Hives - Hives

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Hives - Hives
Hives - Hives

Video: Hives - Hives

Video: Hives - Hives
Video: the hives - T.H.E.H.I.V.E.S. 2023, September

Hives (urticaria)

Hives - also known as hives or urticaria - is the generic term for a group of different diseases that have a typical appearance in common, namely the sudden appearance of a skin rash that is usually very itchy or burning. It is similar to the reactions that occur after contact with a nettle…


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Urticaria is one of the most common skin diseases, affecting around one in five people at least once in a lifetime. It not only affects the quality of life, but also the performance at work or at school and can be life-threatening if the mucous membranes are involved (angioedema). The causes for the appearance of a nettle rash can be very diverse.


Hives are characterized by the sudden appearance of wheals and / or angioedema.

A wheal has three typical characteristics:

  • Superficial swelling of the skin of different sizes, almost always surrounded by inflammatory reddening of the skin (erythema).
  • Itching or, rarely, burning.
  • The appearance of the skin returns to normal within 1–24 hours.

Angioedema is characterized by:

  • Sudden, pronounced swelling of deeper layers of the skin.
  • Sometimes pain, rarely itching.
  • Frequent involvement of the mucous membranes.
  • The regression takes up to 72 hours.

The manifestations of the various urticaria diseases are very different. Wheals and angioedema subside relatively quickly, but can reappear in the same or in a different location. The swellings can often extend over large areas of skin. Several forms of urticaria can also be present in one person at the same time. Urticaria can be acute (lasting less than six weeks) or chronic episodes (lasting more than six weeks).


The urticaria diseases can be classified according to the respective triggers. The table shows the most important forms and sub-forms as well as the triggering factors.

to shape Sub-forms causes
Spontaneous urticaria Acute Spontaneous Urticaria: Spontaneous wheals and / or angioedema last less than six weeks often unknown
Chronic spontaneous urticaria: Spontaneous wheals and / or angioedema last longer than six weeks Unknown. Discussions include chronic infections, non-allergic hypersensitivity reactions to food and medication, and autoimmune diseases
Physical urticaria Cold contact urticaria cold objects, air, liquids, wind
Delayed pressure urticaria: Wheals occur with a delay of 3-12 hours static pressure
Thermal contact urticaria localized warmth
Solar urticaria UV and / or visible light
Urticaria factitia / dermographism: Wheals appear after 1-5 minutes Shear forces
Vibratory urticaria Vibrations, e.g. jackhammer
Other types of urticaria Cholinergic urticaria Increase in body temperature, caused for example by exertion or spicy food
Aquagenic urticaria water
Contact urticaria Contact with certain substances
Exercise-induced urticaria physical exertion, plus food intake if necessary

Prevention & Diagnosis

If the triggering causes of urticaria are known to those affected, these should be avoided or eliminated as far as possible.

First, a thorough medical history is required, taking into account all possible causes and precipitating factors of urticaria. The second step is the physical examination of the patient. Further diagnostic measures depend on the type of urticaria. If necessary, other significant diseases should be excluded by laboratory tests and further examinations should be carried out.


Therapy consists of identifying and eliminating underlying causes and / or triggering factors, as well as treating the symptoms with medication. For this purpose, antihistamines are primarily administered. If this does not have a sufficient effect, other drugs (e.g. leukotriene antagonists, daspon, omalizumab, etc.) can also be used. A cortisone preparation can be given briefly to relieve severe relapses. How long this therapy should be carried out depends, among other things, on the form and severity of the urticaria.

Whom can I ask?

If urticaria is suspected, those affected should contact a general practitioner. If necessary, a referral to a specialist in dermatology or allergology and immunology makes sense. You can find doctors in your area under Search for a doctor.

How are the costs going to be covered?

All necessary and appropriate therapies are covered by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.