A rash that suddenly appears on your face or body may be your
skin’s reaction to an allergen. How can you soothe the itching and heal your hives?
According to research or other evidence, the following self-care steps may be helpful:
Uncover your sensitivities
Work with a knowledgeable health professional to find out what
foods or additives may trigger episodes of hives
Address your stress
With help from a health professional, learn stress-reduction
techniques that may lower your risk for developing hives
Get a checkup
Visit your healthcare provider to find out if your hives are the
result of a treatable medical problem, or a reaction to medication
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full hives article for more
in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
Hives (urticaria) is an allergic reaction
in the skin characterized by white or pink welts or large bumps surrounded by redness.
These welts are known as wheal and flare lesions and are caused primarily
by the release of histamine (an allergy mediator) in the skin. About 50% of people with
chronic hives develop angioedema—a deeper, more serious form of hives involving the
tissue below the surface of the skin.
While the basic cause of hives involves the release of histamine from white blood cells,
what actually triggers this release can be a variety of factors, such as physical contact or
pressure, heat (prickly heat rash), cold, water, autoimmune reactions, infectious organisms (e.g., hepatitis B virus, Candida albicans, and streptococcal
bacteria), and allergies or sensitivities to
drugs (especially antibiotics and aspirin), foods, and food additives.
Reliable
and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies
suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal
or no scientific evidence. For a supplement, little scientific support and/or minimal health
benefit.
What are the symptoms?
Symptoms include an itchy skin rash with red bumps that can appear on the face, trunk of
the body, and, sometimes, on the scalp, hands, or feet. Individual lesions usually last less
than 24 hours and can change shape, fade, and then rapidly reappear. People with hives may
also have wheezing, or swelling of the eyelids, lips, tongue, or throat.
Dietary changes that may be helpful
Allergy to foods and food additives is a
common cause of hives, especially in chronic cases.1 The foods most often reported
to trigger hives are dairy products, eggs,
chicken, cured meat, alcoholic beverages,
chocolate, citrus fruits, shellfish, and nuts.234 Food
additives that have been shown to trigger hives include colorants (azo dyes), flavorings
(salicylates), artificial sweeteners
(aspartame), preservatives (benzoates, nitrites, sorbic acid), antioxidants (hydroxytoluene, sulfite, gallate), and
emulsifiers/stabilizers (polysorbates, vegetable gums).567
Numerous clinical studies demonstrate that diets that are free of foods or food additives that
commonly trigger allergic reactions typically produce significant reductions in symptoms in
50–75% of people with chronic hives.8910
11 People with hives not clearly linked to a known cause should discuss the possibility
of food allergies with a doctor.
Vitamins that may be helpful
In theory, high amounts of vitamin C might
help people with hives by lowering histamine levels.12 Amounts of at least 2,000 mg
daily appear necessary to produce these effects.13 No research trials have yet
explored the clinical effects of vitamin C supplementation in people with hives.
Vitamin B12 has been reported to reduce the
severity of acute hives as well as to reduce the frequency and severity of outbreaks in
chronic cases.1415 The amount used in these reported case studies was
1,000 mcg by injection per week. Whether taking B12 supplements orally would have these
effects remains unknown. On rare occasions, vitamin B12 injections cause hives in
susceptible people.16 Whether such reactions are actually triggered by exposure to
large amounts of vitamin B12 or to preservatives and other substances found in most vitamin
B12 injections remains unclear.
According to preliminary studies from many years ago, lack of hydrochloric acid (HCl)
secretion by the stomach was associated with chronic hives, presumably as a result of
increasing the likelihood of developing food
allergies. In one such study, 31% were diagnosed as having achlorhydria (no gastric acid
output), and 53% were shown to be hypochlorhydric (having low gastric acid
output).17 In a related study, treatment with an HCl supplement and a vitamin B-complex supplement helped to treat people
with hives.18Betaine HCl is the
most common hydrochloric acid-containing supplement; it comes in tablets or capsules measured
in grains or milligrams. One or more tablets or capsules, each containing 5–10 grains
(325–650 mg) are typically taken with a meal that contains protein. Diagnosis of a
deficiency of HCl and supplementation with HCl should be supervised by a doctor.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Two components of green tea, the
polyphenols epigallocatechin (EGC) and epicatechin gallate (ECG),19 are reported to
have an antihistamine effect. Some doctors recommend approximately 3 cups of green tea per day
or about 3 grams of soluble components providing roughly 240 to 320 mg of polyphenols,
although no human trials have studied the effects of green tea in people with hives.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
Psychological stress is often reported as a triggering factor in people with chronic
hives.20 Stress may play an important role by decreasing the effectiveness of immune system mechanisms that would otherwise
block allergic reactions. In a small preliminary trial of people with chronic hives,
relaxation therapy and hypnosis were shown to
provide significant benefit.21 People were given an audio tape and asked to use the
relaxation techniques described on the tape at home. At a follow-up examination 5 to 14 months
after the initial session, six people were free of hives and an additional seven reported
improvement.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
1. Henz BM, Zuberbier T. Most chronic urticaria is food-dependent, not
idiopathic. Exp Dermatol 1998;7:139–42. [review].
