Acute urticaria, often called hives, is one of the most common skin reactions seen in allergy clinics. It appears suddenly as raised, itchy welts that may last a few hours to several weeks. In some cases, swelling beneath the skin called angioedema occurs, which can cause discomfort or, rarely, affect breathing. Understanding acute urticaria, its causes, and treatment options is important for finding relief and preventing future flare-ups.
What is Acute Urticaria?
Acute urticaria is defined as hives that last less than six weeks. These hives can appear anywhere on the body and often move around, fading in one spot while appearing in another. Acute urticaria usually develops quickly after exposure to a trigger and is more common than chronic urticaria, which lasts longer.
Patients with acute urticaria often describe intense itching, redness, or burning sensations. Acute urticaria in adults and children is common, and most cases resolve without long-term complications. However, episodes of urticaria can be disruptive and uncomfortable.
What Causes Acute Urticaria?
The cause of acute urticaria is generally linked to an immune system reaction. Common causes include:
- Food allergens (such as nuts, shellfish, or eggs)
- Medications, especially nonsteroidal anti-inflammatory drugs
- Insect bites or stings
- Viral or bacterial infections
- Environmental triggers like pollen or cold temperatures
In some cases, the underlying cause of acute urticaria cannot be identified. These are considered idiopathic urticaria. Cases of acute urticaria triggered by infections are especially common in children.
Sometimes acute urticaria can be the beginning of chronic urticaria prior to reaching the 6 week mark.
Acute Urticaria and Angioedema
Hives and angioedema often occur together. While a hive appears on the skin surface, angioedema affects deeper layers of the skin, causing swelling in the lips, eyelids, or throat. Angioedema may be mild and resolve with the hives, but in rare situations it can interfere with breathing and require emergency treatment. Patients with hereditary angioedema have similar symptoms, but their condition is genetic and managed differently.
How is Acute Urticaria Diagnosed?
Urticaria diagnosed in a clinical setting often relies on medical history and physical exam. Allergy testing may be recommended to identify triggers. Patients with acute urticaria usually do not need extensive workups unless symptoms are severe or persistent.
Doctors consider the onset of symptoms, potential triggers, and whether angioedema or systemic symptoms are present. This helps distinguish acute cases from chronic urticaria and guides treatment.
Treatment for Acute Urticaria
The treatment of acute urticaria typically focuses on relieving itching and reducing inflammation. First-line therapy usually includes antihistamines. In severe acute cases, short courses of corticosteroids may be prescribed.
Key steps in the management of acute urticaria include:
- Identifying and avoiding known triggers
- Using non-sedating antihistamines
- Treating associated angioedema if present
- Seeking emergency care if hives or swelling affect breathing (urticaria and anaphylaxis)
Most patients with acute urticaria experience resolution of symptoms within days to weeks. Treatment of patients with recurrent or severe hives may require follow-up with an allergy specialist.
When to See a Specialist
While acute urticaria is typically short-lived, recurring episodes or cases that occur with angioedema should be evaluated by an allergy expert. At NY Allergy & Sinus Centers, our allergists specialize in the diagnosis and treatment of urticaria, including acute or chronic forms.
Call us today at 212-686-6321 to schedule an appointment and get personalized care for your hives and angioedema.
