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Get hives when nervous and stressed. Turn blotchy red on my chest, neck and cheeks. Rash does not hurt or itch. Help?

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Allergist and Immunologist
Practicing since : 1999
Answered : 584 Questions
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I get "hives" when I'm nervous, stressed, when I'm overheated, cold, when I lay in the sun, drink alcohol, or when Im excited. I turn blotchy red on my chest, neck, side of my cheeks and my forehead and sometimes my arms. Its been going on since I was a freshman in high school. Im now 33 years and a mother of a two year old and its only getting worse, however when I was pregnant it never happened? What could this be? Sometimes it happens when I eat spicy foods. I haven't had an allergy test and maybe should, but I think it may be due to anxiety? But it happens even when Im not nervous, so I have no idea why this is happening? The rash doesn't itch or hurt . its just blood rushing to theses areas in a blotchy form and its noticeable and gets worse when i see people looking at my hives. I'm an occupational therapist and its impacting my work, social life and overall well-being. Help...
Posted Tue, 8 Oct 2013 in Skin Hair and Nails
 
 
Answered by Dr. Sujoy Khan 50 minutes later
Brief Answer:
Spontaneous urticaria - need high dose antiH1 tabs

Detailed Answer:
Hello,

Welcome to Healthcare Magic.

Your symptoms are consistent with chronic spontaneous urticaria, that can worsen with stress, alcohol exposure, spicy foods, and temperature change on skin (hot or cold can do this).
Interestingly, histamine responses lower in some when pregnant, and urticaria does not occur.

Specific IgE allergy tests are usually not helpful as there are too many occasions when you may not been exposed to medications, foods and urticaria would have occured.
Lowering histamine responses with long-acting antihistamines will help.
Checking a full blood count, ferritin levels, Vit D 25(OH)D3, XXXXXXX TSH fT4 and antithyroid antibodies help in knowing if there is a secondary trigger.

Check with your doctor the availability of long acting histamines as you will need this for 3 months.

Best Wishes.
Above answer was peer-reviewed by
 
Follow-up: Get hives when nervous and stressed. Turn blotchy red on my chest, neck and cheeks. Rash does not hurt or itch. Help? 9 minutes later
So, taking long acting histamines for three months will cure it? Or help minimize the symptoms?
 
 
Answered by Dr. Sujoy Khan 1 hour later
Brief Answer:
Yes, will control your symptoms

Detailed Answer:
Long acting antihistamines is the usual treatment and 3 months is an arbitrary period to see if that helps control the symptoms.

Typicall Fexofenadine 180mg in the morning plus cetirizine 10mg at night is required.

Best Wishes.
Above answer was peer-reviewed by
 
Follow-up: Get hives when nervous and stressed. Turn blotchy red on my chest, neck and cheeks. Rash does not hurt or itch. Help? 10 minutes later
Thanks so much for your help.
 
 
Answered by Dr. Sujoy Khan 9 hours later
Brief Answer:
You are most welcome. Best Wishes.

Detailed Answer:
You are most welcome.

Best Wishes.
Above answer was peer-reviewed by
 
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