| | | | Other Names | | | Urticaria, Hives, Angioedema.
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| | | Hives (urticaria) is an allergic reaction in the skin characterized by
white or pink welts or large bumps surrounded by redness. These welts are
known as wheal and flare lesions and are caused primarily by the release
of histamine (an allergy mediator) in the skin. About 50% of people with
chronic hives develop angioedema-a deeper, more serious form of hives
involving the tissue below the surface of the skin.
While the basic
cause of hives involves the release of histamine from white blood cells,
what actually triggers this release can be a variety of factors, such as
physical contact or pressure, heat (prickly heat rash), cold, water,
autoimmune reactions, infectious organisms (e.g., hepatitis B virus,
Candida albicans, and streptococcal bacteria), and allergies or
sensitivities to drugs (especially antibiotics and aspirin), foods, and
food additives.
What are the symptoms of hives? Symptoms
include an itchy skin rash with red bumps that can appear on the face,
trunk of the body, and, sometimes, on the scalp, hands, or feet.
Individual lesions usually last less than 24 hours and can change shape,
fade, and then rapidly reappear. People with hives may also have wheezing,
or swelling of the eyelids, lips, tongue, or
throat.
Conventional Treatment Options: Conventional
treatment includes medications, such as antihistamines (e.g., hydroxyzine
[Ataraxr], diphenhydramine [Benadrylr], astemizole [Hismanalr], doxepin
[Sinequanr, Adapinr], loratadine [Claritinr], cyproheptadine [Periactinr],
and cetirizine [Zyrtecr]), to relieve the rash and itching. In serious
cases, doctors may also prescribe cortisone-like drugs (e.g., prednisone
[Deltasoner, Orasoner, and Meticortenr]).
Dietary changes that
may be helpful: Allergy to foods and food additives is a common cause
of hives, especially in chronic cases.1 The foods most often reported to
trigger hives are dairy products, eggs, chicken, cured meat, alcoholic
beverages, chocolate, citrus fruits, shellfish, and nuts.2 3 4 Food
additives that have been shown to trigger hives include colorants (azo
dyes), flavorings (salicylates), artificial sweeteners (aspartame),
preservatives (benzoates, nitrites, sorbic acid), antioxidants
(hydroxytoluene, sulfite, gallate), and emulsifiers/stabilizers
(polysorbates, vegetable gums).5 6 7 Numerous clinical studies demonstrate
that diets that are free of foods or food additives that commonly trigger
allergic reactions typically produce significant reductions in symptoms in
50-75% of people with chronic hives.8 9 10 11 People with hives not
clearly linked to a known cause should discuss the possibility of food
allergies with a doctor.
Nutritional supplements that may be
helpful: In theory, high amounts of vitamin C might help people with
hives by lowering histamine levels.12 Amounts of at least 2,000 mg daily
appear necessary to produce these effects.13 No research trials have yet
explored the clinical effects of vitamin C supplementation in people with
hives.
Vitamin B12 has been reported to reduce the severity of
acute hives as well as to reduce the frequency and severity of outbreaks
in chronic cases.14 15 The amount used in these reported case studies was
1,000 mcg by injection per week. Whether taking B12 supplements orally
would have these effects remains unknown. On rare occasions, vitamin B12
injections cause hives in susceptible people.16 Whether such reactions are
actually triggered by exposure to large amounts of vitamin B12 or to
preservatives and other substances found in most vitamin B12 injections
remains unclear.
According to preliminary studies from many years
ago, lack of hydrochloric acid (HCl) secretion by the stomach was
associated with chronic hives, presumably as a result of increasing the
likelihood of developing food allergies. In one such study, 31% were
diagnosed as having achlorhydria (no gastric acid output), and 53% were
shown to be hypochlorhydric (having low gastric acid output).17 In a
related study, treatment with an HCl supplement and a vitamin B-complex
supplement helped to treat people with hives.18 Betaine HCl is the most
common hydrochloric acid-containing supplement; it comes in tablets or
capsules measured in grains or milligrams. One or more tablets or
capsules, each containing 5-10 grains (325-650 mg) are typically taken
with a meal that contains protein. Diagnosis of a deficiency of HCl and
supplementation with HCl should be supervised by a doctor.
Are
there any side effects or interactions? Refer to the individual
supplement for information about any side effects or
interactions.
Herbs that may be helpful: Two components of
green tea, the polyphenols epigallocatechin (EGC) and epicatechin gallate
(ECG),19 are reported to have an antihistamine effect. Some doctors
recommend approximately 3 cups of green tea per day or about 3 grams of
soluble components providing roughly 240 to 320 mg of polyphenols,
although no human trials have studied the effects of green tea in people
with hives.
