four people have asthma attacks while standing on a giant weed called Parietaria Judaica. Images of hives are in the background.

Links Between Asthma And Hives

I have dealt with asthma my entire life. I also have experienced hives from time to time. Often I have wondered if this is unique to me, or if other asthmatics have experienced the same. Also, I have wondered if there are links between asthma and hives. I investigated this subject. Here is what I learned.

What are hives?

Most of us here know what asthma is. Let's take a moment to investigate hives. Hives are when areas of your skin become raised, red, and itchy. The medical term for it is urticaria. Over the years there have been various other names used, including welts, nettle rash, or wheels.1

How do hives occur?

Hives occur when you are exposed to an allergen. An allergen is something you are allergic too. Common allergens that trigger asthma are dust mites, animal dander, pollen, mold spores, cockroach urine, and certain foods. These may also trigger hives, along with latex, bees, other insects, and plants.1-3

Allergens contain proteins. In those of us with an allergic predisposition, our immune systems respond to proteins on these antigens. This induces an immune response that causes the release of chemicals, such as histamine.2

These chemicals cause tiny capillaries close to the surface of your skin to seep some of their fluid. This causes inflammation, which is what causes the hives. This produces a rash that is red and itchy.3 A similar response to inhaled allergens is what causes the asthma response.

They may also be caused by other situations, such as bacterial infections, sunlight, water on the skin, and exercise.3

How do I get rid of hives?

Hives generally go away in time. Although, in some circumstances, medicines such as salves or creams on your skin may prove helpful. Medicines such as antihistamines (like Benadryl) may also prove helpful. Like asthma, hives also respond well to corticosteroids and the biologic Xolair.4

How are hives and asthma connected?

Asthma and hives are two separate conditions. And the fact that an asthmatic also develops hives may be purely coincidental. While researching this, I found a ton of information on hives and asthma. Although, I only found one article describing the potential link between the two.

The article I found was regarding a study. Researchers observed that many of the same people with asthma also experienced hives. Both involve the abnormal immune response as described above.4 Inflammatory chemicals that trigger the asthma response are described in my post, “The Late Phase Asthma Attack.” Inflammatory chemicals that trigger hives are IL4, IL10, IL13, and B-Cell Activating Factor (BAFF).5

Likewise, both asthma and hives involve elevated IgE levels. And, they both respond well to medicines that suppress this immune response, such as corticosteroids and Xolair. So, based on all of these links, researchers aimed to see if there was any merit to these links. The authors of the study noted that this was the first “large scale study” looking into this asthma/hives link.4-5

As part of the study, researchers followed 110 patients diagnosed with asthma, 95 diagnosed with hives, and 100 control subjects who experienced neither disorder. All subjects participated in allergy testing (skin-prick test) to see if they what they were allergic to. All subjects were followed for one year and responded to questionnaires. The results showed the following:4

  • 26 (or 23.6%) of the asthmatic group also experienced hives.
  • Only 2% of the control group experienced hives.
  • Of the 26 asthmatics experiencing hives, they occurred during an asthma attack in the spring
  • Of the 26 asthmatics with hives, most cases were mild. Antihistamines worked well.
  • In 4 asthmatics with hives, the hives were antihistamine resistant and required Xolair.
  • Of asthmatics with hives, 72.4% occurred during seasonal asthma attacks (i.e. spring)
  • Of asthmatics with hives, 73% tested positive for seasonal allergens (dust mites, grasses, trees, and weeds
  • Interesting to note, urticaria episodes were the most frequent in those who tested positive for allergy to the weed Parietaria Judaica.
  • Also, the study found that asthmatics with the most severe asthma were the most likely to experience hives.
  • 10.5% of the urticaria subjects also reported asthma. This was similar to the control group.

What conclusions can we draw?

Obviously, this is just one study. Still, the study concluded that the incidence of hives is elevated in those diagnosed with asthma. It is not elevated in those diagnosed with hives. When asthma and hives occur in the same people, the most common link is seasonal allergies.4

The researchers also made a couple of other interesting observations. First, was that those with the most severe asthma are most likely to also have hives. Second, the most common allergen linked to both asthma and hives is the weed Parietaria Judaica. Interestingly, this weed has long been referred to as “asthma weed.” This is mainly because it has long been associated with seasonal allergies, such as asthma, rhinitis, and hives. Third, those with the most severe asthma are the most likely to also experience hives.4,6

What can we make of this information?

According to this study, I am not the lone asthmatic who also experiences hives. Likewise, a potential link between hives and asthma may be seasonal allergies. It may be allergic asthma. It may also be severe asthma.

What about you? Do you experience hives? When do you experience them and what do you do to treat them? Let us know in the comments below.

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