Urticaria / Hives

Rashes  /Itching / शीतपित्त या पित्ती

 

A skin rash with red itchy bumps as a result of allergic reactions of the body. Very common (More than 1 crore cases per year in India). Treatable by a medical professional. Requires lab test or imaging. Can last several months or years. Family history may increase likelihood.

They are itchy, red and raised and often appear at the worst possible times. They are hives and yes, they can drive you crazy and can dramatically affect your quality of life. Still there is lot  you can do to ease the itch of chronic hives.

Urticaria affects up to 20% of people of all ages, races, and genders. Hives can either be acute or chronic depending on how long they last. Acute hives last for less than six weeks, while chronic hives persist beyond six weeks.

 Rashes. शीतपित्त या पित्ती

Introduction

Hives

Hives  are reddish raised itchy eruptions or welts (raised red bumps) that results from a skin reactions. The welts vary in size and appear and fade repeatedly as the reaction runs its course. Hives are also called as Urticaria and can be acute or chronic. Acute rashes will resolve on their own or with the minimum medications within few days and in chronic hives, welts appear for more than six weeks and recur frequency over months or years that can triggered by many things including Allergic Reactions, certain foods, egg plant, Kabuli channa, green leafy vegetables,  medications, dried meat/ chicken, and stress.

Pathology

Mast Cell Releasing Histamine

Hives are usually caused by an allergic reaction to some thing that one has encountered or swallowed. When you have  an allergic reaction, your body begins to release histamines into your blood from the MAST CELLS. Histamines are chemicals your body produce in an attempt  to defend itself against infection and other outside intruders.

Hives can be seen in any part of the body or the whole body including, the face and the lips with swelling. Persons having hives has a risk of developing life threatening condition called ANAPHYLAXIS. So if any symptom such as swelling of the face, tongue, throat, or a rapid heart beat occurs, it should recieve urgent medical care,

In Ayurveda, Urticaria or the hives is considered as Sheeta pitta which is caused due to imbalance in two doshas : Kapha and pitta.

Gut and skin connection

A recent study found that scratching your itchy skin irritated by eating foods triggers your immune cells in your small intestine. The scratching sets off a gut reaction. This situation is why there may be varied reactions in people with food allergies

Symptoms

Urticaria is most often caused by an allergy or infection, but it can occur due to stress, vibration, or sudden changes in the environment. An abnormal immune response causes blood vessels to leak fluid into the middle layer of skin, called the dermis. Hives are the result.

You can tell hives from other types of rashes by the following signs and symptoms:

• Hives cause raised, red, welt-like bumps.
• Hives usually have well-defined borders.
• Hives cause redness and itching, sometimes intense and often worse at night.
• Hives can sometimes cause burning or stinging.
• Hives blanch (whiten) when pressed.
• When hives resolve, they leave no scarring or tissue damage.

Hive can appear on any part of the body and be as small as a pinpoint or large as a plate. They can change shape, move around, disappear, and reappear over short periods of time.

Hives most often appear in the evening or early morning just after waking. 

Good news : They generally aren't associated with fever, nausea, muscle aches, joint pain, or headaches unless an infection is involved.

Types

Acute Urticaria

It is more common in children and young adults. The majority are meaning that the cause is unknown. Acute hives tend to start and stop quickly, often lasting a few hours and rarely for more than a few days. If a cause is found, it is most often an infection, insect bite, or a drug or Food allergy. 

Chronic Urticaria

It is often idiopathic and can recur over the course of months or years. 70% of people with chronic hives had symptoms that lasted for more than a year, while 14% had symptoms for five or more years. In half of the cases, no cause was found.

Symptoms and Type

Cold Urticaria

Cold urticaria (essentially meaning cold hives) is a disorder in large red welts called hives (urticaria) form on the skin after exposure to a cold stimulus. The hives are usually itchy and often the hands and feet will become itchy and swollen as well. Hives vary in size from about 7 mm in diameter to as big as about 27 mm or larger.

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  Cold Urticaria develops reddish itchy welts
  

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  Cholinergic Urticaria
• Also known as heat rash, this type of hive is caused by excessive sweating, usually due to strenuous exercise. It causes very small weals surrounded by bright red flares.
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  Cholinergic Urticaria
  
  

  Dermographism Urticaria
• This is caused by the firm stroking or scratching of the skin, creating hives along the line of contact. The weals tend to appear within five to 10 minutes and disappear within 10 to 15 minutes.
• Signs and symptoms of dermatographia may include:
  • Raised red lines
  • Swelling
  • Inflammation
  • Hive-like welts
  • Itching
  The signs and symptoms may occur within a few minutes of your skin being rubbed or scratched and usually disappear within 30 minutes...

