria. Treatment is symptomatic, and prevention is the best way to deal with physical hives.
Physical hives, or urticaria, is an allergic reaction to environmental stimuli that causes a red, itchy rash and bruising on the skin. Environmental factors that can lead to physical hives include water or sun exposure, delayed pressure, cold temperatures, perspiration, and writing on the skin. The hives and rash usually subside on their own, so treatment is aimed at relieving the itching. Treatment can be oral or topical, over-the-counter or by prescription; phototherapy is also used as a treatment.
Histamine is a chemical that is released in response to an allergy. It builds up in certain areas and causes itchy welts and rashes. Some people have an allergic reaction to certain environmental triggers. Exactly why this occurs is unclear.
Aquagenic urticaria is a rare type of physical hives in which exposure to water causes an allergic reaction. Water temperature does not appear to be a factor in the development of rashes. The water can be cold, warm, or hot and still cause a reaction.
Another rare type of hives is caused by the sun. When someone has solar urticaria, they develop the itchy rash whenever their skin is exposed to sunlight. To avoid the rash and hives, a person with this condition should cover their skin whenever they are outdoors or refrain from going outside during the day.
Delayed pressure urticaria occurs when the skin has been placed under pressure for a period of time. For example, someone who has a tight seat belt or seat belt that puts pressure on the skin may develop symptoms of hives. This usually happens between four and six hours after the pressure has been removed. It’s rare.
Cold-induced urticaria is also rare. Hives develop when the skin is exposed to cold conditions, such as rain, wind, or snow. Doctors aren’t sure whether it’s the cold that triggers this type of hives or if the trigger is heating up of the skin. The rash can be widespread or localized to one part of the body.
Cholinergic urticaria is triggered by sweat and produces very small bruises, mostly on the trunk and arms. This condition is more common than the other types of hives. Some people experience shortness of breath for the 30 to 60 minute duration of the rash. This condition often develops in early adulthood and can improve with age.
Dermatological urticaria can occur when the skin is stroked or written on. A short-lived rash can develop along the lines of writing or stroking. Sometimes this rash can be very itchy, but not always. About one in 20 people develop this condition, usually in early adulthood. As a person gets older, they may experience fewer episodes of dermatographism.
There is no cure for any of these types of physical hives, and treatment is symptomatic. Some individuals may find that oral antihistamines help the rash fade more quickly and be less itchy. Antihistamines are available over the counter or with a prescription. Ultraviolet light phototherapy treatment may help some people with physical hives, but the hives are only kept away for a few months. Steroids, antifungal antibiotics, or tricyclic antidepressants may also be prescribed.
Topical treatments that contain camphor, menthol, diphenhydramine, and pramoxine can be purchased over the counter. These treatments work by smoothing out the nerve endings, which helps reduce the intensity of the itching. According to some dermatologists, hydrocortisone or other cortisone-based lotions don’t offer much help for physical urticaria. Prevention and symptomatic treatment are generally the best ways to deal with physical hives.
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