Recurring Urticaria: Causes and Treatment Options - Internal Medicine

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Recurring urticaria, commonly known as hives, can be a frustrating and uncomfortable condition for many individuals. Understanding its causes and exploring treatment options is essential for managing symptoms effectively.


Causes of Recurring Urticaria
Urticaria can be triggered by a variety of factors, and identifying these triggers is crucial for effective management. Some common causes include:
1. Allergic Reactions: Foods (like tomatoes and fish), medications, and insect stings can provoke hives. In your case, the onset of urticaria after consuming canned fish suggests a potential food allergy.

2. Environmental Factors: Changes in weather, exposure to sunlight, or temperature fluctuations can also trigger hives. You mentioned experiencing symptoms during fluctuating weather conditions, which may indicate a sensitivity to environmental changes.

3. Infections: Viral infections can sometimes lead to hives, especially in children and young adults.

4. Stress: Emotional stress can exacerbate or trigger hives in some individuals.

5. Physical Triggers: Pressure, scratching, or even sweating can lead to physical urticaria.

6. Water Quality: You mentioned concerns about the water quality in Kaohsiung. While it’s less common, some individuals may react to certain minerals or contaminants in water.


Treatment Options
Managing recurring urticaria often involves a combination of avoiding known triggers and using medications to control symptoms. Here are some treatment options:
1. Antihistamines: Over-the-counter antihistamines (like cetirizine or loratadine) can help reduce itching and hives. If you find that your symptoms are not adequately controlled, a healthcare provider may prescribe a higher dose or a different antihistamine.

2. Corticosteroids: For more severe cases, short courses of oral corticosteroids may be prescribed to reduce inflammation and control symptoms.

3. Injectable Treatments: You mentioned receiving an injection that provided immediate relief. This could have been an injection of corticosteroids or possibly an antihistamine. In some cases, healthcare providers may use medications like omalizumab (Xolair), which is an injectable medication used for chronic urticaria that does not respond to antihistamines.

4. Avoiding Triggers: Keeping a diary of food intake, environmental exposures, and symptoms can help identify specific triggers. Once identified, avoiding these triggers can significantly reduce the frequency of outbreaks.

5. Lifestyle Modifications: Staying hydrated, managing stress, and maintaining a stable environment can help mitigate symptoms. Drinking RO (reverse osmosis) water is a good choice if you are concerned about contaminants in tap water.

6. Consulting a Specialist: If symptoms persist, consider seeing an allergist or dermatologist who specializes in urticaria. They can perform specific tests to identify allergens and recommend tailored treatment plans.


Conclusion
Recurring urticaria can be challenging, but with the right approach, it can be managed effectively. It’s essential to identify potential triggers and work closely with a healthcare provider to develop a treatment plan that suits your needs. If you are concerned about the cost of consultations, many hospitals offer sliding scale fees or community health services that may provide more affordable options. Don’t hesitate to seek help, as effective management can significantly improve your quality of life.