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What are nonallergic hives?

Dr. Lawrence T. Chiaramonte, MD
Allergist & Immunologist

Nonallergic hives or nonallergic urticaria are those types of urticaria where a clear-cut allergic basis cannot be proven. These take many forms:

  • Dermographism ("skin writing") is an urticaria-like wheel that develops when the skin is stroked with a firm object like a blunt pencil. This can accompany other forms of allergy, but often is an isolated problem that comes and goes.
  • Cold-induced urticaria appears after a person is exposed to low temperatures, for example, when an ice cube is placed against the skin or after a plunge into a cold swimming pool or the ocean, which can actually be fatal if the throat swells up. Cold-induced urticaria is best treated with Periactin, an otherwise seldom used antihistamine.
  • Cholinergic urticaria, which is associated with exercise, hot showers, and anxiety, is a form of hives related to release of certain chemicals from parts of the autonomic, or involuntary, nervous system, which controls such body functions as blood pressure and heart rate.
  • Pressure urticaria develops from the constant pressure of constricting clothing such as sock bands, bra straps, belts, or other tight clothing.
  • Solar urticaria occurs on parts of the body exposed to the sun, often within a few minutes after exposure. This may be a reaction to drugs, such as doxycycline, months after taking them.

Allergic urticaria is less common than nonallergic, although it is somewhat more common in children than in adults. It is caused by the immune system's overreaction to foods, drugs, infections and various substances. Foods such as eggs, nuts and shellfish, and medications such as penicillin and sulfa are common causes of allergic immunologic urticaria. Recent studies also suggest that some cases of chronic urticaria are caused by autoimmune mechanisms, when patients develop immune reactions to components of their own skin.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.