• Causes

  The exact causes of dermatographia aren’t known. The condition is thought to be triggered by:

  • stress
  • a history of allergies
  • excessive rubbing from clothing or bedding
  • infections
  • certain medications, including penicillin
  • exercises that cause excessive.

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  Dermographism Urticaria

  
  
  
• Pressure Urticaria 
• This type is caused when pressure is placed on the skin, such as when you wear tight clothing or stand on your feet for too long. It causes dense, red, itchy weals that can sometimes be a little painful.

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  Pressure Urticaria
  
  

  
  
  
• Solar Urticaria
• Exposure to ultraviolet (UV) light from the sun can cause hives on sun-exposed areas of skin, often within minutes. The hives will appear "angry," often with intense redness and warmth. Fainting can occur if the hives are widespread.

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  Solar Urticaria
  
  

  
  
  
• Stress Urticaria
• This is a type of chronic hives caused by emotional stress. With that said, the condition is hard to define as stress is only presumed to be the cause. The weals tend to be larger and can occur on any part of the body. In addition to physical stimuli, stress is commonly associated with the development or worsening of chronic hives. Again, the exact cause is unknown, but it is believed that the release of stress hormones such as cortisol may have a knock-on effect in which the underlying cause of hive is activated.

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  Stress Hives

• Vibratory Urticaria
• Vibrations, such as clapping or a bumpy car ride, can cause hives in some people. The hives tend to come and go within an hour. Flushing, headaches, blurry vision, or a metallic taste can sometimes occur along with them.

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  Vibratory Urticaria
  
  

  
  Water / Aquagenic Urticaria
• This rare form of hives is caused by contact with water regardless of its temperature. The hives are usually small and are most often on the neck, upper trunk, and arms. They also tend to come and go within an hour. It most commonly affects women.

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  Aquagenic/Water Urticaria
  
  

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What are common triggers for hives

• Allergies
• Stress
• Excessasive Scratching
• Medication
• Cold/heat exposure
• Exercise
• Use of Alcohol
• Illness & Infections
• Foods
• Medications /  Drug hyper sensitivity
• Sun exposure
• Air born Allergens
• Applying direct pressure to skin (such as wearing tight clothing)
• Contact allergens
• Environmental changes (like changes in temperature , excessive sun exposure, or extremes vibrations
• Food allergens.
• Insect bite 
• Some medical conditions like HIV and Hepatitis can also make you more prone to hives.

Causes According to Ayurveda

• Excessasive intake of food prepared from  freshly harvested grains.
• Intake of uncooked food.
• Excessive intake of mustard.
• Suppression of natural urges.
• Performing heavy physical exercise just after meals.
• Consistence consumption of too hot  salty, spicy, oily, sour, pungent, fermented, non veg food.
• Sleeping in day time. and irregular diet timings.
• Improper vamana karma.
• Hive from laundary detergent

Other Causes

Diaper Rash

Peanut Rash

A peanut allergy is your immune system mistaking the peanut proteins as dangerous. Your immune system releases mast cell chemicals such as histamines into your bloodstream, giving you an allergic reaction. An allergic reaction may occur minutes after you’re exposed to peanuts. Skin rash symptoms to peanuts include stuffy nose, skin reactions like hives, swelling, or redness over a large area.

Peanut Rash

Tree Nuts

Walnut Rash

Tree nut allergies are increasing, and the reactions can be acute. Part of the reason for the growing number of tree nut allergies is that they’re being used more and more in baked goods and processed foods. Studies found that nine tree nuts cause the most allergic reactions. These include:

• Walnut
• Pistachio
• Cashew
• Pecans
• Hazelnuts
• Pine nut

Stinging Nettle Rash

Stinging Nettle Rash

Cow's Milk

Cow’s milk is another common allergy that causes skin rashes. If you’re allergic to cow’s milk, your immune system will overreact to the protein in milk from the cow. Further, if both parents have atopic dermatitis from a milk allergy, the chances of a child having this allergy increase 40% to 60%.

