Urticaria, commonly known as hives, are extremely itchy, raised, red, rashes on the skin.  They can affect up to one-quarter of the population over their lifetime. Hives can come on without any warning and can occur at any age.  

Angioedema is a swelling that occurs in the subcutaneous tissue of the skin. An important distinction for diagnosis is whether it occurs with or without hives.  Some of the most frequently affected areas are the face, throat, hands, and feet.

A genetic disorder that causes angioedema without hives is called Hereditary angioedema.  In this case, patients do not improve with antihistamines or steroids.

Hives and angioedema can be incredibly frustrating because it is often difficult to identify a cause.  In most cases, there is no identifiable allergy. Proper diagnosis and treatment should be discussed with your allergist.    

Treatment for hives is focused on controlling the itch and swelling.  Many patients respond well to antihistamines. For those that don’t, there is an FDA approved biologic therapy.  This medication is omalizumab (Xolair) and is injected under the skin once a month. Many patients have called this therapy “life-changing.”