2. Winkelmann RK. Food sensitivity and urticaria or vasculitis. In:
Brostoff J, Challacombe SJ (eds.) Food Allergy and Intolerance. Philadelphia: WB
Saunders, 1987, 602–17. [review].
3. Wraith DG, Merrett J, Roth A, et al. Recognition of food allergic
patients and their allergens by the RAST technique and clinical investigation. Clin
Allergy 1975;9:25–36.
4. Lewis-Jones MS, Barnes RMR, Macfarlane AW, et al. Frequency and
isotype distribution of serum antibodies reactive with dietary proteins in adults with chronic
urticaria. Clin Exp Dermatol 1987;12:419–23.
6. Juhlin L. Additives and chronic urticaria. Ann Allergy
1987;59:119–23. [review].
7. Kulczycki A Jr. Aspartame-induced urticaria. Ann Int Med
1986;104:207–8.
8. Zuberbier T, Chantraine-Hess S, Hartmann K, et al. Pseudoallergen-free
diet in the treatment of chronic urticaria. ACTA Dermatologica Venerol (Stockh)
1995;75:484–7.
9. Henz BM, Zuberbier T. Most chronic urticaria is food-dependent, not
idiopathic. Exp Dermatol 1998;7:139–42. [review].
10. Verschave A, Stevens E, Degreef H. Pseudo-allergen free diet in
chronic urticaria. Dermatologica 1983;167:256–9.
11. Gibson A, Clancy R. Management of chronic idiopathic urticaria by the
identification and exclusion of dietary factors. Clin Allergy
1980;10:699–704.
12. Johnston S, Martin LJ, Cai X. Antihistamine effect of supplemental
ascorbic acid and neutrophil chemotaxis. J Am Coll Nutr 1992;11:172–6.
13. Johnston S, Martin LJ, Cai X. Antihistamine effect of supplemental
ascorbic acid and neutrophil chemotaxis. J Am Coll Nutr 1992;11:172–6.
14. Simon SW. Vitamin B12 therapy in allergy and chronic dermatoses.
J Allergy 1951;22:183–5.
15. Simon SW, Edmonds P. Cyanocobalamin (B12): comparison of aqueous and
repository preparations in urticaria; possible mode of action. J Am Geriatr Soc
1964;12:79–85.
16. Meyer de Schmid JJ, Zeller J. Urticaria due to vitamin B 12 allergy
verified by the lymphoblastic transformation test. Bull Soc Fr Dermatol Syphiligr
1969;76:670–1 [in French].
17. Rawls WB, Ancona VC. Chronic urticaria associated with
hypochlorhydria or achlorhydria. Rev Gastroenterol 1951;18:267–71.
18. Allison JR. The relation of hydrochloric acid and vitamin B complex
deficiency in certain skin diseases. South Med J 1945;38:235–41.
19. Matsuo N, Yamada K, Shoji K, et al. Effect of tea polyphenols on
histamine release from rat basophilic leukemia (RBL-2H3) cells: the structure-inhibitory
activity relationship. Allergy 1997;52:58–64.
20. Green G, Koelsche G, Kierland R. Etiology and pathogenesis of chronic
urticaria. Ann Allergy 1065;23:30–6. [review].
21. Shertzer CL, Lookingbill DP. Effects of relaxation therapy and
hypnotizability in chronic urticaria. Arch Dermatol 1987;123:913–6.
The information presented in Aisle7 is for informational purposes only.
It is based on scientific studies (human, animal, or in vitro), clinical experience,
or traditional usage as cited in each article. The results reported may not necessarily occur
in all individuals. For many of the conditions discussed, treatment with prescription or over
the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist
for any health problem and before using any supplements or before making any changes in
prescribed medications.
Reliable
and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies
suggesting a health benefit or minimal health benefit.