                                  

Cow's Milk Rash

Eggs

Egg allergies are more common in kids than adults. But there are cases of adult-outbreak egg allergies. A reaction may happen within minutes of eating an egg. Symptoms include skin rashes, hives, congestion, or digestive problems. These can range from mild to more severe reactions such as hives-red welts on your body. Many people have an egg intolerance which is similar to an allergy, but not life-threatening. It can last a person’s entire lifetime.

Egg Allergy

Soy

Soy allergies that cause eczema, or atopic dermatitis, is more common in children than adults, but if you had a soy allergy that caused skin rashes when you were younger—good chance you’ll be allergic to soy as an adult. Allergic reactions to soy may include a flushed face, hives,  or tingling inside your mouth. Eczema symptoms are red itchy skin, scaly areas on your skin. Some people have more severe symptoms such as swelling of the lips, face, tongue, or throat.

Soy Rash

Wheat

Wheat allergies are especially common. Studies show that an allergic reaction to grain occurs when your body makes antibodies to the proteins that are in wheat. Gluten is one protein that causes this type of immune response. Studies reported that wheat allergies worsen atopic eczema in some adults. Wheat can be found in a variety of foods and even everyday items. Places you’ll find wheat include:

• Bread, pasta, crackers, cereals, cookies, and cakes
• Condiments, salad dressings, sauces, soy sauce
• Deli meats, hot dogs, other processed meats
• Stamps, envelopes
• Play-doh
• Cosmetics
• Bath items
• Medications-used as a binder
• Pet food
• Chewing gum

Gluten Rash

Sea Food

Many adults in the United States have a seafood allergy. It’s more common in adults than in kids. Kids that have a seafood allergy will typically grow out of it as they get older. Allergic reactions to seafood can cause hives, tingling in your mouth and throat, swelling, or stomach upsets like vomiting and diarrhea.

Sea Food Rash

Shell Fish

Invertebrates (no backbone) can also cause an allergic reaction.

• Shrimp
• Lobster
• Mussels
• Crab
• Oysters
• Crayfish
• Mollusks
• Clams
• Octopus
• Squid
• Calamari
• Sea slug
• Prawns

Typically, shellfish allergies cause vomiting, diarrhea, shortness of breath, face, lips, or throat swelling. Reactions are often delayed by a couple of hours

                                                

Shell Fish Rash

Corn

Corn

Corn is a less common food allergy than some foods. Allergic reactions to corn may differ depending on how allergic you are to the grain. Hives or skin rash are common. Corn products are used today in lots of different foods such as

• Jams
• Syrups
• Sauces
• Beverages
• Meats, deli meats, hot dogs
• Cereals
• Candy
• Snack foods

Corn Rash

Dehydration

Pregnancy stretch Mark hives

Pregnancy rash are known as Puppp / pupps / or pep  rash 

Allergic to cold

Cold Hives

Post Partam Hives

If you have postpartum hives, you might have signs and symptoms like: skin rash on the face, neck, chest, stomach, arms, or legs (pretty much anywhere) single welts, large flat bumps, or patches on the skin. skin bumps that are pink, red, or skin-colored.

Post pregnancy Hives

Chickpea/Kabuli Chana rash

                             

Chickpea rash

 

Covid  19 Rash

Covid 19 Rash

Dry Skin Patch

Sun Burn / Prickly Heat Rash

Plants that can cause skin irritation

Vegetable like brinjal

Green leafy vegetable urticaria

Cruciferous Vegetables

Criciferous vegetables can cause hives

Skin rashes from high Acidic foods

• Fresh and processed meats, Eggs, Beans, Oilseeds, Salt, High-sodium condiments, Some types of cheese, Certain grains. The most acidic fruits are lemons, limes, plums, grapes, grapefruits and blueberries. Pineapples, oranges, peaches and tomatoes are also high in acid.
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  skin rash from high acidic food
  
  

  
  

Milk Allergy

Egg Allergy

Egg Allergy

Meat Allergy

Meat allergy

Keratosis Pilaris

Keratosis Pilaris

Bee sting

Bee Sting

Foods

Ten foods that can calm your skin rash

So, now you know what foods can worsen your skin rash, but there are foods that can help calm down your skin rash. You’ll be surprised to see the various foods you may not have known could calm down your uncomfortable skin rash.

