Jonathan W. Buttram, board certified allergist and immunologist at UT Health Northeast, leads the Dec. 1 Walk With a Doc. He will discuss hives. 

Walk With a Doc, a project of the Smith County Medical Society, begins with registration at 5:45 p.m. at Tyler Junior College's Pat Hartley Field. The presentation begins at 6 p.m., followed by walking.

For more information on Walk With a Doc, call the Smith County Medical Society office at 903-593-7058 or visit

Q. What is urticaria?

A. Urticaria is another term for hives. An episode of hives usually begins with itching and then progresses to raised, red, itchy areas on the skin that may come and go for a few minutes to a few hours. When the hives go away, the skin may continue to be red for a few hours but will shortly go back to normal.

Q. What are the types of urticaria?

A. Hives are usually defined by their time, course and cause. Acute (short-lived) urticaria episodes occur over six weeks or less. These are most often caused by infections (such as the common cold, strep throat, or mononucleosis), medications (most commonly non-steroidal anti-inflammatory drugs like ibuprofen and pain killers containing codeine or codeine-like drugs), foods or insect stings. When urticaria are caused by foods, medications or insect stings they generally occur within minutes of the exposure and last less than 24 hours.

Chronic (long lasting) urticaria episodes last for more than six weeks. Most chronic cases of hives do not have an easily identified cause but may be related to some chronic illnesses like rheumatoid arthritis and diabetes. Some cases of chronic hives involve "physical urticarias" which are caused by exposure to scratching or rubbing, heat, cold, pressure, or sunlight. These are also forms of pressure and vibrational angioedema.

Q. Can it be life threatening?

A. Acute and chronic urticaria are not life-threatening. The angioedema, swelling of the deeper layers of skin, that is often associated with urticaria can rarely cause asphyxiation due to airway swelling.

Q. How is urticaria treated?

A. Hives and angioedema result from the release of histamine from the mast cells in the skin. Once histamine is released and binds to the histamine receptors, itching, redness, and swelling will usually persist for 30 minutes to a few hours. Thus, prevention of histamine release and blocking histamine receptors are the mainstay of treatment.

Avoid the followng triggers: • If your hives are thought to be caused by exposure to specific foods, medications or insect stings, strict avoidance to these exposures is always the best and safest course of treatment.• Physical urticarias are best treated by avoiding the specific physical stimulus that causes the hives or angioedema.• Other triggers are common to all causes of urticaria and should be approached cautiously, especially if the hives have already appeared or have been appearing on a regular basis:* Hot water* Excessive rubbing or scratching* NSAIDs (like ibuprofen, aspirin, naproxen, etc…)* Narcotics (like codeine or other similar pain-killers)

Q. Who is at risk?

A. Everyone is at risk for urticaria and angioedema, although some forms may be seen more commonly in families. Acute urticaria affects approximately 20 percent of the population once in their lifetime. Chronic urticaria affects approximately 1 percent of the population

Q. Can you prevent it?

A. There is no way to prevent the onset of urticaria, but you can prevent and manage the symptoms once you have it.


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