• Try to avoid exposing your skin to sudden and extreme changes in air temperature.

• Wear soft, light-weight clothing. Tight clothing made from rough, scratchy material is too irritating to the skin.

• When washing, avoid soap and hot water; both can draw natural oil from the skin and dry it further. Instead, bathe in lukewarm water with a moisturizing "cleansing" bar or liquid "non-irritating" cleanser; both are available at most drugstores. And remember: Don't rub your skin with a towel; pat yourself dry. Apply moisturizers when you have finished bathing.

• If the maxillary sinuses inside your cheekbones are infected, the pain will be in your upper jaw and teeth, and your cheeks may be tender.

• If your ethmoid sinuses behind the bridge of the nose are infected, the pain will be around your eyes. Your eyelids may be swollen and you may have tenderness on the sides of your nose, a stuffy nose and a temporary loss of your sense of smell.

• When the sphenoid sinuses above the ethmoids are infected, you'll probably have an earache, neck pain, and an ache on the top of the head.

In addition to pain, sinusitis also can cause postnasal drip due to the drainage of mucus from the nose into the throat.

• drugs (such as penicillin, aspirin, or sulfa)

• plants (such as nettles) and pollens

• animal fur

• insect bites or stings

• exposure to heat, cold, or sunshine.

To determine the cause of your hives, the doctor may suggest that you do the following:

• Keep a detailed diary of everything you eat, drink, take, or are exposed to for 2 to 4 weeks.

• Avoid foods, one at a time, to which you think you may be allergic.

• See an allergist for skin tests.

It is easiest to identify drugs, foods, or plants that may cause you to have hives because the response usually occurs within an hour of exposure. Finding what triggers hives such as emotional stress or multiple allergies may take more time and require skin or other tests.

The treatment your doctor recommends will depend on how serious your hives are. He or she may suggest that you do one or more of the following to relieve the itching and reduce the swelling:

• Soak in a lukewarm bath or use cool compresses.

• Avoid heat or rubbing, which releases more histamines.

• Take antihistamine medicine to reduce the allergic response.

If the rash is severe and/or not responding to the above treatments, you may need to take a brief course of oral corticosteroids (for example, prednisone).

Some allergic reactions are emergencies. If your hives have abrupt onset and are spreading quickly, you will likely receive an injection of antihistamine such as Benadryl (diphenhydramine). If there is any question of throat swelling or tightness or of difficult breathing or of wheezing, you will also receive an injection of epinephrine (adrenaline) to counteract the reaction. Once the emergency symptoms have been treated you will be instructed in medication to take for the next several hours to days to prevent the reaction from recurring.

These severe allergic reactions can be life-threatening and require immediate medical treatment.

The effects of hives can last from a few hours to several weeks or months. Hives will eventually clear without treatment, but taking drugs such as antihistamines or corticosteroids help the hives go away faster, treat the itch, and prevent new hive formation.

Chronic urticaria last for a longer period. Most often, more than 50% of the time, it is not possible to determine their cause. Antihistamines are usually very helpful. The hives resolve spontaneously after weeks or months but may recur off and on.

Call the doctor or 911 at once if you have an allergic response that affects your breathing.

In addition, follow these guidelines:

• If your face begins to swell around the eyes and lips, call your doctor or 911 at once.

• Take antihistamines or other medications to help relieve your symptoms. Be sure to ask your doctor or pharmacist about possible side effects or drug interactions.

• Avoid foods that seem to cause you to break out.

If you have a known severe allergy, such as to a bee sting or a food such as peanuts, which you might inadvertently contact, ask your doctor about carrying EpipenŽ. Epipen is a single dose injection kit of epinephrine you can give yourself to counteract the allergic reaction until help arrives.

When you know the cause of your hives you should take steps to avoid the offending irritant. You may need to take frequent, even daily, antihistamine to prevent recurrences.

Last updated December 03, 1996