032: What's Going On Beneath Hives w/ Dr. Alan Dattner

We haven't discussed this particular skin condition yet, and it's a big one, despite being quite misunderstood! Hives. Many people who suffer with chronic hives assume they are just a part of life, and always caused by stress or allergies. My guest today is here to turn that theory on its head.


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Dr. Alan Dattner is a board-certified Dermatologist practicing Holistic and Integrative Dermatology for nearly 40 years, helping patients who have failed conventional care. He uses nutrition, herbal medicine, supplements, Functional Medicine, Applied Kinesiology, psychosomatics, and more to heal the underlying causes of skin disorders.

Dr. Dattner has a background in Immunology, having worked in six different immunology laboratories with renowned scientists, culminating in studies of cross-reactive immune recognition as a Visiting Scientist at the National Institutes of Health. That research led him to understand the scientific validity of digestive issues as a cause of inflammation in the skin.

Today, we'll be talking about hives: the different types, as well as how supplements, food, and the digestive system can have an impact on this condition. 

Have you used any of Dr. Dattner's strategies to manage hives? Leave a comment!


In this episode

  • Stress management tips when it's a rash trigger
  • What are hives?
  • Aside from histamine, what causes hives?
  • Appropriate lab testing for those with hives in their medical history, as well as why your medical (and sometimes even personal) history is such an important diagnostic tool.
  • Different types of hives.
  • Natural anti-inflammatory and anti-histamine herbs and supplements that might be helpful (after you have discussed them with your practitioner).



“Hives appear as red blotches on the body that are slightly raised (they're not scaly). They tend to itch or occasionally burn and they tend to move around. So if you were to draw a circle around the periphery of a lesion that came up, and then look an hour or two later, it would have moved somewhere else.” [1:38]

“Stress is a known and listed cause of hives. And of course, there are also physical kinds of hives from pressure, from cold…” [12:03]

“I think that leaky gut allows allergens to get through that shouldn't. Fixing leaky gut (enhancing digestion), that's something that I've used to fix somebody who was on two antihistamines and was still breaking out with hives.” [16:33]



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“Hives appear as red blotches on the body that are slightly raised (they're not scaly). They tend to itch or occasionally burn and they tend to move around. So if you were to draw a circle around the periphery of a lesion that came up, and then look an hour or two later, it would have moved somewhere else.”

032: What's Going On Beneath Hives w/ Dr. Alan Dattner FULL TRANSCRIPT

Jennifer:              Hi everyone and welcome back to The Healthy Skin Show. I've got a fantastic guest with you today, someone that I am deeply honored to interview and to be honest with you, as I was reading his bio, I was just like, man, this man has done a ton of stuff and it is really, it is just such an honor to have him here and to talk about the topic of hives today with me. His name is Dr Alan Dattner and he's a board certified dermatologist practicing, practicing holistic and integrative dermatology for nearly 40 years helping patients who have failed conventional care. He uses nutrition, herbal medicine, supplements, functional medicine, applied kinesiology, psychosomatics, and more to heal the underlying causes of skin disorders. Now this is the cool part about him. He has a background on immunology having worked in six different immunology laboratories with renowned scientists culminating in studies of cross-reactive immune recognition as a visiting scientist at the national institutes for health. The research led him to understand the scientific validity of digestive issues as a cause of inflammation in the skin. Dr Dattner, thank you so much for joining us.

Dr Dattner:         You are very welcome.

Jennifer:              Wow. Yeah. So let's do a little, let's do a little bit of like a once over on what exactly hives are for people that aren't exactly sure. I think most people have them know, but there are people who aren't sure what hives are and what causes them.

Dr Dattner:         Well, hives appear as red blotches on the body that are slightly raised. They're not scaly. And they tend to itch or occasionally burn and they tend to move around so that if you were to draw a circle, draw around the periphery of a lesion that came up and then look an hour or two later, it would move somewhere else as opposed to other kinds of skin reactions that come up and stay in the same place. And they're caused by release of various kinds of molecules that open up the vessels and let the fluid go out into the skin causing edema. And usually we think of them as being caused by histamine. That's the most common cause of hives. But there are all kinds of other vasoactive peptides that can cause them as well. So it's more complicated than just a histamine release.

