Hives

Hives (urticaria) is an itchy skin condition characterized by recurring, raised, and swollen patches on the skin. When caused by a drug allergy, it’s typically referred to as a drug rash. When triggered by other allergies, such as reactions to certain foods, it’s simply called hives. Hives are often allergic in nature and are thought to result from an immune response, where histamines or similar substances are released, leading to superficial swelling in the capillaries of the skin.Common food triggers include fish, bamboo shoots, spinach, dairy products, and nuts. Other types of hives can be caused by factors such as:Psychological stress (psychogenic hives)Sun exposure (solar urticaria)Heat (cholinergic urticaria), such as during a bath or when the body warms upCold (cold-induced urticaria), from contact with cold air or waterFor some people, the skin is highly sensitive to physical irritation, so pressure from socks, jeans, or waistbands can trigger hives.Symptoms include intense itching and the appearance of red or white raised patches, usually ranging from the size of a grain of rice to a fingernail. Each patch usually disappears within 10–20 minutes or a few hours, but new patches may continue to appear, which is a hallmark of hives. Some cases resolve within a few days to a week, while others can persist for weeks, months, or even years. Cases that resolve quickly are called acute, while those lasting over a month are termed chronic hives. Conventional treatment involves identifying and avoiding allergens. In chronic cases, addressing factors like abnormal stomach acid or intestinal health may also help prevent symptoms.In Traditional Korean Medicine (TKM), hives are thought to be linked to digestive imbalances, excessive heat in the stomach from dietary factors, or emotional disturbances affecting the liver. Chronic cases may involve "blood stasis," a unique TKM concept of stagnant blood circulation. TKM treatment emphasizes addressing the root cause of hives, focusing on holistic improvement of the patient’s particular constitution rather than just relieving symptoms temporarily.Treatment Case 1: 32-year-old femaleThe patient was a 32-year-old female, she worked as an architect in a busy firm. She complained of recurrent hives appearing on arms, legs, and abdomen with significant itching, particularly after consuming seafood, spicy foods, and dairy. Hives tend to flare up in the evenings and worsen with stress. Even when not consuming those foods, she noted that she had occasional bloating, acid reflux, and mild constipation. Recently, her firm was bidding on a major federal government contract, and her irregular work and eating schedule, as well as the work stress, aggravated her symptoms. This led her to seek help.According to her symptoms, the practitioner diagnosed her as having accumulation of heat in the stomach and spleen with damp-heat and qi stagnation. The hives appear to be aggravated by dietary factors, such as foods that induce internal heat or dampness (like seafood and spicy foods), and are also triggered by stress. According to TKM, the spleen and stomach are responsible for digestion and can become imbalanced from dietary habits and emotions, leading to damp-heat, which manifests as hives. Additionally, the liver qi may be stagnated due to her work-related stress, exacerbating the condition.The practitioner prescribed her herbal formulas to treat skin itching and hives by expelling wind, clearing heat, and nourishing the blood. Other herbs were also included in this formula such as Huang Lian (Coptis) and Fu Ling (Poria) to help reduce the inflammation from her stomach and intestines, as well as support the function of her digestive system and remove excess fluid circulation. Dietary recommendations were also given. To strengthen spleen function, the patient was told to have lightly cooked meals, such as congee with ingredients like sweet potato, ginger, leafy greens, mung beans, and Chinese yam. After 1 month of treatment, the patient reported that her hives looked less inflamed in character, and that her digestion was a lot better. The same treatment was continued for another month. The patient noted that while she still had the occasional flareup, they were much more manageable and did not cause her excessive mental distress. Her digestion was again improved, and she had much less bloating and stomach pain as well.