Urticaria (Hives)
Overview
Urticaria is characterized by recurrent itchy wheals that appear anywhere and come and go rapidly. Chinese medicine calls it "hidden rashes," usually from constitutional sensitivity, wind-cold or wind-heat, dietary triggers, or qi–blood deficiency causing wind to lodge in the skin. Patterns include wind-cold or wind-heat fettering the exterior, stomach–intestinal damp-heat, and qi–blood deficiency. Throat tightness, wheezing, or swelling of the face/lips/tongue signals anaphylaxis and requires immediate emergency care.
Pattern differentiation (clinical patterns)
Wind-Heat Invading the Exterior
Red burning itchy wheals worse with heat, sore throat, dry mouth, red tongue thin yellow coating, floating rapid pulse.
Disperse wind and clear heat to stop itching.
Wind-Cold Fettering the Exterior
Pale wheals worse with cold or wind and relieved by warmth, chills, pale tongue thin white coating, floating tight pulse.
Disperse wind and scatter cold; harmonize construction and defense.
Blood Deficiency with Wind-Dryness
Chronic recurrent hives with severe itch at night or after fatigue, dry skin, dull complexion, dizziness, fatigue, pale tongue, fine pulse.
Nourish blood and dispel wind; moisten dryness to stop itching.
Connections
Daily care & prevention
Keep a diary to identify triggers (shellfish, nuts, eggs, dairy, additives, medications, heat/cold, stress, infections); during flares eat bland food, avoid hot showers and scratching, keep nails short, and wear loose cotton clothing. Massage Quchi (LI11), Hegu (LI4), Xuehai (SP10), and Sanyinjiao (SP6). Chronic recurrent hives over 6 weeks warrant dermatology evaluation; do not abruptly stop prescribed antihistamines.
When to seek medical care
Swelling of lips/eyelids/tongue, hoarse voice, throat tightness, wheezing or breathing difficulty, dizziness/fainting, vomiting or abdominal pain—signs of anaphylaxis—call emergency services immediately and use a prescribed epinephrine auto-injector if available.