Jennifer:              Interesting. So could you just share a little bit about what other things could cause hives?

Dr Dattner:         So some hives are caused by an allergic reaction and one that the allergists will claim as a true allergic reaction involving IGE immunoglobulin E, the antibody that one the allergists test for to look for reactions to pollen and dust and that sort of thing. And some are caused by various kinds of molecules that set off a series of reactions that are not necessarily allergic. They may be more something that trips off histamine release or something that trips off release of other vasoactive peptides. So there's a whole literature, a lot of it coming from Germany on pseudo allergens causing hives. So pseudo allergens because they're not, they're not getting IGE responses, so they call them pseudo allergens. And it's a very confusing literature because if you look at it really carefully, you can understand that there could be other things going on besides pseudo allergy.

Dr Dattner:         No drugs, certain drugs can cause hives. And that's certainly one of the questions you ask. Somebody who has hives. Various kinds of infections and parasites can set off hives. And there's some specific ones related to perhaps the kind of exposures of given individual has for instance, is a kind of parasite in fish in the Mediterranean that's known to cause hives. So you know, you might ask somebody, if they'd been traveling in the Mediterranean and eating fish, you know, and then mycoplasma pneumonia can cause it. So you might want to check somebody for that. There are, so there's also in the pseudo Allergan category are a lot of food additives, food dyes, things like smoke, meats alcohol. These are things that are probably not actually allergic but setting off a set of reactions. So and there are people who have pseudo allergen free diets, so that you can look at.

Dr Dattner:         But when I look at some of the pseudo allergen-free diets, I realized some of those still could be allergies. You see the people, the true allergists really think that the IGE is the main cause of allergy. Okay. So the immune system is much more complicated than that. My, my studies have been in lymphocytes, the white cells that cause delayed hypersensitivity reactions and kind of direct the immune system to do other things. But there are also immune complexes. There's IGG, there's IGA protects the barriers of the mucus membranes. So any one of these can be involved. So the problem is that if you only look in one place, you know, you only see what the police are doing. You don't necessarily know what the coast guard and the army and the air force are doing.

Jennifer:              That's a good point.

Dr Dattner:         So that's something that people forget about when they're, you know, when they're doing tests to study what kind of reaction they have. So what I found is it's best if you can do the test that really looks at something that's related pathologically to what, what the pattern of pathological processes in your body.

Jennifer:              It does. So most people will go to the allergist and if the allergist is willing, I, it's amazing how many times the allergists are not sometimes willing to actually look any deeper. Like just take some Benadryl, you'll be fine. You know, maybe they'll do like a scratch test and sometimes they might run an IGE panel on their blood. I assume that those are just looking at, as you were saying like the police force, so to speak and not looking at other things. So what do you recommend if someone presents to you with a oh, a pretty decent history of hives. They can't figure what I did out, what it is they've taken out strawberries and all these other foods. They've tried to manipulate their diet and they're not getting anywhere. What would you recommend for their first few steps is where to look and any type of lab testing that might be appropriate.

Dr Dattner:         Well, let me say, you mentioned the magic word there and that was history and one of the most valuable things that I have working with people and I hope that this medicine gets to be able to shift again to get back to that, is that the history is the most important thing. So what I'm vitally interested in is what happened before in the in the hours, days, or weeks preceding the outbreak, preceding an aggravation, preceding an improvement. Looking at that very carefully and going over and over again is what brings me the information that I need most before I do any testing.

Jennifer:              Wow. So what listeners could take from this is they need to do some detective work at home and really think about what happened before and then what's going on around the reactions before , during, after.

Dr Dattner:         Exactly. And presenting that information to a willing position. Will then allow that willing physician to ask questions to go deeper and deeper because usually even my first questionnaire doesn't bring the answer. It's, beginning to get hunches and suspicions and ask further questions to find out what it was. For instance, I had somebody yesterday who I on the phone who had some issues that I suspected had an allergic basis and it was only a half an hour into the conversation before I found out that it all started right after they'd put a new wing on their house. Why was I interested? Because I suspected formaldehyde sensitivity and the new wing would have plywood and press board. That would be degassing formaldehyde.

Jennifer:              Wow.

