About urticaria and/or angioedema

Urticaria, more commonly known as hives, is a condition characterised by the appearance of red, raised welts on the surface of the skin that are typically very itchy and uncomfortable. The welts often appear in clusters that migrate or ‘move’ around the body over the course of hours to days.

Angioedema, a medical term for swelling, is a condition whereby fluid accumulates under deeper layers of the skin causing prominent swelling or protrusion. This is often seen in areas where the skin is loose or supple, such as around the eyes, the lips, the groin, and extremities.

Urticaria and angioedema can occur at the same time or independently of one another, both resulting from the release of histamine and other chemicals by specialised immune cells (mast cells) within the skin. These chemicals cause the skin to feel itchy, hives to form, and small capillaries to leak fluid leading to areas of localised swelling.

These conditions are common, particularly in children, and may be acute (single or several short-lived episodes) or chronic (frequent symptoms lasting for 6 or more weeks). Although urticaria and angioedema are commonly seen in allergic reactions to foods, medications, or insect stings; they also occur frequently in the context of an acute or recent infective illness as well as appearing completely randomly with no apparent or identifiable cause. The latter is referred to as spontaneous or idiopathic urticaria and/or angioedema.

Urticaria and/or angioedema treatment

Whilst rarely life threatening, this condition can be extremely bothersome, impacting upon one’s ability to sleep and function well in everyday activities. Treatment with non-sedating antihistamines is effective at establishing control in most paediatric patients, although sometimes additional medications are necessary for more severe cases, such as those with Chronic Spontaneous Urticaria or CSU. These may include different medications that block histamine or stabilise mast cells and, in the most troublesome cases, an injectable medication called omalizumab (also known as Xolair- as discussed under “Biologics” in the treatment section of the website).