URTICARIA HIVES

Dr DEEPAN P SHAH (MD)

URTICARIA HIVES HOMEOPATHIC TREATMENT GUIDE

Urticaria or Hives is a condition which presents itself on skin with welts and weals (red elevated bumps) typically lasting for few hours to days and then changing location, which are usually( not necessarily always) itchy burning and stinging in nature.

Hives can be Allergic or Non Allergic in nature that is Hives with Immunoglobin involvement(allergic) and Hives without Immunoglobulin involvement (non allergic) that is no allergen-antibody interaction.
It is  caused due to response of immune system to certain stimulus in susceptible individuals. Such stimulus can be of various types and nature.

CAUSATIVE FACTORS

FOOD – Allergy to food item is one of the common cause to urticaria. Food items commonly known to cause urticaria are Nuts, Shell Fish, Brinjal, Tamrind, Tomato, Channa dal, Wheat, Soyabean.

ENVIRONMENTAL AGENTS – Individuals allergic to certain environmental agents of the place they reside or work if comes in to inhalation or in contact to skin may cause urticaria or hives. Some are even sensitive to photons or solar light and heat where as some individuals to water and cause aquanergic urticaria which in most cases is not histamine mediated

MEDICINES – Allergies to certain medicines especially Penicillin, Clotrimazole, Codiene, Dextroamphetamine, Aspirin, Ibuprofen, Sulphonamide, Sulphonylurea, cefclor, Piracetam.

INFECTIONS – Viral, Bacterial, Parasites, Protozoal, Fungal, Dermatophytes etc infection can cause urticaria during the course of infection or post infection. Worms, Lice, Dental Carries and Ear Infections may also  urticaria cause urticaria.

THERMAL – Its observed that many individuals develop urticarial rash with 20 hours after exposure to excess of heat or cold

CHOLINERGIC – Triggered on perspiration due to exercise, hot bathing, hot climate, emotional stress etc.

PROPRIOCEPTIVE – There are two types in this, one is pressure induced and other is dermographic urticaria, in pressure induced the wheal are more thicker and elevated and appear few hours after the pressure and lasts for 6hrs to 3 days whereas indermographic urticaria it appears much sooner is not much elevated or thick compared to former.

EXERCISE – Induced after intense Exercise may result into death in some severe cases who shos respiratory and cardiac sptoms along with, its different from cholinergic as individauls suffering from it has no relation to perspiration pattern and is not induced due to hot bath emotional stress like in cholinergic type.

EMOTIONAL – Triggers purely due to emotional stress with no relation to perspiration like in cholinergic.

SCOMBROID – Ingestion of Excess of histamine through food eg diseased fish with excess of histamine in it.

IDIOPATHIC – Cause most of the cases of urticaria remains unknown.

Pathogenesis of Urticaria

HOMOEOPATHIC TREATMENT APPROACH IN CASE OF URTICARIA

Each and every detail of all systems and a proper history of patient to evaluate and exclude certain factors like –

1)Whether patient is on any medicines. If he is, then since how long he is on that medicine. Whether those medicines are for chronic condition or recent acute complaint. Whether there is any recent change or addition of any medicine, in those who are on long-term medicines for chronic condition. eg Glimipride in Diabetes Mellitus patient. history of drug allergy. Sometimes drug allergies presenting as mild urticaria initially, might soon trigger up, in no time and can prove fatal, even before we can treat it

2)Exclude presence of Infections in past / recent past / current, as many infections may cause urticaria during its course or after it has run its course, as a reactive response of immune system. It can be either viral, fungal, bacterial, protozoal, dermatophyte or parasite infection. Parasite infection can be external like Lice or internal worm or helminthic manifestation to which body might show urticaria as reaction. Sometimes chronic Ear Infections and Dental Carries patients show up urticaria as reaction.

3)Make a careful note of, recent Consumption or Exposure or Contact atleast from 48hrs before untill his complaint started or triggered, of the following

  • A list of food items and should be done for every subsequent episode to rule out or find out allergy to particular food items.
  • A list of thing that comes in contact of skin or respiratory and other mucous membrane should be made, Change in cosmetic and toiletries like soaps, creams, lipsticks, eyeliners, oils etc. Fabrics new garments, undergarments, bands, scarfs, bed-sheets, pillow etc. Aerosols like room fresheners, insecticidal spray, recently done pest control, perfumes, deodorants, mouth fresheners etc. Jewelries and other accessories note of various materials that comes in contact with surface of skin.
  • Presence of pets, pests or rodents, bed bugs etc in patience close surroundings .
  • Presence of flowering plants with pollen in house or in garden.
  • Exposure to pollution at work place or unusual environmental exposures.
  • A note of trigger after exposure to extremes of Heat or Cold,
  • Relation with Emotion Stress or
  • Urticaria trigger due to exercise Exercise with respiratory or cardiac symptoms frequently tends to fatal.
  • Relation to sunlight exposure should be noted
  • Any change in place of residence or work should be noted
  • Change in source of water should be noted.

