What’s the Difference Between Urticaria and Angioedema?

Anyone who has allergies must learn to differentiate between urticaria and angioedema because it could indicate a much severe allergic reaction than usual.

Urticaria
Urticaria is better known as hives or weal, those raised patches on the skin that are itchy and are the result of the presence of the histamine in the skin’s blood vessels. Most people with allergies have had urticaria as it is the most common reaction to allergens, pressure, and friction. The raised, itchy patches on the skin can spread and can cause discomfort if it covers a large part of the body. The wheals that appear in the body are described as having a central swelling, is pruritic or severely itchy, and will not leave obvious marks. To treat urticaria or to lessen instances of developing hives, the cause must be identified and eliminated.

Fortunately, hives will respond well to antihistamines and steroids, but it can recur if the person is exposed again to the allergen. It will not leave any obvious marks once the hives go away, usually within 24 hours. There are cases called chronic idiopathic urticaria in some individuals who get hives for no apparent reason. The outbreak of the hives can recur nearly everyday for weeks at a time.

Angioedema
Angioedema can sometimes occur with urticaria, but it is a more serious allergic reaction that can cause life-threatening symptoms. The name angioedema refers to the condition where the dermis, subcutaneous tissue, and mucosa and surrounding tissues become swollen. If a person has angioedema due to an allergen, the area around the mouth is swollen and the upper airway is obstructed. Other parts of the body can also be affected, especially areas with loose connective tissue, such as the tongue, pharynx, the extremities, periorbital region, and genitals. Angioedema is also believed to be caused by a deficiency in C1 esterase and usually runs in the family.

Angioedema is treated as an emergency. If a person with allergies has angioedema, his/her airways must be kept open and protected, along with a prescription of antihistamines or steroids to reduce the swelling. Those individuals with chronic urticaria are more likely to experience angioedema as well, and the swollen areas will take at least 72 hours to go away.

Treatment
Triggers of urticaria and angioedema should be avoided, including medications such as NSAIDs, antihypertensive, and ACE inhibitors. Both physical and food triggers should also be noted, and other people should be informed on what to do during an emergency. Whether the person will need to take antihistamines regularly will depend on the severity or the number of allergies, that is why it’s important to talk to a doctor about the possible side-effects of the medications that can potentially impair academic and workplace performance.

Treatment of angioedema will also require special attention from an allergologist, especially if the condition is inherited.