Most cases of urticaria resolve in time, but in some cases urticaria complications ensue. Hives complications tend to result in severe cases where hives is compounded by the simultaneous occurrence of severe angioedema.

Online descriptions of urticaria tend to list the symptoms and complications of hives together in order of severity. Detailed descriptions of the wheals or welts characteristic to hives are first on the list, followed by itching skin and discomfort. Fortunately, most patients with hives recover completely. No scars or discolored skin remain to tell the tale of their discomfort. As for the itching and discomfort, these are usually mild and topical creams or soothing home remedies can be applied to the skin to minimize them. Loose-fitting cotton clothing also helps tremendously.

Unfortunately, not all cases of hives have a happy ending. In some cases, the symptoms are severe: the wheals associated with hives may cover much of the body. Rather than feeling just some itching and discomfort, the patient may have to endure a burning sensation on the affected patches of skin. Such cases of hives may be resistant to treatment by antihistamines. Instead of resolving with time, they may occur again and again in repetitive cycles that frustrate the poor patient. Some people have been known to live this way for decades with little relief.

Life-Threatening Urticaria Complications

There are yet other cases of hives where the progression of the condition results in swelling inside the mouth or the throat. These urticaria complications cause acute upper airway obstruction, the results of which can be agitation, confusion, cyanosis, breathing difficulties, wheezing and loss of consciousness. Such hives complications must be resolved with medical assistance, which may entail a tracheotomy or the insertion of an endotracheal tube. Failure to get the appropriate treatment in time can result in brain damage or even death.

Anaphylactic shock is one of the more alarming urticaria complications. It is a severe, full-body allergic reaction that is sometimes associated with hives and angioedema. The release of histamine causes the narrowing of the breathing tubes, which makes breathing difficult. Other symptoms of anaphylaxis include abdominal pain, anxiety, lightheadedness, palpitations, nausea, low blood pressure, cyanosis and angioedema in the throat. The angioedema might cause obstruction of the upper airway, leading to suffocation, while the drop in blood pressure can result in loss of consciousness or death. Because these hives complications are severe and can progress in a matter of minutes, emergency medical care is necessary.

Hives affects all age groups, but hives in teenagers are of special interest. This is because teenagers are at a stage of great emotional vulnerability and any condition that sets them apart from their peers can cause them much anxiety.

Of course anybody suffering from hives is bound to feel self-conscious. That is not a reaction unique to teenagers. However, teenagers, above other age groups, have a special need to fit in among their peers and to feel physically attractive. The sudden appearance of red wheals on their bodies or, sometimes, on their faces, puts paid to this dream. The longer the hives last, the more pronounced the anxiety they are likely to feel.

Hives in teenagers are caused by a variety of factors, essentially the same factors that trigger hives in other age-groups. Teenagers are susceptible to seasonal allergies and to autoimmune conditions. They also get bacterial and viral infections and react negatively to certain medications, foods and food additives.

It is also worth pointing out that teenagers experience fluctuating hormonal levels as they go through the rapid physical and emotional changes that characterize adolescence. The other population groups that experience fluctuating hormonal levels due to milestone changes are pregnant women and menopausal women. These two groups of women happen to have increased vulnerability to hives. It therefore shouldn’t come as a surprise that hormonal fluctuations coincide with hives in teenagers.

Cholinergic Hives in Teenagers

Cholinergic urticaria is one form of hives that affects teenagers. It is triggered by temperature rises or by sweating. When one suffers from this condition, activities that increase body temperature, such as exercise, can provoke the development of hives. Sitting in a heated room, which is comparatively passive, can also provoke cholinergic urticaria, as can extreme emotions.

While cholinergic urticaria affects all age groups, most of those who develop it first do so in their late teens or early twenties. Is there something about belonging to this age group that increases vulnerability to cholinergic hives?

Vulnerability to cholinergic urticaria has been linked to stress in different age groups. So it is possible that high stress levels contribute to the development of cholinergic hives in teenagers. If this is the case, then counseling could make a difference as could various relaxation and coping strategies.

Cholinergic urticaria is often a cyclical condition. Those who develop it can have attacks followed by periods of remission, at the end of which they succumb to fresh attacks. This state of affairs can continue for years or even decades before finally resolving.