Dr Dattner:         So that's what I mean about persisting and, and I really you know, I, I appreciate it now when my patients bring me a history, not that that gives me all the answers, but it gives me more of a basis to go deeper and deeper to find out what's going on. Cause once I had one suspicion, then I can ask more relevant questions. It's impossible for you to go to a physician and tell him everything that happened in the past year would take a year.

Jennifer:              That is true. That is true. I mean even my intake is like an hour then it's a 90 minute call and it's long. It's a long process to really understand, a patient's or a client's history for sure. And one thing that's interesting, I wanted to point out to everyone you mentioned about this patient of yours had this recent home renovation project. So what I'm taking from this that somebody who maybe has only seen a very conventional doctor is that you really shouldn't leave anything out. Like you shouldn't self edit anything. Like maybe getting new carpeting, repainting your house, anything that's a real shift in your environment or your history could be a clue.

Dr Dattner:         I like that terminology that you use a shift in your environment. Yes, that's very important. I mean you can't say everything, everything that happened, but the structure and I think we're going to learn how to do that better. We're going to get better software tools to build a structure. Just like when you read something and there's a little blue word and you can press on it and find out more about it. I think we're going to eventually be building our histories that way so that, so that we can give further detail when somebody needs to look into it. You know, we're, we've gotten a medicine to the point where the, the drugs get paid for the, you know, there's some nice drugs that help with the IGE response. There I think they discount them down from 37 to 31,000 a year. So,

Jennifer:              Oh my goodness.

Dr Dattner:         So there is some kindness there in the industry. But these could be replaced in large part by allowing a knowledgeable physician to spend the time with a patient who takes the time to prepare their information. It's not like, you come in and you say, oh, you know, I don't remember that. An individual has to sit down with a calendar and they think about when this started. It started, you know, it started oh, after, right after the holidays. Oh yes. And then you begin to say, you know, I, well, we had a few extra drinks. We, we went out. I don't normally eat walnut pie, but I had walnut pie.

Jennifer:              And even like, maybe there was a traumatic incident, like your father in law suddenly died and it was very upsetting. Or you lost your job. You were in a car accident, any number of things.

Dr Dattner:         Stress is a known and listed cause of hives and of course there are also physical kinds of hives from pressure from cold. You know those are all causes of hives. Sometimes with cold there may be certain kinds of cryo globulins in the blood. So one brings all that information together. A person with cold urticaria can be in serious trouble if they jump into cold water.

Jennifer:              Well, so here's my question to you. I think it would be great since we have a few minutes left in our conversation to just talk about some natural anti-inflammatory anti-histamine type herbs and supplements that might be able to help somebody. Like, you know, right now they're in the midst of it, they don't know what to do, but they want some relief and maybe they're just getting fed up using Benadryl and some of these other drugs that are over the counter on the market. Do you have any suggestions of what someone could consider shifting to that might not be so not toxic. But you know, a lot of people get uncomfortable with using medications longterm when they're not, they don't know what to do. They're just uncomfortable. But,

Dr Dattner:         Well, I will give you some, but with a caveat. Remember and this is because I don't want it to tell somebody that this is going to be the answer and then have them go into anaphylactic shock and die.

Jennifer:              Good point.

Dr Dattner:         That's ability because, you know, a lot of the things that we use that are natural substances are herbs and herbs are weeds and weeds can be allergic and it depends upon the family. So somebody really, I think that somebody who is going to use these things needs to go over it with their practitioner beforehand and make sure that they don't, the thing that they're taking is not related to something that's going to put them in even worse trouble.

Jennifer:              True. That is an excellent point. I appreciate you for saying that.

Dr Dattner:         So with that caveat, I, these are, these are things that I'm recommending somebody talks to their natural practitioner or their physician about before they use them because the last thing I want to know is that I saved a hundred people from hives and one person went into anaphylactic shock and died. And I don't want that to be out there. That would be terrible, I feel.

Jennifer:              Exactly. Exactly.

