Rash with wheals


A generalized rash that is characterized by wheals is also known as urticaria. The wheal is the so-called skin fluorescence, which is characteristic of the rash. It is caused by a small, localized swelling (edema) in the skin. It is typically very itchy and heals without scars. One speaks of urticaria when a skin rash develops due to many wheals. Urticaria can have various causes and occur as an acute or chronic clinical picture.

This must be distinguished from urticarial eczema, which does not affect the entire body, but only localized parts of the body. However, strictly speaking, these cannot be called a rash, as a rash affects most of the skin.

Read more on the topic: Wheals on the skin

Treating rash with wheals

Treating a rash with wheals differs depending on the cause and type of the rash. One has to distinguish symptomatic from causal treatment. Since the causes can be very diverse, the measures to be taken are also very different. An underlying infection with the often causative bacterium Helicobacter Pylori occurs antibiotically. Fungal infections are treated with fungicidal drugs (Antifungal drugs) treated. Triggering drugs should be discontinued or switched. Possible food intolerances should also be determined by means of omission tests.

For symptomatic therapy, there are both external and internal drugs. In topical (external) therapy, cooling gels, zinc shaking mixtures or lotions with antipruritic additives such as polidocanol, glucocorticoids or menthol are used. Light therapies are also used for the external treatment of urticaria. Internal therapy for a rash with wheals is carried out with antihistamines such as desloratadine, loratadine, ceterizine and levoceterizine. The use of glucocorticoids, ciclospoprin A and dapsone is also possible.

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Home remedies for rash with hives

Treatment with home remedies should be avoided if a rash with wheals occurs. It is often very difficult to determine the cause of a rash. Additional treatment with home remedies that are applied to the skin or taken internally often make it very difficult to determine the root cause of the rash. In the worst case, they also worsen the complexion. They can irritate sensitive skin or even cause allergic reactions. The essential oils that are often recommended are therefore not recommended.

Causes of rash with wheals

The causes of a rash with wheals are very diverse. A common cause of an acute rash with wheals is intolerance or allergies. Food allergies in particular can lead to such rashes.Such rashes often occur in people who have previously suffered from neurodermatitis. Typical allergens are eggs, milk, soy, peanuts, wheat or fish. The second most common cause of temporary rashes with wheals is exercise urticaria. A skin rash with wheals develops after thermal, emotional or physical stress.

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  • Stress rash
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Infections or taking medication can also lead to an acute rash with wheals. Infection with the bacterium Helicobacter pylori in particular can cause a rash with wheals. Other possible causes are insect bites or skin infections with parasites.

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  • Medication rash
  • Rash from taking antibiotics

Less often, autoimmune processes, tumors or inflammation of the liver (hepatitis) can also be responsible for such a rash. In some people, cold, warmth or pressure on the skin also lead to the formation of wheals. Rarely, people react to sunlight with a rash with wheals. The intensity of the light irradiation at which wheal formation begins differs.

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Diagnosis of rash with wheals

The diagnosis of a rash with wheals is made by a dermatologist. Often such rashes are very fleeting, so it is best to see a doctor immediately after the rash appears. The anamnesis is particularly important for diagnosis. In this way, possible allergens and other causes can be determined. Blood tests also provide information about possible causes, such as allergies, autoimmune diseases or even tumor diseases. Typically, allergy values ​​(RAST laboratory, total IgE, ECP), thyroid values, rheumatoid factors, inflammation values ​​(CRP, ESR) and a differential blood count are determined.

In addition, special diagnostics can be carried out to clarify hepatitis or an infection with Helicobacter pylori. If necessary, a stool examination can be carried out to clarify further infections. Skin samples are only part of the diagnosis in rare cases.

Accompanying symptoms of rash with wheals

A very common symptom accompanying a rash with wheals is burning itching. Especially allergic rashes or rashes associated with neurodermatitis are characterized by excruciating itching. The rash occurs primarily at night and primarily affects the arms, back, and legs. Allergic rashes with wheals can also be accompanied by shortness of breath, circulatory problems and even allergic shock. Another symptom that accompanies a rash with wheals can be angioedema. This manifests itself as a swelling of the lids and lips, which regresses after about one to two days.

Read more on the topic: Rash on forearm

Wheals with itching

Itching is a very common symptom of a hives rash. An allergic rash, in particular, is often accompanied by severe itching. This has a burning, stinging character and is felt to be very tormenting. The itching worsens, especially at night, so that it often robs people of sleep. It is caused by the release of histamine from mast cells. This is why so-called antihistamines are used therapeutically for itching. Some antihistamines, such as Fenistil, not only relieve itching, but also have a sedative effect, so that they can make sleep easier in the evening. Medication for sleeping, such as zolpidem, mirtazapine or pipamperon, can be prescribed, especially in the case of very agonizing itching.

Wheals without itching

Classic urticaria, i.e. a skin rash with wheals, is typically associated with itching. There may be a complete absence of itching, but it is rare. If there is no itching at all, other diagnoses similar to urticaria can be considered. Other skin rashes, fungal diseases, or eczema should at least be investigated if the diagnosis is uncertain.

Read more on the topic: Rash without itching - what's behind it?

Duration of a rash with wheals

A wheal rash can be a very fleeting event that goes away within 24 hours. However, there are rashes that persist for several weeks. Some rashes with wheals also have a chronic or chronic recurrent course, so that they will recur over the course of life. That depends a lot on the cause of the rash.

Rash with wheals in children

Rashes with wheals can appear in childhood. Often children are affected who have previously suffered from neurodermatitis. Around 15% of children suffer from this so-called atopic eczema. They generally have a tendency to allergic diseases and often also have asthma, hay fever or other allergies and food intolerances. Allergic skin rashes with wheals are also not uncommon. Not only food allergies, but also bee and wasp stings are common triggers of such a rash. However, the classic childhood diseases such as measles, mumps and rubella, with their blotchy skin rashes, are often initially mistaken for urticaria by parents. Typically, however, children are not “sick” with urticaria and do not show any fever or symptoms such as coughing and runny nose.

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Rash with wheals in pregnancy

Skin rashes with wheals can also occur during pregnancy. These can have very different causes. In principle, such a rash can hide the same causes as outside of pregnancy. However, there are also special skin changes that only occur during pregnancy. Around one in 200 pregnant women suffers from polymorphic pregnancy dermatosis during pregnancy. This itchy skin disease occurs in the last few weeks of pregnancy or immediately after pregnancy and is characterized by severe itching and wheal-like skin changes. These are called urticarial papules. The itchy changes on the skin will go away after pregnancy and will not appear again. Autoimmune progesterone dermatitis is a very rare disease that can also result in wheal-like rashes during pregnancy or when taking a progestin pill. This manifests itself in the spontaneous occurrence of various skin changes that can affect the entire skin and are fleeting. That means the skin changes come and go. However, the disease is very rare.

Rash with wheals in allergies

A skin rash with hives (urticaria) can be caused by an allergic reaction. This is a so-called type I allergy. After contact with the allergen, substances such as histamine and other inflammatory mediators are released in the body, which lead to the typical symptoms of the allergic reaction. This includes not only rashes and itching, but also shortness of breath, circulatory problems, nausea and edema can occur. In the case of an allergic rash with wheals, antihistamines are used therapeutically to calm the itching. Tablets containing corticosteroids such as dexamethasone or prednisolone are also given. If circulatory reactions, shortness of breath or even edema of the eyelids, lips or tongue occur, immediate therapy is initiated via the vein.

Read more on the topic: Rash from an allergy