Hives, also known as urticaria, are a common skin reaction characterized by raised, itchy welts that can appear anywhere on the body. They result from the body releasing histamine and other chemicals into the bloodstream. While often associated with external skin, hives can also manifest on the mucous membranes inside the mouth. This internal occurrence, known as oral urticaria, signifies the same immune response within the oral cavity.
Recognizing Oral Hives
Hives inside the mouth present with distinct symptoms. These include raised bumps or patches that may be reddish or similar to the surrounding tissue. Welts can range from tiny spots to larger blotches, sometimes merging into broader areas. They can appear on the lips, tongue, gums, soft palate, and throat.
Accompanying these visible signs are sensations such as intense itching, burning, or tingling. Individuals might also report discomfort, tissue swelling, and difficulty swallowing or speaking. Swelling in deeper skin layers, known as angioedema, can occur alongside hives or independently, especially around the lips, tongue, and throat, often feeling painful rather than itchy.
Common Triggers
Hives inside the mouth can be provoked by allergic and non-allergic factors. Allergic reactions often stem from specific food allergens like nuts, shellfish, eggs, milk, soy, and certain fruits or spices. Medications, including NSAIDs, antibiotics like penicillin, and some blood pressure medications, are also common culprits.
Beyond allergies, non-allergic triggers can also induce oral hives. These include physical stimuli like temperature changes (e.g., cold foods causing “cold hives”), pressure, or excessive perspiration. Infections, such as viral illnesses, bacterial infections like strep throat, or parasitic infestations, are recognized causes. Psychological stress can also exacerbate or induce hives. Sometimes, the cause remains unknown, termed idiopathic. Oral Allergy Syndrome (OAS) is a specific allergic reaction to certain fruits, vegetables, and nuts, often linked to pollen allergies, causing itching or minor swelling in the mouth and throat.
Relief and Medical Care
Managing oral hives involves immediate relief and medical attention. For mild cases, home care includes avoiding known triggers, applying cool compresses, and consuming soft, bland foods. Over-the-counter oral antihistamines like cetirizine or loratadine can reduce itching and swelling.
Medical intervention is necessary if hives persist, recur frequently, or are severe. A healthcare professional may prescribe stronger antihistamines or a short course of oral corticosteroids to reduce inflammation if initial treatments fail. Seek immediate medical attention if oral hives accompany signs of anaphylaxis, a severe allergic reaction. Urgent symptoms include difficulty breathing, wheezing, swelling of the face, tongue, or throat, dizziness, a rapid or weak pulse, or a sudden drop in blood pressure. In such emergencies, an epinephrine auto-injector might be necessary, followed by prompt medical assessment. A professional diagnosis is important to identify the underlying cause and ensure effective management.