URTICARIA

Urticaria Treatment in Gurgaon

Urticaria is a relatively common heterogeneous skin disorder that may be acute or chronic. It is difficult to determine, especially when it becomes chronic. We, Estique Clinic, have the best dermatologists in Gurgaon who can give the best treatments for Urticaria

There are two types of Urticaria to classify such as:

A. Spontaneous Urticaria - It is the most common type of urticaria The symptoms and the signs of illness will be visible such as wheals, angioedema, and itchiness. According to the duration, spontaneous urticaria classified into two types such as: –

  1. Acute Spontaneous urticaria – It is characterized by spontaneously according wheals for at less than 6 weeks.
  2. Chronic urticaria – It is characterized by spontaneously occurring wheals and itchiness for at least 2 days per week for a period of 6 weeks or more.

B. Inducible urticaria – It is also known as chronic physical urticaria which occur when triggered by specific physical stimuli.

Symptoms of Urticaria

The main symptom of urticaria (hives) is the appearance of itchy welts on the skin. These welts can have various characteristics, including:

  • Raised, itchy bumps: These bumps can vary in size, ranging from a small pinhead to several inches across.
  • Red or skin-coloured:The welts may appear red, especially on lighter skin tones, or they can be the same colour as your skin.
  • Blanching: Pressing on the center of a red welt will often cause it to turn white (blanch).
  • Changing shape and disappearing: Unlike bug bites, hives tend to change shape, move around, and disappear and reappear over short periods of time, often within minutes or hours. Individual welts typically don't last more than 24 hours.

Pruritus(Itching) is the most predominate symptom. Other characteristic signs include wheals and flares that vary in size, with individual wheals usually resolving within 24 hours without residual hyperpigmentation.

Pathogenesis: Acute or chronic urticaria may occur as a result of mast cell and basophil release of bioactive mediators, such as histamine and leukotrienes, after activation of either the innate or adaptive immune system.

Therefore, activation of mast cells by particular IgE, IgG or IgM antibody results urticaria activates the classical complement pathway. Other mediators (neuropeptides such as substance P, calcitonin gene-related peptide and neurokinin A) and medications such as opiates can also activate mast cells or basophils through specific receptors and for cyclooxygenase inhibitors (i.e., ASA, NSAIDS) to induce hives through non-IgE mediated pathways.

Treatment lies in removing the source of allergy. Since common causes of acute urticaria include infection and food allergy, investigation for these underlying causes should be guided by the history and physical examination. Detailed evaluation needs to be done for patients with chronic urticaria.

Antihistamines form the baseline for management. Newer treatment options include the usage of Oma-li-zu-mab.

URTICARIA TREATMENTS

Urticaria is an autoimmune disease. In response to certain antigens (intruders) there is mast cell degranulation. These mast cells on activation release histamine and they also encourage other cells to get activated. Histamine production leads to hives formation.

Urticaria can be either acute or chronic. In acute urticaria there are spontaneously occurring hives for duration less than six weeks whereas in chronic urticaria they persist beyond six weeks.

  • Food sources like: nuts, soy, dairy, fish, eggs, tomatoes, certain food additives.
  • Stress – if you are continuously stressing about hives your body will release histamine and in return you may get more hives.
  • Certain medications like NSAIDS ( aspirin and ibuprofen), ACE inhibitors can cause hives.
  • Infections, recent surgeries can also cause urticaria
  • Presence of any other autoimmune conditions like thyroid.

Treatment lies in removing the source of allergy. Causes of chronic urticaria are usually more difficult to find than acute urticaria. Detailed evaluation and investigations can help in figuring out the source of allergy.
Best treatment is removal of the trigger. Anti histamines form the backbone of treatment for hives. Other advanced options includes biologicals.

  • Batches of red or skin-colored welts (wheals), which can appear anywhere on the body
  • Welts that vary in size, change shape, and appear and fade repeatedly as the reaction runs its course
  • Itching, which may be severe
  • Painful swelling (angioedema) of the lips, eyelids and inside the throat

Less commonly, urticaria may precede a severe allergic rection known as anaphylaxis. In anaphylaxis, there are hives and angioedema, difficulty in breathing, lightheadedness, rapid or irregular heartbeat, stomach cramps, nausea, vomiting, diarrhea.

If left untreated, anaphylaxis can lead to shock, coma, cardiac or respiratory failure, asphyxiation and death.

Fish, eggs, dairy, nuts, soy, shellfish, wheat, tomatoes, berries are certain foods that can trigger hives.
At night, there is increase in the production of cytokines which increases inflammation whereas production of corticosteroids which reduce inflammation is decreased. Also, at night we tend to focus more on itchy skin as there are fewer distractions than during the day. The body temperature as well as blood flow increases at night warming your body. Rise in skin temperature can make you feel itchy.
Keep a record of events that happen just before development of hives. This way you will be able to note your triggers. Staying away from these triggers in the future will prevent the development of hives. Read the labels of foods and medicines carefully.

DR NEHA SHARMA

Medical and Cosmetic Dermatologist and well renowned as the Best Dermatologist in Gurgaon, has formerly practised in prestigious Hospitals such as VMMC & Safdarjung Hospital (New Delhi) and All India Institute of Medical Sciences (AIIMS, New Delhi). She has done teo superspecializtions - Fellowship in LASERS and Dermatology from National Skin Centre , Singapore and Fellowship in Aesthetic Dermatology from Bangkok. She has a total experience of 14 years and has treated over 20000 patients.
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