The most characteristic symptom of urticaria is the wheal-like raised red-colored rash which can be very itchy. They can be of any size from a few millimeters to a large patch. Individual wheals fade – sometimes after hours and sometimes after days, without leaving any residue. Rash appears on trunks, arms, legs – areas generally covered.
Rashes have defined looking edges, may change in size; can be linear, circular or quite irregular shapes. They may join up to form a larger patch of raised but flat-looking rash. When the central area of the rash is pressed, it will turn white – called blanching. Wheals come as batches of rashes. As they resolve, new ones get formed. An urticaria attack lasts for a few days at best. They can be intensely itchy and even light scratching will make the skin turn red – called dermographism.
The most common variety, manifests as
- Rash, temporary in nature.
- Sudden appearance of rashes.
- May be quite severe within 8-12 hours.
- Resolve within 24 to 48 hours – mostly within 24 hours.
Not very predictable, recurrent manifestation of rash
- More lasting in nature.
- Present for 6-12 weeks, sometimes more.
- Symptoms get worse in the evenings.
- Interferes with sleep.
- May get better gradually.
- Sometimes remission occurs and rash disappears altogether.
- Occasionally stays for year-round.
Occurs when skin is directly affected by triggers
- Appears at the place of contact or stimulation by triggers.
- Rash appears within an hour of trigger exposure, almost instantly.
- Dermographism may be present.
Urticaria vasculitis –
Less common – where blood vessels in the skin become inflamed
- Wheals last for more than 24 hours.
- Can be more painful.
- Often there is a bruise left behind.
- Must seek specialty consult.
You will get rashes due to same triggers, mostly at the same locations.
Checking for systemic symptoms
- Edema of lips, larynx and tongue.
- Joint pain.
- Weight changes.
- Bone pain.
- Sore throat, cough, runny nose.
Seeking medical advice
If you have a sudden onset of urticaria and your symptoms last for longer than 24 hours, you should see your GP. When symptoms are severe, interfere with activities of daily living and cause problem, you must seek medical care immediately.
- Indian Journal of Dermatology, Venereology & Leprology – Chronic urticaria in patients with autoimmune thyroiditis: Significance of severity of thyroid gland inflammation view
- American Association of Dermatology – Hives: Signs and Symptoms view
- Emedicine Health – Hives and Angioedeme view
- WebMD – Hives and Urticaria view
- British Association of Dermatologists – Urticaria and Angioedema view
- University of Maryland Medical Center – Urticaria view