Allergies can manifest in a variety of ways. Their symptoms can include hives, sickness in the form of queasiness, red eyes and asthma. Hives are of particular interest because of their appearance. They present as reddish bumps on the skin that eventually disappear before resurfacing on a different part of the body.

Hives can be triggered by factors other than allergies. So they constitute a complex condition for which any generalizations have to be qualified. It is, however, safe to say that, when hives are triggered by an allergy, they tend to manifest shortly after exposure to the allergen, and then to eventually resolve. If one is not subsequently exposed to the allergen again, there is no reason for the symptoms to recur. Thus, avoiding the factors that one is allergic to is often an effective way to prevent recurrent bouts of allergic hives.

It sometimes takes medical tests to link hives to an allergy and to identify the precise substance to which one is allergic. A simple principle lies behind the more basic tests employed in the diagnosis of allergies like hives: Sickness symptoms that develop shortly after exposure to a substance often indicate that one is allergic to that substance.

Tests for Hives Sickness

The first step taken by allergists in diagnosing hives often involves asking their patients to keep a diary of their activities, diet and medication, beginning with the period just before their hives appeared. If a patient recently started using a new body lotion and immediately thereafter developed hives, then this would be made evident by the diary. The diary would also show how the patient reacted if he was re-exposed to the allergen or if he wasn’t exposed to it again. Simple tests would be able to confirm whether the lotion was responsible for triggering the hives. A doctor would use allergy skin testing to confirm the diagnosis of allergic hives. Sickness such as suspected urticarial vasculitis, a more serious hives-like condition, would be approached differently: instead of allergy skin testing, a doctor would opt for a skin biopsy.

When it seems likely that a patient has an allergy to a food item, then the doctor can have her take tests designed to diagnose food allergies. One of them requires the patient’s avoidance of the problem food for some time. If there are no allergy symptoms until the patient next eats the food, then an allergy diagnosis is confirmed. Another one involves trying out different foods under the doctor’s observation and seeing if they trigger hives. Sickness that develops in response to this test can be considered to confirm a food allergy.

Urticaria is a common complaint. In many cases it lasts briefly and the person can soon go back to life as usual. Knowing hives’ stages can help a person figure out whether the condition is a minor annoyance that can be resolved quickly, or a serious condition for which medical help will be necessary.

The Progression of Hives’ Stages

In the experience of many people, there are no obvious warning signs that indicate that hives is on the way. The condition just appears out of the blue. It starts out as itchy skin and, afterward, wheals start to appear on the skin. This, the first of hives’ stages can be mildly alarming. Wheals come in a variety of shapes and sizes. Sometimes they stand alone, but other times they merge. On a light-complexioned person, they may be reddish, pinkish or milky white in color.

In the next of hives’ stages, the individual wheals disappear, only to reappear elsewhere. Depending on the particular variety of hives, they may be concentrated on certain body parts like the trunk and limbs or just on the body part that was directly exposed to an allergen. The wheals continue to disappear and reappear on the body and, with them, the itching and discomfort persist. In most cases, when they disappear they do so without leaving any scars.

Hives’ stages can vary considerably from person to person. In some people, the condition is mild. Itching, discomfort and some wheals are all that characterize it and then, in a matter of hours, it is over. In other people, hives come with fatigue, nausea and vomiting, fever, stomachache and diarrhea. The complications can progress to pain in the chest and throat, and breathing difficulty. If this form of complicated hives is allowed to proceed without intervention, it could end in suffocation and, ultimately, brain damage or death.

Hives can also be classified in two forms: acute hives and chronic hives. The acute form tends to last a few hours to six weeks while the chronic form lasts more than six weeks. A three month-long case of hives falls under the rubric of chronic hives, as does a two decade-long case.

The length of hives’ stages will obviously vary with its forms. Acute cases end in a few hours, days or weeks. Their stages do not stretch out indefinitely, without any relief in sight. Chronic hives can be the exact opposite, negatively affecting a patient’s quality of life indefinitely.