1. Asparagus

Asparagus

Who would have thought asparagus would help calm your skin rash reactions. It’s actually prebiotic with lots of inulin. Inulin feeds healthy bacteria found in your gut like bifidobacteria and lactobacilli. Asparagus is high in Vitamin B and antioxidants.

2. Fermented foods

Fermented foods are good for your gut, which in turn helps your entire body when you’re fighting off a food allergy. Foods and drinks like sauerkraut, kimchi, miso, kefir, kombucha, sourdough bread, and Greek yogurt are healthy fermented foods to help calm your allergic reactions.

3. Pineapple

Pineapple

Pineapples contain bromelain, a chemical that helps digest acid and breaks down proteins to fight off stomach problems. It’s so tangy and sweet, it’s hard to think this juice can help relieve food allergy symptoms, but it does.

4. Plants and Herbs

There is a growing awareness of how plants and herbs help us stay healthy. Herbs have been used medicinally for centuries, although in the United States, it’s been more in the last 25 years or so that doctors and scientists are seeing the benefits of recommending herbs and plants for their patients.

• Aloe vera-Aloe has been used to ease skin disease for thousands of years. It’s known to heal skin wounds, plus studies found that aloe vera kills certain bacteria and fungi.

Aloe Vera

• Marigolds-Marigold flowers made into a tincture can be used on skin inflammations. Ointment. Suitable for topical use, ointment can be applied to soothe inflamed skin and relieve pain caused by external irritation.

                                                       

• Lavender- Lavender has a reputation for being a calming scent. It slows down the release of histamines that cause allergic reactions.

Lavender flower

6. Raw onions

Raw Onion

Raw onions are prebiotics with strong antioxidant properties.  They’re packed with Vitamin C, which helps your immune system.

7. Apple cider vinegar

Some are surprised to learn that apple cider vinegar is another healthy food that can calm skin rashes.  ACV kills micro-organisms plus antioxidant results. It also helps with reducing your weight,  lowering cholesterol, and controlling symptoms of diabetes.

8. Ginger

Ginger

Ginger is packed with antioxidants that help elevate stress. It’s especially helpful to lower your blood pressure, help with chronic diseases and aging.

9. Dandelion greens

Dandelion Greens

These recognizable plants are some of the best detoxifying plants. They’re full of fiber, antioxidants, prebiotics. Dandelion greens contain vitamin A, iron, Vitamin B, and calcium.

10. Garlic

Raw garlic isn’t just a smelly plant. It’s full of inulin, which helps your gut’s good bacteria. It’s full of vitamins. Selenium and a powerful compound that kills diseases. It’s a powerful healing plant. Eating it can help you soothe your skin rashes.

Garlic

Prevention

Home Remedies for rashes

Application of Ice

Treatment

Coconut oil

Its  a good moisturizer  and sooths the skin.

Cold pressed coconut oil

Green Tea

 It reduces the inflammation caused by hives.

Green Tea

Turmeric

Turmeric

Curcumin is an important bioactive compound found in  Turmeric. Overall this miracle herb has anti inflammatory, anti histamine, antioxidant and  properties. It is a quick and effective way to get rid of hives.

Stress

Insect Bite

Sleep Deprivation

Heat Rash /Prickly Heat

Hives/ Welts / Nettle/ Rashes

Dehydrated & Dry Skin

Treatment

Medication

• Antihistamines: Reduce symptoms.
  Loratadine · Fexofenadine · Cetirizine · Desloratadine
• Corticosteroids: Reduce swelling and itching.
  Prednisone
• Histamine (H-2) blockers: Used if antihistamines are not effective.
  Cimetidine · Ranitidine · Famotidine
• Monoclonal antibodies: Effective against certain cases of hives that are difficult to cure.
  Omalizumab
• Leukotriene receptor antagonists: Drugs that prevent release of histamines from mast cells.
  Montelukast

Self care

• Apply cool compresses to the affected area
• Wear loose, light clothing preferably cotton or Khadi.
• Apply sunscreen lotion before going out in sun
• Eurax 10% locally

For Itching

Moisturizer

Moisturizer

Sunscreen Lotion

                                                                 

Hydrocortisone Cream

Antihistaminic : Tab Avil, Phenergan, Allegra to relieve itching. Taking these pills daily will help block the release of histamine. Which can in turn lessen your symptoms. If you have a busy day a head, take non drowsy.

Steroids : Oral steroids can help decrease swelling, redness and itching but it is recommended for short term course. Along with Antacids.

