Urticaria / Hives

Hives – Causes, Symptoms & Treatment

Urticaria (also known as hives) is a common eruption characterised by short term swelling of the skin, manifesting as raised, often itchy, red welts on the surface of the skin. It is usually caused by an allergic reaction which causes histamine release. 

One off outbreaks of hives will usually resolve themselves within a few hours to days however some individuals suffer from chronic urticaria where the skin is regularly under stress

Causes of Urticaria / Hives

• Allergic reaction to foods, medications, animals, insects or environmental factors. Common triggers include:
• Animal dander and saliva (especially cats)
• Insect bites
• Pollen
• Medications e.g. penicillin, aspirin
• Foods e.g. shellfish, fish, nuts , eggs, milk, oranges
• Food additives e.g. sulphites, azo dyes (especially tartrazine)
• Chemicals e.g. perfumes
• May also be triggered by:
• Emotional stress
• Heat or cold
• Excessive perspiration
• Pressure / friction
• Infection e.g. acute strep throat in children
• Contact with plants e.g. nettle, poison ivy

Signs and symptoms of Urticaria / Hives

• Raised red welts with clearly defined edges that are intensely itchy
• Blanching with pressure
• Welts may grow and spread, forming larger areas of flat, raised skin
• Welts may appear and disappear rapidly within minutes or hours
• May develop into angioedema (edema of subcutaneous tissues)
• In severe cases, may become systemic (anaphylaxis)

TREATMENT STRATEGY FOR URTICARIA / HIVES

• Identify / avoid triggers
• Investigate gut bacterial overgrowth, mucosa damage and pathogenic infections
• Regulate TH1/TH2 immune response
• Reduce histamine production
• Repair gut permeability (in food allergy)
• Stimulate digestive function
• Manage stress

Diet plan guidelines for Urticaria / Hives

• Identify and avoid food triggers:
• May need elimination/rechallenge diet; most common are shellfish, milk, eggs, chicken, strawberries, oranges, nuts
• Avoid food additives
• Minimise pro-inflammatory foods: sugar, refined carbohydrates, trans fats, excessive red meat, saturated fats, omega-6 fatty acids, caffeine and alcohol
• Emphasise anti-inflammatory foods: in cold-water oily fish, berries, nuts and seeds, turmeric, ginger, green tea, olive oil
• Emphasise antioxidant-rich foods to promote tissue repair: berries, green tea, turmeric, fruits and vegetables
• High fibre diet to support bowel function and growth of beneficial gut flora, and promote clearance of estrogen metabolites
• Probiotic foods to support healthy immune response and reduce intestinal permeability
• Include bitter foods, lemon juice and/or apple cider vinegar to support digestion of food

Supplements that support Urticaria / Hives

• Vitamin C 2-5 times daily: anti-inflammatory and anti-histamine
• Quercetin 5 minutes before meals: anti-histamine
• Probiotics: to module immune response
• Omega-3 EFA’s: to down-regulate inflammation
• Glutamine: to repair gut lining in food allergy

Herbal medicine treatment for Uticaria / Hives

• Anti-allergics: albizzia, baical skullcap, chamomile
• Anti-inflammatory: turmeric, rehmannia, ginger, licorice, feverfew
• Topical applications: chickweed, nettle, aloe, calendula, marshmallow
• Repair gut permeability (in food allergy): slippery elm, goldenseal, licorice, calendula

Lifestyle / physical measures that support Urticaria / Hives

• Manage stress
• Bicarb soda or oatmeal baths to relieve itching
• UV light
• Hypoallergenic skin care products

FUNCTIONAL MEDICINE TREATMENT OF URTICARIA / HIVES

Chronic urticaria can be a condition that dramatically affects the quality of life of the patient.  Addressing underlying conditions that contribute to the allergic response is vital in achieving long term relief.  Intestinal permeability, food and environmental irritants and intolerances and a problem in the histamine processing pathway are all major contributors to the condition. 

Histamine processing may be impaired genetically through a down-regulated DAO enzyme, an overgrowth of bacteria in the small intestine (SIBO), a problem with methylation or key nutrient imbalances such as B6 and zinc.

At our Perth clinic of Advanced Functional Medicine we treat people with urticaria and other skin conditions with great success. 

If you or a family member are suffering from urticaria or other skin condition we would love to hear from you.  What are your triggers for Urticaria?  Doi you have issues when consuming high histamine foods?  Please write a comment below.

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