and Treating Urticaria Scars: Causes and Solutions - Dermatology

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Urticaria, commonly known as hives, is a skin condition characterized by raised, itchy welts that can appear suddenly and may vary in size. It often results from an allergic reaction, but can also be triggered by stress, infections, or certain medications. In your case, it seems that you experienced a significant outbreak during high school, which eventually subsided but left behind brownish spots on your legs.

These brown spots are likely post-inflammatory hyperpigmentation (PIH), a common occurrence after skin inflammation or injury. When the skin undergoes inflammation, such as from hives, it can lead to increased melanin production in the affected areas, resulting in darker patches once the inflammation resolves. This is particularly common in individuals with darker skin tones, but it can occur in anyone.


Causes of Urticaria Scars
1. Inflammation: The primary cause of the brown spots is the inflammatory response of the skin to the hives. When the skin is inflamed, it can lead to changes in pigmentation.


2. Scratching: If you scratched the affected areas, this could have exacerbated the inflammation and increased the likelihood of pigmentation changes.

3. Duration of Outbreak: The longer the hives persist, the more likely it is that pigmentation changes will occur.


Will It Get Better?
In many cases, post-inflammatory hyperpigmentation will fade over time, but this process can take several months to years, depending on various factors such as skin type, sun exposure, and individual healing processes. Here are some steps you can take to help improve the appearance of the spots:
1. Sun Protection: Protecting your skin from sun exposure is crucial. UV rays can darken hyperpigmented areas, making them more noticeable. Use a broad-spectrum sunscreen with an SPF of at least 30 on the affected areas.

2. Topical Treatments: Over-the-counter creams containing ingredients like hydroquinone, retinoids, or vitamin C can help lighten hyperpigmented areas. However, it's essential to consult with a dermatologist before starting any new treatment.

3. Chemical Peels or Laser Treatments: For more persistent cases, dermatologists may recommend chemical peels or laser treatments to help reduce pigmentation. These treatments can promote skin turnover and improve overall skin tone.

4. Patience: It's important to be patient, as hyperpigmentation can take time to resolve. Avoid picking or scratching the skin to prevent further irritation and potential scarring.


When to See a Doctor
If the brown spots do not improve over time, or if you notice any changes in the spots (such as increased size, color change, or new symptoms), it would be wise to consult a dermatologist. They can provide a thorough evaluation and recommend appropriate treatments tailored to your specific condition.

In summary, the brown spots on your legs are likely a result of post-inflammatory hyperpigmentation from your previous urticaria outbreak. While they may fade over time, taking protective measures and considering topical treatments can help speed up the process. Always consult with a healthcare professional for personalized advice and treatment options.