Sunday 13 July 2014

Urticaria

An Overview
Urticaria (also known as hives) is a rash that is primarily a manifestation of an allergic reaction on the skin. One of commonest reasons for Urticaria is exposure to allergens. Peculiarly seen as clusters of raised, red wheals of varying sizes on the skin, this condition lasts for some time and then disappears without any trace. The condition is not life-threatening; however Angioedema is a severe variant and this condition may endanger life if not attended to promptly.
In a study involving natural treatment of 60 Japanese patients with chronic skin diseases (including Urticaria), the holistic approach used in natural ingredients was concluded as a useful strategy. Natural treatment can indeed be effectively used to treat Urticaria which otherwise tends to be a very elusive disease, especially in chronic cases. At Hashmi Dawakhana, we have the proficiency and experience in treating this disease successfully for more than 35 years now. Go ahead and experience an Urticaria-free life!

What is Urticaria?
Urticaria (hives) is basically an allergic skin rash that 15% of the world population will have experienced at some point in their lives. In most cases, the hives go away within a few weeks or less; however sometimes they may turn into a chronic problem. And a whopping 80% of the chronic cases are idiopathic, which means that no cause can be found.

The typical description of Urticaria is an itchy skin eruption that is characterized by 'wheals'. The wheals usually have with well-defined red margins and pale interiors. As discussed earlier, Urticaria is a manifestation of an allergic reaction and the eruptions tend to come and go intermittently. The wheals can last for several hours or even the whole day before fading off. When the wheals disappear, they do so without any trace.
Urticaria rashes can occur anywhere on the body such as the trunk, arms, legs, face, etc. They have a tendency to change locations - disappearing from one place and reappearing in another often in a matter of hours. A severe variant of Urticaria, called Angioedema is marked by swelling that occurs beneath the skin (at a deeper level) and this can be life-threatening.
The cases may be acute in nature (lasting less than 6 weeks) or may run a chronic course (for more than 6 weeks). In either case, treatment must be sought early on, so as to treat it effectively in the early stages itself.

Causes
The primary mechanism that leads to development of an urticarial rash is the release of histamine (a chemical) by the human immune system into the blood. In response to histamine, blood plasma leaks out of small blood vessels in the skin resulting in swelling.
A large number of things can trigger the onset of Urticaria and some of them have been discussed here:
•    Allergens: A number of food allergens, environmental allergens, etc. can trigger Urticaria; however reactions may vary in different individuals
o    Foods: Some of the common culprits are fish, crabs, oysters, shell fish, prawns, milk, cheese, eggs, nuts, chocolates, citrus fruits, spices, yeast, food additives and preservatives like tartazine, berries, wheat, tomatoes, pineapple, strawberries, alcohol, etc.
o    Environmental: Pollen, dander, fungi, house-dust are few of the common reasons
•    Drugs: A number of drugs can trigger an Urticaria rash and these include morphine, codeine, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen), certain antibiotics, vaccinations, contraceptive pills, etc.
•    Stings of insects such as bee stings commonly cause acute urticarial rashes
•    Infections: Parasitic worm infestations such as round worms, tapeworms, etc; bacterial infections, etc can also cause Urticaria
•    Cold Urticaria is one variant that results from exposure to extremely cold climates 
•    Solar Urticaria - results from exposure to sun
•    Pressure on the skin such as that caused by tight clothes may lead to pressure Urticaria
•    Physical exertion, exercise, hot shower, perspiration may trigger Cholinergic Urticaria
•    Direct physical stimulation of the skin by vibrations, firmly stroking or scratching the skin, etc.
•    Abnormal functioning of the immune system (auto-immunity) - has been considered to be a trigger for chronic Urticaria. Other auto-immune systemic illness such as thyroid disorders, systemic lupus erythematosus, etc. may be linked to Urticaria
•    Idiopathic - In about 80% of chronic Urticaria cases, the cause is unknown