Dr Dattner:         So these are things that one should consider discussing. So one of them is a stinging nettles. Yeah. It was an interesting nettles or nettle leaf, if you touch it, it causes histamine release and it gives you, it will give you hives. But if you, if you boil the nettles or you treat them in different ways, they have an anti-histamine effect. Sometimes combined with an enzyme called DAO, they can be very effective because you're blocking two different pathways of histamine release. Again, DAO often comes from animal sources. You've got to make sure that you don't a problem with those, with those sources. And you need to be sure that the urtica doesn't further aggravate you. Or if you were to use the fresh leaf, you would get a lot worse. Of course it didn't can be very helpful. It's part of the program that I use. And there are, I think those are some of the biggest ones that I like. It depends upon the reaction. You know, there are people who get food reactions who do well with a a bicarbonate. But that's not necessarily for hives. Let me think of some other things that I like.

Jennifer:              Yeah, I've had, I've had some really good luck with stinging nettles and quercitin, but obviously it has to be appropriate for that client. And obviously digging deeper is a big piece to this. You can't just because it's not just about stopping them or managing the reaction.

Dr Dattner:         Well, the you know, there, there are certainly other things that are listed, you know, licorice is, helps you enhance your cortisone levels and that can be helpful. Ginger can be helpful. Curcumin can be helpful. Enzymes like bromelain may be helpful, but, but these are all these are all symptomatic natural treatments for me. Again, going back to the cause is really crucial and getting worked up. Is this an infection for me also, I think that that leaky gut allows allergens to get through that shouldn't and fixing leaky gut enhancing digestion. That's something that I've used to fix somebody who was on two anti-histamines and still breaking out with hives.

Jennifer:              Oh my gosh.

Dr Dattner:         Yeah. And you know, going in and fixing the leaky gut and the organisms in the gut that were leading to that, helping the digestion in liver, that all made a big difference for somebody. So, so you see the use of the natural anti-histamines is just a part, I'm doing a proper natural workup.

Jennifer:              So anybody listening to this, would you say that there is hope that this doesn't necessarily have to be a forever situation, but by figuring out what those root cause triggers are, you have a much better chance getting your body back to a better, a more balanced homeostasis.

Dr Dattner:         Oh, exactly. But of course, you know, if you're living in a house that's you gassing all kinds of things that you're toxic to, it becomes a bigger prescription.

Jennifer:              Good point.

Dr Dattner:         So, if you're eating a diet that you know, that it's challenging if you're if you're drinking alcohol and that's one of the stimuli and that's what you need to do to have a business lunch to stay in work, that's a big challenge, you know. And so for some people it's not just an addiction, it's you know, it's a work in lifestyle issues has to be addressed. So the, you know, these are some of the bigger questions. People who keep pursuing the issue can find an answer. Some probably 30 years ago there was at the dermatology meetings is one dermatologist who had a presentation that he gave called A Hives Seek at least two causes. So it's often not just one thing that's causing it that, you know, there may be more than one stimulus for the hives and from the standpoint of leaky gut and various kinds of allergens. Once you have that, you get all kinds of things coming through, you know, and you've got to work your way back along the causal chain. If a stress is a big part of it, you need to develop some techniques for calming yourself down. That's crucial. Whether it be deep breathing or yoga or exercise. Uthose are all pieces to getting well. So if you're willing to follow a path and keep peeling off the layers of the onion that are leading to the problem that you're having, you're going to get improvement.

Jennifer:              Yeah, and I also wanted to kind of end on a positive note that you also have a really fantastic book that readers could check out called Radiant Skin From The Inside Out, the holistic dermatologist guide to healing your skin naturally, which is available on Amazon. And I'll put that link in the show notes. So it's really easy for everyone listening to get access to that. And you also have a fantastic website over at holisticdermatology.com you've got a great free ebook. Anybody that's dealing with acne, 10 Steps To Clear Acne Naturally. So they should definitely get in touch and check out what you're doing because you've got a wealth of information. For those of you watching this video, you can even see Dr Dattner is in the midst of all the research, which is what I love about him. He's really in it. And,uyou know, that's just such an amazing thing and I feel so honored to have you with us.

Dr Dattner:         Thank you very much. It's been an honor for me to be on this show and I hope that the information that I have out will help people understand more from a more scientific, solid standpoint before they go off on all the blogs. Because the more you understand the actual causes, the actual things that are going on, the better you're going to be able to make choices when something is suggested to you to do, to help fix your problem.

Jennifer:              Absolutely.

Jennifer Fugo, MS, CNS

Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.

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