Medical science has identified a number of possible triggers for hives, and kidney disease, liver disease, thyroid disorders and other metabolic diseases are among them. Allergies have also been cited as possible triggers of hives, as have autoimmune diseases and bacterial and viral infections.

It is worth noting that there is some degree of overlap between the categories described above. For instance, hepatitis B is a liver disease that is caused by a virus. Other examples are thyroid disorders like Grave’s disease, hypothyroidism and Hashimoto’s disease, which are also autoimmune diseases.

Metabolic processes are essentially the wide range of chemical reactions that make life possible: they help the body to produce energy, to break down large molecules into smaller ones that can be used in other reactions, and they also synthesize molecules. Metabolic disorders affect many of these chemical reactions. A metabolic disorder that negatively impacts the synthesis of one enzyme could easily disrupt multiple chemical pathways. This could, in turn, provoke a number of conditions, among them hives and kidney disease.

Emphasizing the role that metabolic disorders play in triggering hives is a particularly useful way to think about hives. This is because the various factors that trigger hives tend to be associated with dysfunction in one or more bodily systems. All bodily systems are connected by complex metabolic processes. So it should not come as a surprise when a disorder or dysfunction in one organ triggers symptoms in a completely different organ. In fact, when one thinks of things in this way, it seems to follow that, under certain circumstances, hives and kidney disease would be associated with each other. Hives has actually been described as a cutaneous manifestation of various systemic diseases.

Treating Metabolic Disorders: Approaches to Hives and Kidney Disease

One of the suggestions made for treating metabolic disorders is to modify the diet to reduce the body’s intake of nutrients that it cannot metabolize appropriately. Another one is to supplement the diet with nutrients that will help enhance the affected enzyme systems. Enzyme replacement can also be helpful. These techniques could be helpful in treating both hives and kidney disease as these are both conditions that can fall under the rubric of metabolic disorders.

Severe chronic hives, kidney disease, liver disease and thyroid disorders all significantly decrease the quality of life experienced by patients. Hence, these patients would welcome the opportunity to address them effectively if such an opportunity was afforded by the forms of treatment mentioned above.

Urticaria research has helped to demonstrate that autoimmune diseases, bacterial infections and viral infections have played a role in triggering some forms of hives. Research of this kind has made it clear that urticaria does not constitute a simple ailment: It can be a manifestation of dysfunction in the immune system, pushing it to respond to infection in an unusual manner or to attack the body’s own cells.

Research on some forms of hives has revealed an association between them and some autoimmune diseases. These autoimmune diseases include autoimmune thyroid disorders (like Hashimoto’s disease and Grave’s disease) and lupus. All of these autoimmune diseases have been shown to coincide with hives in a number of patients. In many cases, it has turned out that the coincidence of hives and autoimmune disease is statistically significant.

One study, involving a group of chronic hives patients and a healthy control group, showed that the patients with hives were more likely than the people in the control group to show positive results when tested for autoimmune thyroid disease. When these patients were treated for thyroid disease, their hives were eliminated. The results were shown to be statistically significant. Hence they provided some evidence for the claim that autoimmune disease played some role in triggering hives.

Urticaria Research Findings on Bacterial and Viral Infections

Hives research, highlighting the implication of bacterial infections in the development of hives has shown that, with the successful treatment of bacterial infections using antibiotics, associated hives cases have been completely resolved. Of course, not all cases of hives are triggered by bacterial infections. In fact, it is possible for one’s hives to coincide with an unrelated bacterial infection. So it is important to recognize that given research findings will apply in a specific set of circumstances, but not in others.

Among the bacterial infections that have been identified as hives triggers in the aforementioned research are a variety of dental, gastrointestinal and ear, nose and throat infections. These include Helicobacter pylori infections (which cause stomach ulcers) and yersiniosis. Tonsillitis, pharyngitis, otitis and sinusitis, which may be caused by bacteria like staphylococci and streptococci, are also included in this category.

Some urticaria research cases have linked the development of hives to viral infections. These have included cases of both acute and chronic hives, and the associated infections have typically affected the upper respiratory system, the ENT region and the digestive system. The infections in question have included the flu, adenoviruses and rhinoviruses. It is telling that, with the successful treatment of these viral infections, the associated hives attacks have been completely eliminated.

