Who Gets Hives?

Hives, known in the medical literature as urticaria, areAnother contributing factor to recurrent food allergies
a localized itchy outbreak of the skin. In thisis the permeability of the intestinal wall. This is the
essentially allergic reaction, the skin breaks out inreason reactions to food are more severe when
bumps surrounded by elongated flares. These "hives"they are consumed after taking aspirin. Aspirin
are referred to as wheals or welts. The welts tendirritates the lining, increasing its permeability and
to be pink except that they turn white wheneasing transport of allergens into the bloodstream.
touched. Welts may coalesce into plaques coveringAlcohol, NSAIDs, and many food additives have a
substantial areas of skin.similar effect. Consuming any substance that irritates
Hives are intensely itchy. They may involve any areathe lining of the digestive tract increases the severity
of the body from the scalp to the soles of the feet,of the food allergy that causes hives.
and appear in crops of 24- to 72-hour duration. TheFood colorings, especially yellow dye #5 (tartrazine),
most common sites for outbreaks are the hands,can provoke hives in about 0.1 percent of the
feet, and face. Angioedema, a swelling below the skinpopulation. Tartrazine is added to almost every food
caused by the same allergic mechanism, usuallyand even antihistamines, antibiotics, sedatives, and
occurs around the eyes and in the lips. While thesteroids. This yellow dye modifies fatty acid
itchy bumps usually go away without treatment,metabolism in the same manner as aspirin and
angioedema in the upper respiratory tract may be lifeincreases the susceptibility of the skin to allergic
threatening and requires immediate medical attention.inflammation.
A survey of college students indicates about one inFood flavorings are a major factor in many cases of
five people has hives at some point in life. They mayhives in children. A wide range of salicyclic acid esters
occur at any age, but young adults in their twentiesflavors cake mixes, chewing gum, puddings, and soft
are the most frequently affected. The precisedrinks. These chemical relatives of aspirin also occur
causes of the condition vary person to person.naturally in curry powder, dill, licorice, oregano,
Aspirin sensitivity is observed in up to 67 percent ofpaprika, peppermint, prunes, raisins, and turmeric. The
persons who have recurrent outbreaks of hives.average child consumes as much 200 mg of salicylate
Aspirin alters the metabolism of free fatty acids soper day. This dosage approaches the amount of
that it favors the production of leukotrienes. Thesesalicylate in children's aspirin. Other flavorings, including
are hormonal messengers that make the walls ofaspartame, cinnamon, menthol, and vanilla may
blood vessels more permeable to histamine. Aspirinproduce urticaria in some individuals.
also makes the lining of the intestines moreThe food preservatives BHA (butylated
permeable to allergens, increasing the risk of reactionhydroxyanisol) and BHT (butylated hydroxytoluene)
to common food allergens such as cheese, chocolate,provoke reactions in about 15 percent of individuals
eggs, milk, pineapple, shellfish, and strawberries. Atwho have chronic hives. As many as 44 percent of
least one study found taking a single adult aspirin dailypersons with chronic urticaria are allergic to
for three weeks desensitizes the immune system tobenzoates, which occur in relatively high
aspirin and also to foods, but the benefits vanish ifconcentrations in fish and shrimp. Sulfites, which are
aspirin is discontinued.sprayed on fruits, vegetables, and shrimp to keep
Two factors increase the risk of outbreaks of hivesthem fresh in countries outside the United States,
after eating allergenic foods. One is incompleteaggravate a wide range of allergic conditions, including
digestion. A study published in the 1940's reportedasthma as well as hives. Sulfites occur naturally in
that of 77 patients diagnosed with chronic hives, 65beer and wine.
had failures to produce enough stomach acid toAbout 1 in 10 people is allergic to penicillin, and about 1
break down the proteins that cause allergies.in 4 of those allergic to penicillin will develop urticaria,
Treatment with hydrochloric acid and a vitamin Bangioedema, or anaphylaxis after taking it. Penicillin is
complex relieved symptoms in most of the patientsa common additive to livestock feeds. Both skin
in the study. Failure to secrete sufficient gastric acidoutbreaks and anaphylactic reactions have been
is especially common in persons over the age of 60.traced to penicillin in frozen dinners, milk, and soft
It may be a major contributing factor in repeateddrinks. Among patients with chronic hives and an
outbreaks of hives after consuming allergenic foods inallergy to penicillin, about half will improve on a
older persons.dairy-free diet.