Eczema and urticaria: Identifying and Managing Them Successfully

What are the differences between eczema and urticaria ?

Although eczema and hives are common skin conditions that cause itching and redness, their causes, symptom progression, and treatment strategies differ significantly. 
Understanding these differences is crucial for accurate diagnosis and treatment. 
Eczema is a typically chronic inflammatory skin condition marked by severe itching. It's often linked to genetics, environmental triggers, and immune factors. The most prevalent type, atopic dermatitis, is mainly seen in babies and children. 

Urticaria, or hives, on the other hand, presents as red, swollen welts (oedema) that can quickly emerge and vanish across various body areas. Causes range from allergic reactions and infections to sometimes physical triggers like pressure or warmth. 
Managing hives primarily focuses on easing the immediate symptoms, especially with antihistamines, and avoiding future triggers. Eczema management, however, demands a longer-term strategy that includes regular skin moisturisation and flare-up prevention.

What's Urticaria, and What Triggers It ?

Characteristics of Urticaria

Outbreaks of red or pinkish welts characterise hives, resembling the effect of a nettle sting. Accompanied by itchiness, these marks result from skin swelling and frequently shift around. Typically, they vanish within 48 hours. 
Sometimes, hives are joined by angioedema, which affects the mucous membranes, notably on the face. While usually harmless, it can occasionally lead to severe respiratory issues, known as Quincke's oedema. This condition requires immediate medical attention.

Urticaria splits into two categories:
 - Acute urticaria is marked by an isolated flare lasting hours to days, potentially recurring in different spots, and usually non-allergic. 
- Chronic urticaria is characterised by persistent or recurrent outbreaks over at least six weeks. It's a non-allergic skin inflammation, sensitising the skin's mast cells to a variety of non-allergic stimuli. It might come with abdominal pain, joint discomfort, and fever. Chronic hives' course can last months or years.

A Mechanism Different from Eczema

Urticaria results from a complex reaction involving mast cells, key immune system cells in the skin, and mucous membranes. These cells contain an inflammation molecule: histamine. 
When mast cells are activated, they release histamine, which causes blood vessel dilation and increased permeability. This reaction leads to fluid and cell infiltration into the surrounding tissues, causing oedema. This mechanism is at the root of urticaria patches.

What can cause urticaria ? 

Here are some of the most common triggers of urticaria:

Non-Allergic Urticaria

This is the most frequent form of urticaria.

Contact Urticaria

Contact urticaria, not to be confused with contact eczema, can be caused by certain plants (nettles), cleaning products, or animals (jellyfish).

Allergic Urticaria

Though rare, allergic hives are severe, resulting from an allergen's widespread activation of mast cells. Common triggers include insect stings, peanuts, shellfish, latex, and certain medications. Accompanying symptoms might consist of asthma attacks, vomiting, abdominal discomfort, and low blood pressure. Anaphylactic shock, the most severe form, is life-threatening and necessitates emergency care.

What are the treatments for urticaria and eczema ?

Eczema and hives are two distinct skin conditions requiring specific treatments.