Guidines as per my clinical experience of Homeopathy in cases of Urticaria in Discussion format.

Personally for me, Urticaria cases are too interesting, as these patients human-organism/ Vital force/immune-system is too sensitive to certain stimulus. Shows very quick reaction and same applies to susceptibility and reaction to well selected similimum remedies. You dont have to wait much to realise the effect of doses you have given, they will show quick aggravations even if u have reached a nearby similimum remedy and even if its a chronic case.

The human-organism and vital reactions are so much eager to express themselves from within outwards, that they come up not only on skin but also with various mental symptoms, opening up after medicine is administered. Usually when urticaria resolves with homeopathy it takes away, along with, many other psychological skin respiratory and digestive disturbances.

In homeopathy, while treating case of urticaria, we should keep in mind that its a deep seated constitutional complaint. Even if it is acute and recent we have to be cautious as we can never say wether patient will go into chronic phase or not. These patients have high susceptibility towards certain stimulus and most paients are constantly being troubled by continious stumulus so considering these two important aspect of disease pathology, accordingly the medicine and potency and repetition should be selected so that we are able to create very similar artificial medicinal disease (aggravation) in such patient.

Usually these patients wether acute or chronic are most of the time psoric in maismatic nature and doesnt require antisyphillitic or antipsycotic remedies unless they have urticaria as secondary to syphillitic or psycotic constitution type, which can be evaluated by physical generals with signs of such miasmatic presentation.

Low to medium  potency with frequent repetition initially, patient within couple of days or weeks will show aggravations moderate to severe, at this point patient should be switched to placebo. Patient should be guided to bear with it and not to succumb to anti-allergic, anti-histaminic allopathic medicines for temporary relief, as it will completely disrupt the chain of event that been set in by homeopathic medicine and bring patient to ground zero again. In such case where patient has taken allopathic medicine to relieve itching and other complaints, a physician should wait for next aggravation get new case taking done and new indicated similimum medicine delivered.

When patient are guided not to take allopathic medicines for urticarial aggravations they need to be alerted and observed that they are not developing any complications in respiratory or any other vital organ or system due to aggravation. If doubted, required measures to be taken soon.

Gradually after lasting for couple of weeks the aggravations starts subsiding. In very few cases it relapses again but every subsequent episode is milder and symptom free interval longer compared to previous *. And this is how it phases off and gets completely annihilated.

(*Acute similimum medicines to be restarted on every such subsequent episode untill symptoms aggravated and then switched to placebo.)

Urticaria – 10 best Homeopathic Medicines

(Only Theraputic Indications)

  1. Natrum Sulphuris – Urticaria in patients with liver affections, Hives alternates or accompanies gouty affections, Gouty diathesis, Hydrogenoid constitution, typically suited to Psycotic Maismatic backgroung with tendency towards warty overgrowth, Complaints aggravates when climate changes from dry to damp, arthritis of small joints of toes and fingers accompanies with urticarial eruptions, pruritus aggravates on undressing, lying on left side and music, patient feels better in dry climate pressure and changing position frequently.
  2. Ledum Pal Urticaria in patients with rheumatic diathesis and Gouty diathesis, sensation of severe itching burning and sticking like from insect bite, complaints aggravate from heat of bed and covering, in pt with tetanic convulsions accompanying urticarial rash, eruptions more on ankle and feet especially rt side.
  3. Urtica Urens again this remedy is good for patients with Gouty Diathesis, Hives accompanies or alternates joint affections, urticaria relapses same time every year. Hives accompanies with catarrhal conditions, Urticarial eruptions burning heat violent itching and formication, complaints arising from suppressed nettle rash, suits well in Urticaria Nodosa and Dermographic Urticaria, patients having urticaria with angio-neurotic oedema have responede well to this remedy.
  4. Apis Melifica this remedy has a special affinity towards skin and mucous membranes where there is oedematous swelling due to innate immune response, inflamation, this remedy is made from poison of honey bee sting , and it is homoeopathically used to cure any skin , mucous membrane and any other connective tissue inflamatory affections showing symptoms and sensation as of from bee sting also urticaria showing similar symptoms and has very promising symptoms; typically the symptoms have an acute onset with severe burning and stinging pain with red rosy hue. sudden puffing up of whole body worse by heat touch motion afternoon colsed warm room on sleeping affects right side more compared to left side.pt finds relief in open air cold climate on uncovering.
  5. Belladonna Smooth shinny dry and hot skin due to subcutaneous congestion and dilation of superficial blood vesseles, urticarial rashes accompanies with fever with complete thirstlessness and head perspiring.
  6. Rhus Toxicodendron red swollen with intense itching and burning, aggravates on cold damp wether , at night during sleep, better in dry warm wether.
  7. Ranunculus Bulbosus Hives with severe itching on palms, itching palms with or without eruptions, aggravates on wet stormy wether.
  8. Natrum Muriaticum Hives due to Hyperacidity and other Digestive disturbances.
  9. Kreosotum  Hives due to dental carries
  10. Santonine Hives due to worms

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