Other integrative approaches that may be
helpful: Psychological stress is often reported as a triggering factor
in people with chronic hives.20 Stress may play an important role by
decreasing the effectiveness of immune system mechanisms that would
otherwise block allergic reactions. In a small preliminary trial of people
with chronic hives, relaxation therapy and hypnosis were shown to provide
significant benefit.21 People were given an audio tape and asked to use
the relaxation techniques described on the tape at home. At a follow-up
examination 5 to 14 months after the initial session, six people were free
of hives and an additional seven reported
improvement.
References:
1. Henz BM, Zuberbier T.
Most chronic urticaria is food-dependent, not idiopathic. Exp Dermatol
1998;7:139-42. [review].
2. Winkelmann RK. Food sensitivity and
urticaria or vasculitis. In: Brostoff J, Challacombe SJ (eds.) Food
Allergy and Intolerance. Philadelphia: WB Saunders, 1987, 602-17.
[review].
3. Wraith DG, Merrett J, Roth A, et al. Recognition of
food allergic patients and their allergens by the RAST technique and
clinical investigation. Clin Allergy 1975;9:25-36.
4. Lewis-Jones
MS, Barnes RMR, Macfarlane AW, et al. Frequency and isotype distribution
of serum antibodies reactive with dietary proteins in adults with chronic
urticaria. Clin Exp Dermatol 1987;12:419-23.
5. Lessof MH.
Reactions to food additives. Clin Exp Allergy 1995;25 Suppl 1:27-8.
[review].
6. Juhlin L. Additives and chronic urticaria. Ann Allergy
1987;59:119-23. [review].
7. Kulczycki A Jr. Aspartame-induced
urticaria. Ann Int Med 1986;104:207-8.
8. Zuberbier T,
Chantraine-Hess S, Hartmann K, et al. Pseudoallergen-free diet in the
treatment of chronic urticaria. ACTA Dermatologica Venerol (Stockh)
1995;75:484-7.
9. Henz BM, Zuberbier T. Most chronic urticaria is
food-dependent, not idiopathic. Exp Dermatol 1998;7:139-42.
[review].
10. Verschave A, Stevens E, Degreef H. Pseudo-allergen
free diet in chronic urticaria. Dermatologica 1983;167:256-9.
11.
Gibson A, Clancy R. Management of chronic idiopathic urticaria by the
identification and exclusion of dietary factors. Clin Allergy
1980;10:699-704.
12. Johnston S, Martin LJ, Cai X. Antihistamine
effect of supplemental ascorbic acid and neutrophil chemotaxis. J Am Coll
Nutr 1992;11:172-6.
13. Johnston S, Martin LJ, Cai X. Antihistamine
effect of supplemental ascorbic acid and neutrophil chemotaxis. J Am Coll
Nutr 1992;11:172-6.
14. Simon SW. Vitamin B12 therapy in allergy
and chronic dermatoses. J Allergy 1951;22:183-5.
15. Simon SW,
Edmonds P. Cyanocobalamin (B12): comparison of aqueous and repository
preparations in urticaria; possible mode of action. J Am Geriatr Soc
1964;12:79-85.
16. Meyer de Schmid JJ, Zeller J. Urticaria due to
vitamin B 12 allergy verified by the lymphoblastic transformation test.
Bull Soc Fr Dermatol Syphiligr 1969;76:670-1 [in French].
17. Rawls
WB, Ancona VC. Chronic urticaria associated with hypochlorhydria or
achlorhydria. Rev Gastroenterol 1951;18:267-71.
18. Allison JR. The
relation of hydrochloric acid and vitamin B complex deficiency in certain
skin diseases. South Med J 1945;38:235-41.
19. Matsuo N, Yamada K,
Shoji K, et al. Effect of tea polyphenols on histamine release from rat
basophilic leukemia (RBL-2H3) cells: the structure-inhibitory activity
relationship. Allergy 1997;52:58-64.
20. Green G, Koelsche G,
Kierland R. Etiology and pathogenesis of chronic urticaria. Ann Allergy
1065;23:30-6. [review].
21. Shertzer CL, Lookingbill DP. Effects of
relaxation therapy and hypnotizability in chronic urticaria. Arch Dermatol
1987;123:913-6.
Source: NOW Foods
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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Urticaria (Hives) - Health - Calendula + First-Aid Cream
1.80 oz / 51 g
10.32 US
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