Histamine blockers : Also called H2 Receptors antagonist. These medicines can be taken orally or given as a shot. They are similar ti Antihistamines, but somewhat stronger.

Monoclonal Antibodies

This injectable treatment targets a specific protein, helping you to become less reactive over time. Its delivered about once a month, until your symptoms improve.

• Avoid applying cream or lotion to broken skin or open blisters.
• Take an oatmeal bath
• 

Depending on the severity, your doctor may prescribe over-the-counter or prescription antihistamines to reduce itchiness and swelling. Severe cases may require a biologic drug called Xolair (omalizumab) which is approved for the treatment of chronic hives. Immunosuppressants like cyclosporine are also sometimes used off-label.

In Ayurveda

Good for skin

The two main causes of any disease in Ayurveda are wrong diet and lifestyle. Therefore those food and activities should be withdrawn first. Since the skin diseases are caused by vitiation or aggravation of  one or more doshas. The line of treatment or selection of drugs is based on predominance of specific doshas, which are causing the ailments.

In Ayurveda both internal and external therapies play an important role in  treating and curing Hives.

Internal treatment includes Panchkarma therapies and internal medication which are called Shodhana (purificatory treatment) and Shamana Chikitsa (Palliative treatment)

Shodhana Therapy

Purificatory therapies  helps in eliminating the vitiated doshas and balances the doshas. The shodhana chikitsa is usually done  admitting the patient in house, as keen observation and monitoring of  the patient is neccessary during this period.

In hives, Virechana (purgation) and Vaman (emesis) are the two panchkarmas therapies and they help in elimination the vitiated doshas and the toxins out of the bodies which are very effective.

Shamana Therapy

This is followed after purification treatment. This includes internal medicines, diet and lifestyle modification.

There are some external treatments to reduce the symptoms which includes Lepa which is an application over the lesion by using various herbs. Abhyanga  body massage using oils which reduce itching and rashes .Kashaya dhara medicated water using drugs poured over the body.

Tips

• Hive after pregnancy

• Avoid overheating .
• Prevent dry skin.
• Try to keep cool.
• Wear loose fitting cotton / Khadi cloths.
• Keenly observe the foods which trigger the symptoms and stop using such foods.
• Avoid diet and lifestyle that are against the season.
• Avoid tea, coffee, hot, spicy, sour, fried foods, curds, eggs, fish, sweets, paneer, red meat, bakery foods, maida, preserved foods, carbonated drinks and tinned foods. 
• Avoid exposing to very hot  and cold climate.
• Drink 3-4 liters of water daily.
• Avoid outside foods, junk and chats.
• Sleep at night on time.
• Use cold water or lukewarm water for shower.

Aloe vera gel

Some common remedies used to reduce symptoms :

White Sandalwood / Shwetchandan : Santalum album. Various skin disorders. Improves the skin complexion, relieves itching, burning and redness of skin

White Sandalwood

• Apply moisturizer to skin several times.

• Eladi oil for application.
• Aloe vera gel.
• Sariva water for drinking.
• Turmeric with milk.
• Taking soft or mild laxatives to clear the bowels.

Useful herbs in Hives

Cold Compress

• Guduchi , haridra (turmeric), amla, neem etc. are effective in soothing the allergic reaction.
• One can take bath with neem infused warm water for relief.
• Apply coconut oil or mustard oil or Neem oil all over the body.
• If the urticaria is chronic and does not seems to  pacify with Ayurvedic medicines than restoring of Panchkarma is the best option.

Cold Compress for Hives

Aloe vera gel

One can also apply wet cloth or cold compresses on the affected area. How to make an ayurvedic cold compress at home ?Here's how ?

• Fill a small bowl with ice cold water.
• Add 6 drops to soothing/balancing essential oil as per your skin type.
• Swish through the water to disperse the oil.
• Take a clean absorbent cloth such as cotton wool, or linen, and dip into the infusion.
• Wring out  and apply over affected area for 10-15 minutes.
• Another way is to choose organic herbs, tea and prepare a decoction. Strain and proceed from there with a cloth.
• Because hives can be caused or worsened by heat, applying a cold compress to hives for up to 10 minutes can relieve irritation. Wrap ice in a towel or soft cloth and apply to your skin. For an ice pack that conforms to your body, consider wrapping a bag of frozen vegetables for application to your skin.

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