Symptoms
A red, raised, itchy rash that comes suddenly, lasts for some time and then disappears without any trace is the typical history any patient of Urticaria will provide. The rashes may come and go with no apparent trigger at times. They can occur anywhere on the body and have the following features:
•    Irregular shaped, red, raised rashes - small or large in size
•    The rashes may have a central clearing
•    Intensely itchy - may lead to disturbance at work, sleeplessness, irritability, restlessness, impatience, etc.
•    Burning or stinging pain in the areas of affection
•    May be surrounded by a red flare
•    Lasting from few hours to the whole day
•    The frequency of the rashes is also not fixed - some people experience it once in a while whereas others may get rashes several times daily
Some of the variants of Urticaria that differ in presentation are discussed here:
•    Cholinergic: triggered by physical exertion or a hot bath or shower, this is marked by hundreds of small itchy bumps. These occur quickly and disappear in the same manner. Cholinergic Urticaria is seen more often in young people.
•    Dermographism:  This literally means 'skin writing'. The hives in this case are produced by direct physical stimulation of the skin such as stroking with a blunt object.
•    Angioedema: This is a severe variant also known as 'Giant Urticaria'. Large areas of affection are seen and swelling occurs around the eyes, lips, hands, feet, genitalia and inside the throat. When the wind-pipe in involved due to swelling in the throat, it can obstruct breathing and this is a medical emergency (Anaphylactic shock)
Symptoms to watch out for (report to your physician immediately if you experience any of these)
•    Difficulty in breathing
•    Dizziness
•    Tightness in chest, wheezing
•    Swelling of the lips, tongue, face

Diagnosis
Your medical history and a thorough examination by your physician are usually sufficient to diagnose Urticaria and no tests are usually required for this. However, to detect the cause of your Urticaria, your physician may ask you to get certain tests done such as:
•    Allergy tests: To check if the Urticaria is related to specific allergic triggers
•    Blood tests: Tests to rule out thyroid disease, other auto-immune diseases, etc.
You can help your physician in effective diagnosis and treatment by keeping a diary to track activities, drugs, foods, etc. that trigger your Urticaria.

Natural Treatment
In a study conducted on 60 Japanese patients with chronic skin diseases (including Urticaria as well as psoriasis vulgaris, eczema, atopic dermatitis, severe acne), the holistic approach used in natural ingredients was found to be a useful strategy.
A total of 88.3% of patients reported over 50% improvement in this study. The results were based on patient-reported and clinically observed effects of the individualized natural treatment. It was concluded that individualized natural treatment can provoke a good response in patients with chronic skin disease.
Apart from this study, a number of cases that have seen excellent relief with natural ingredients also provide clear evidence that natural treatment works effectively in allergic diseases like Urticaria.
At Hashmi Dawakhana we have treated thousand of cases of Urticaria and provided relief to a large number of suffering patients. We have helped many of them to get rid of their dependence on anti-histamines and steroids which provide only temporary relief.
The treatment for Urticaria may vary from cases to case - some requiring short-term whereas others requiring long term treatment. The duration of treatment depends on various factors such as the severity, duration and extent of the illness, nature of treatment taken for the same and general health of the patient. Some forms are obstinate and need more patience on part of the patient. Over a period of time, we can taper and even stop the conventional medications being taken by the patient.
Natural ingredients also help to deal effectively with the psychological aspects of this illness such as depression, irritability, aggressiveness, etc. Overall, patients report significant change in their physical and mental health with continued treatment. And not to mention that the treatment is without any side-effects whatsoever! Natural treatment is definitely suggested in all cases and forms of Urticaria.

Self Care Tips
Our experience and expertise of treating a large number of cases has helped us devise effective tips that can be very fruitful to our patients of Urticaria. Some of these are discussed here:
•    For relief from the burning and itching, apply cool compresses or wet cloths over the affected areas
•    Stay in cool (not very cold) environment as far as possible
•    Wear cotton garments and preferable loose-fitting ones
•    Avoid known triggers such as foods or food additives, alcohol, medications, temperature extremes, stress, etc. that can trigger an attack
•    Keep a diary of your activities to help your doctor identify triggers
•    Avoid foods that contain high levels of histamine naturally such as eggplant and spinach. Food additives such as azo dyes, preservatives, etc. also mediate the release of histamine.
Report to your physician immediately if you experience any of these symptoms which may be signs of an impending Angioedema:
•    Difficulty in breathing
•    Dizziness
•    Tightness in chest, wheezing
•    Swelling of the lips, tongue, face

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