The article that follows was printed in the "Today's Therapist" magazine and was written by Dr Martin Schiele, a Biomedical Research Scientist by profession.
Dr Schiele recommends using products that have been developed using only natural ingredients of the highest quality. The natural products do not include any STEROIDS, HORMONES, CORTISONES, PEROXIDES, ALCOHOL, PARABENS and ANTIBIOTICS
What is urticaria?
Urticaria appears as raised flesh-coloured or whitish bumps, welts on the skin, sometimes surrounded by a red blotch and occurs anywhere on the body, but most often on the trunk, arms and legs.
Urticaria usually strikes suddenly and often comes and goes. This common disorder can affect 15-25% of the population at some time. It is a baffling disorder and the cause is often obscure. Urticaria is seldom serious, but it can be very frustrating.
It is commonly known as hives or nettle rash and is one of the most common dermatological conditions seen by allergists. However urticaria is not just an allergic disease. It can be caused by metabolic disease, medications, infectious diseases, autoimmune disease, or physical sensitivity and is often accompanied by severe itching, sometimes painful or burning, and swelling (angioedema) of the skin.
Acute urticaria lasts less than 4-6 weeks and the chronic form lasts more than 4-6 weeks. Incidence rates for acute urticaria are similar for men and women; chronic urticaria occurs more frequently in women. Urticaria can occur in any age group, although chronic urticaria is more common in people in their 40’s and 50’s.
Causes
Finding the causes often requires considerable “detective work” and patience. Detailed history, skin testing and environmental control are some of the tools used to identify the cause.
Trigger factors are:
For non-allergic reactions –
Physical factors such as sustained pressure on the skin (belts,
shoulders straps etc), stress, sunlight, exercise, heat, cold, sudden increase in body temperature (fever, hot bath or shower), irritating chemicals, soaps, cosmetics etc.
Non-allergic urticaria are mainly those types where a clear-cut allergic basis cannot be proven and the trigger for the problem can’t be found; in this instance it is called Idiopathic Urticaria.
However, some cases of non-allergic urticaria maybe caused by a reaction to aspirin and possibly, certain food dyes, sulfides and other food additives.
For allergic reactions-
Symptoms of a systemic (whole-body) reaction to something that was:
Inhaled – mold, animal dander, pollens etc.
Ingested – foods, fish and shellfish, food additives, legumes, tree nuts, peanuts, dairy products, medication such as aspirin or penicillin etc.
Injected – insect stings or bites, bee or wasp stings, injected medication etc.
Contacted – any substance which the body regards as an allergen, which has penetrated the skin, for example certain latex proteins, plant juices etc.
Allergic urticaria is less common than the non-allergic urticaria, although it is somewhat more common in children than in adults. It is caused by the immune system’s overreaction to certain substances, which the body regards as allergens. In this case functional autoantibodies react with IgE receptors on the mast cells which induce the release of histamine (IgE – mediated allergies).
Urticaria and Angioedema
Urticaria maybe associated with swelling reactions (Angioedema). This happens when chemicals (histamine is the primary culprit) are released into the blood stream, the blood vessels swell and leak fluid into the skin and underlying tissues. Angioedema is a deep, subcutaneous swelling usually in the area of the face or mucous membranes involving the lips or tongue. If angioedema involves the upper respiratory tract, life-threatening obstruction of the laryngeal airway may occur. In very rare cases this could also develop further into an anaphylactic shock.
Urticaria with angioedema is thought to affect 20% of the population at some time during their lifetime and is more common in women, while angioedema alone, in the absence of urticaria, is more common in men.
Urticaria with angioedema can be due to definable IgE mechanism as is the case with all allergies, but it also can be due to additives found in food, or food itself or drugs.
Urticaria associated with other medical conditions
- Thyroiditis (Hashimoto’s disease)
- Chronic tinea pedis
- Collagen vascular disease (e.g systemic lupus erythematosus, LE)
- Pruritic urticarial papules and plaques of pregnancy (PUPPP)
- Complement deficiency
- Viral infections (including hepatitis B and C)
- Allergic drug eruptions
- Serum sickness
- Protozoan (parasitic-, bacterial infections)
Diagnosis and Treatment
If the cause can be identified, the best course of treatment is avoidance of the substance that triggers urticaria but this is very often not immediately possible. Therefore information regarding the history of previous urticaria attacks and duration is very useful, in particular the past cause and effective treatment, identification of previous precipitants (triggers), and any known other medical conditions that can cause and are associated with urticaria.
Next investigate for possible precipitants and initial workup factors, in particular;
Any recent illness (headache, cough, sore throat, vomiting, fever, diarrhoea)
Consumption of any new foods (nuts, berries, shellfish, cheese, eggs and chocolate etc)
Use of any new perfumes, creams, make-ups, lotions, nail-polish, detergents, clothes.
Come in contact with new pets (dander), chemicals, plants, molds, dust, jewellery, and rubber including latex.
Present use of any medication (penicillin, anaesthetics, bromides, ACE inhibitors, diuretics, sulfas etc)
Exposure to extreme temperatures (sun, water)
Regular exercise, travel
Recent emotional or physical stress
For the relief of uncomplicated attacks of urticaria a general moisturising lotion, and or non-prescription antihistamine medication is recommended. It is important to stop the itching which leads to scratching as this can stimulate more urticaria and itching.
Treatment of chronic urticaria-angioedema is more difficult also because symptoms can persist for longer durations.....
For further free information on the treatment of urticaria, the therapeutic agents commonly in use and their possible side effects read more in the consultation room...