The causes of hives in women include the same factors that trigger hives in the general population, namely food, insect bites, toxins, infections, physical stimuli and others. However, it is also true that there is a higher incidence of chronic urticaria or hives among women than among men. Additionally, some situations that only women experience play a role in triggering hives among a number of them. Such situations include pregnancy, the use of contraceptives and menopause. In these three situations, the changes in the hormonal levels are considered causes of hives in women.

If a woman on contraceptives develops sensitivity to their constituent hormones or other components, she could respond by developing hives. Women experiencing menopause undergo a lot of physiological changes which, in turn, affect their psychological well-being. It is not unheard of for them to experience fluctuating hormonal levels and tremendous stress. Both of these factors are causes of hives in women: increased sensitivity to either estrogen or progesterone could result in hives as could the increased production of cortisol and adrenalin, two stress-associated hormones.

Pregnant women have also been known to develop hives. The drastic bodily changes that they experience, including hormonal fluctuations are causes of hives in women. Hives can occur at any stage during pregnancy. Their duration varies, ultimately depending on the presence of triggering factors. They may present on a pregnant woman’s face, back, breasts, abdomen, arms, or on the back of her legs. The symptoms tend to disappear completely within a few weeks of delivery.

Pregnant women who develop hives usually have no cause for worry. While the condition causes them a lot of discomfort, it is not a threat to their babies’ health. They are generally advised not to take medication like steroids unless their symptoms are severe. This is because such medication would affect their pregnancies. However, they can use various remedies to help relieve the discomfort.

What Causes Hives On Buttocks?

A condition known as Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP), which is similar to hives, commonly occurs during the last trimester of pregnancy. The hive-like rash of PUPPP tends to occur on the buttocks, thighs, arms and elsewhere on the woman’s body. It itches severely and is highly sensitive. A good part of the reason for this is the fast growth typical of pregnancy and the resultant stretching of the woman’s skin. Pregnant women who seek to understand what causes hives on buttocks are more likely than not to be suffering from PUPPP.

While there isn’t too much data on the clinical association of celiac disease and hives, at least one past study has shown a strong link between the two conditions. The study in question was conducted in Italy in 2005, and it involved the screening for celiac disease of 79 children who were known to have oral antihistamine-resistant chronic hives. The results were compared to those of 2545 healthy controls.

The outcome of the study was that celiac disease was diagnosed in 5% of the group that had chronic idiopathic hives, while only 0.67% of children in the control group were found to have celiac disease. The occurrence of celiac disease in the hives-stricken group was concluded to be significantly more frequent than the occurrence of celiac disease in the control group.

The children with both chronic hives and celiac disease were subsequently fed a gluten-free diet. After a period of 5 to 10 weeks, their chronic hives cleared completely. However, their celiac disease serological tests remained abnormal until they had been on the gluten-free diet for 5 to 9-month.

If once considers the results of the study meaningful, then it is apparent that, in this particular group of children, chronic hives were related to the mechanism by which allergic reactions to gluten were triggered. This is obviously not the case for all cases of chronic idiopathic hives, but it does suggest a possible line of investigation for medical researchers who want to understand hives better.

When the Association between Celiac Disease and Hives Is Not Statistically Significant

A second study to investigate the relationship between celiac disease and hives was also conducted in Italy. This time, the subjects were 80 adult patients with chronic idiopathic hives and a control group of 264 blood donors (none of whom had a history of chronic idiopathic hives). Out of the patients with idiopathic chronic hives, 1.25% tested positive for celiac disease.  Out of the control group, only 0.38% tested positive for celiac disease.

The association between celiac disease and hives (of the chronic, idiopathic variety) proved to be statistically insignificant. Hence, the researchers concluded that, as far as the population they tested was concerned, patients with chronic idiopathic hives were not more likely to have celiac disease than the hives-free general population.

The different conclusions suggested by the 2 studies make the case for devoting more time to studies on the clinical association between celiac disease and hives. It would especially make sense to conduct a comparative study of both child and adult populations using equally-sized control groups.

