Hives (urticaria)

What it is

Hives are raised, itchy welts that move around and usually fade within 24 hours.

How it works

Mast cells in the skin release histamine, which makes blood vessels leak fluid, forming wheals.

Why it matters on darker skin

On dark skin hives may look skin-coloured or slightly darker, not red.

Causes and triggers

Infections, foods, medicines, insect stings, heat, pressure, and often no cause is found.

What helps — and why it works

Non-drowsy antihistamines, pharmacist advice: block histamine. Expected timeline: hours. Avoid known triggers: fewer episodes. Expected timeline: ongoing.

More detail

Hives can be acute — lasting less than six weeks, often triggered by a viral infection, a food, a medicine (such as some antibiotics or painkillers) or an insect sting — or chronic, recurring most days for more than six weeks, where a single cause is rarely found. Individual wheals usually fade within 24 hours without leaving marks, although new ones may keep appearing elsewhere. Some people develop hives from pressure, cold, heat, exercise or scratching. Deeper swelling of the lips, eyelids, hands or feet (angioedema) can occur with hives. Non-drowsy antihistamines are the main treatment and are available from pharmacists; a doctor may increase the plan for chronic hives. Keep a simple diary of foods, medicines and activities if hives recur. Hives that come with swelling of the tongue or throat, wheezing, difficulty breathing, dizziness or collapse may be anaphylaxis and need emergency care immediately.

What to avoid and why

Avoid hot baths and tight clothing during flares.

Common mistakes

• Using steroid creams on hives.

Building a routine that lasts

Most skin problems improve with a short routine used every day rather than many products used occasionally. A practical base is a gentle cleanser, a fragrance-free moisturiser and a broad-spectrum sunscreen in the morning, with one targeted treatment at night. Introduce one new product at a time and give it two weeks before adding another, so that if your skin reacts you know the cause. Patch-test on the inner arm or behind the ear for a few days first. Skin renews itself roughly every four to six weeks, so most treatments need two to three cycles — eight to twelve weeks — before you can judge them fairly. Photographs taken in the same light every four weeks are more reliable than memory. In the Nigerian climate, heat, humidity and harmattan all change what your skin needs: lighter gels in the humid season and richer creams in dry months are both reasonable. If a product stings for more than a few minutes, causes swelling, or leaves new dark patches, stop it. Buy from registered pharmacies or official stockists, and use the Authenticity Check if you are unsure whether a product is genuine.

Reading labels and choosing products

On the label, look first for the active ingredient and whether the product is fragrance-free and non-comedogenic. Ingredients are listed in order of amount, so an active at the end of a long list may be present only in a small quantity. Be wary of products that promise results in days, that list no ingredients, or whose label is a sticker or handwritten. Words such as 'natural', 'herbal', 'organic' and 'dermatologist-inspired' are marketing terms, not safety standards. Hydroquinone, mercury compounds (sometimes listed as calomel or mercurous chloride) and strong steroids such as clobetasol do not belong in an over-the-counter cosmetic. A real NAFDAC registration number should be printed on the pack and should match the product on the official Greenbook register. Price is not proof: counterfeiters copy expensive brands. When in doubt, ask a pharmacist, keep your receipt, and use Melanin & Me's Authenticity Check and barcode scanner as a first screen.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.