Hives in the Morning?

[mefter0913]

Almost every morning, I wake up with a rash that looks like hives.  It's bumpy and puffy and swollen looking.  They start at my wrists and then extend to my hands, but sometimes continue up my arms as far as my shoulders as well.   Usually, other than being a little red, they're gone by noon. Sometimes, they'll crop up again at night, but usually not.  This has been going on for about two months and I can't seem to figure out what the problem is.  

About three months ago, I started receiving occiptal nerve blocks for migraine headaches every 6 weeks, but I don't see how this could be related.  The severity does not seem to be tied to the time of the injections.  

I'm on birth control and gabapentin.  

I've tried changing my soap, my shampoo, the type of sheets, everything, and it doesn't seem to matter.  I have a dog and two cats but they've never bothered me before.  I also work with glass a lot in the evenings (I have a small jewelry business), but I've been doing that for years.  

Any idea what could be causing this, or is it just a minor annoyance?

[Bhupinder Kaur, MD]

Hello,

Hives result from dilation of capillaries allowing fluid to leak out into the surrounding tissue, the epidermis.They are red, itchy, raised areas of skin that appear in varying shapes and sizes. They have a tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours.

Many cases of hives are "idiopathic," meaning no cause is known. Others may be triggered by viral infections or medications.It may be due to gabapentin or other medications.

Take some over the counter oral antihistaminics like benadryl or Claritin,Sometimes they are required for prolonged periods.Since benadryl causes drowsiness so can be used at night to get urticaria control. Short courses of oral cortisone or steroids are taken for short periods (one to three days) to settle more severe symptoms.Application of calamine and mild steroid cream like dermacort will also help in controlling itching.

If the symptoms become severe,then it can be a case of chronic urticaria which needs further evaluation as it may be due to auto antibodies.A dermatologist’s evaluation is mandatory.

Hope it helps .Take care and pls do keep us posted in case you have any additional queries.Kind regards.