A number of infections have been known to trigger hives. Bacteria such as Helicobacter pylori and various other infections are included among them. Urticaria, bacteria and other infections are thus linked in a number of cases.

A number of studies have been done on hives patients suffering from stomach ulcers. In these cases, the stomach ulcers were attributable to infection with Helicobacter pylori. It emerged that, when these patients were successfully treated for the bacterial infection, they were cured of the stomach ulcers and there was also a quick resolution to their hives. Bacteria, more specifically Helicobacter pylori, were shown to be linked to the hives in these cases. It must be pointed out that many of these studies were not conclusive. However, they did indicate that the investigation of the connection between hives and various infections was worthy of further pursuit.

As the first paragraph above suggests, Helicobacter pylori is not the only bacterial infection that has been linked to hives. Others, like cystitis and tonsillitis have been linked to acute hives. As for chronic urticaria, bacteria and other infections in the gastrointestinal tract, the dental region, and the ear, nose and throat region have been linked to it.

Studies completed in the past have shown a connection between the eradication of such infections and the resolution of associated attacks of chronic urticaria. To give an example, yersiniosis is an urticaria-associated gastrointestinal infection whose treatment with antibiotics has brought about the resolution of hives. So are the pharyngitis, tonsillitis, otitis and sinusitis that result from streptococcal or staphylococcal infection. Often, testing for the relevant antibodies is done to show the presence of these infections. Their subsequent eradication using antibiotics confirms the connection between them and hives.

Increased Vulnerability to Hives: Bacteria and Other Infections

The exact mechanisms by which the infections outlined above trigger hives remain a mystery. However, there is evidence to suggest that gastrointestinal infections like Helicobacter pylori have the capacity to influence the development of disorders in other organ systems. Thus, the infections could understandably trigger the development of skin diseases and autoimmune diseases.

The relative ease with which hives have been resolved in the cases of infection described above is diametrically opposed to the complicated and often ineffective treatment of hives using such drugs as corticosteroids. The former treatment eliminates the apparent cause of the hives while the latter only addresses its symptoms. This comparison makes the case for testing for bacterial and other infection during the diagnosis of a given patient’s urticaria.

Hives can be triggered by a number of factors, including infections, physical stimuli, food and medication. In some cases it is appropriate to refer to hives as immune hives: Immune system changes make the body more prone to developing urticaria. Immune system disorders or diseases have also been implicated in triggering hives.

It is theorized that approximately half of all cases of chronic idiopathic hives are triggered by an overactive immune system. Hives of this kind are, thus, associated with immune system attacks on the body’s own cells. That the immune system is overactive can be confirmed by testing for autoantibodies. One might refer to the associated hives as autoimmune hives.  Some speculate that this form of hives is a primary autoimmune disorder all its own, distinct from those hives that are triggered by autoimmune diseases like thyroid disease and lupus.

That autoimmune hives have an immune system trigger is also supported by the additional symptoms or conditions that may be exhibited by the patient: vitiligo, swelling in the joints and specific abnormalities in the blood. Some might dismiss the existence of a connection between the hives and these other symptoms, describing it as nothing more than a coincidence. However, in doing so they would be dismissing the bigger picture: No organ or organ system functions in complete isolation from the others. Even if one were able to demonstrate that there was no direct link between the hives and the other autoimmune symptoms, there would likely be some indirect but significant connection.

Hives and Immune System Disorders

The relationship between hives and immune system dysfunction can be further investigated by devoting some attention to known autoimmune diseases and their association with urticaria. Immune system diseases such as Grave’s disease and Hashimoto’s disease were shown to be significantly associated with hives in at least one medical study: The patients had chronic hives and also tested positively for thyroid autoantibodies. The association between hives and the presence of thyroid autoantibodies was statistically significant, suggesting that autoimmune thyroid disease had played a role in triggering the hives.

Immune system diseases like multiple sclerosis and lupus have been linked to chronic hives as indicated earlier in this article. It is worth noting that chronic idiopathic hives have some striking parallels to a number of autoimmune diseases: A lot remains unknown about their causes and about the mechanisms by which they develop. In addition, the medications taken to treat them are geared more towards managing the symptoms than towards curing the condition.