Author: Jeanne Sager

Mattress skin. Cottage cheese thighs. Orange peel tush. There are dozens of words we’ve come up with to avoid talking directly about the cellulite that starts cropping up on our bodies when we least expect it.
The reality is cellulite is simply a part of life—a normal part of life at that. As many as 80 to 90 percent of girls and women who are past the puberty stage have at least some cellulite somewhere on their bodies.
Unfortunately, being one of the girls doesn’t necessarily make us love our lumps. We live in a society where tabloids splash paparazzi shots of celebrity women across their covers with giant headlines labeling the stars “imperfect” and using arrows to point to a few dimples on their thighs. The implication (however false it may be) is clear: Cellulite is proof your body’s falling apart.
We’ve certainly internalized those headlines. In one survey performed on behalf of a company that develops laser treatments, women with cellulite rated their own appearance on average lower than the appearance of women without cellulite. Almost all (97 percent) of the participants with cellulite said they’d change their appearance if they could.
But while there’s almost no avoiding the lumpy fat that crops up on tummies, butts, and thighs of famous models and not-so-famous moms driving minivans around the neighborhood, cellulite treatments are out there if you want them. The problem for most women is sorting through the overhyped claims of fast fixes and overpriced offers to find cellulite treatments that can help us reclaim some of that smooth, pre-puberty skin.
That’s where we come in. We talked to the experts about the most popular cellulite treatments out there and found out what works, what doesn’t, and what you can do if you’re not feeling comfortable in the skin you’re in.

Cellulite: A Female Curse?

Before we even consider treating cellulite, did you ever wonder what the heck was going on down under your skin to make all those bumps and valleys? Let’s take trip back to high school science, shall we?
The skin has three layers: The epidermis is the outermost layer of skin. The dermis is the layer right beneath the epidermis. Below that is the subcutaneous layer, which is made up of fat and connective tissue.
“Throughout the fat layer, there are connective tissue septae, or bands, that run down from the skin and divide the fat layer into compartments,” explains Sejal Shah, MD, a board-certified dermatologist and RealSelf contributor from New York City. “Cellulite occurs when this underlying fat begins to push up against the overlying connective tissue and skin, while those septae pull down the skin, resulting in that characteristic dimpled appearance.”
Essentially, the fat that’s in our bodies sections off into little pockets deep underneath the skin, resulting in the dimples we know as cellulite. It typically begins sometime in a woman’s twenties or thirties—although it can happen earlier (some teenagers have cellulite) or later—and it’s most prevalent on the thighs, butt, and lower abdomen, although it can also appear on the arms.
While these fatty pockets can crop up on men’s bodies, it’s much rarer than it is in women. Just about 10 percent of cisgender men have cellulite, compared to more than 80 percent of cisgender women. There are a number of reasons for the gender divide, but the main thing? It’s yet another thing we can blame on our hormones, Shah says, specifically estrogen, the primary female sex hormone.
“Estrogen plays role in the development of cellulite,” Shah explains. “Women tend to have more body fat, and women’s fat is typically distributed in the thighs, hips, and buttocks, which are common areas for cellulite.”
Also at play in cellulite’s appearance is the way muscle develops in men versus women.
“In men, the connective tissue bands that connect skin and muscle are thicker, more in number, and form a crisscross pattern (unlike the vertical pattern in women), making it less likely for the fat to push through,” Shah notes.
Of course, not all women develop cellulite, and just why that happens and who it will happen to is still somewhat up in the air. Even scientists have yet to suss out exactly why some women wake up one day to cellulite while others never experience it at all.
“Because we don’t know exactly why people get cellulite, it’s not always possible to prevent it, especially since factors like genes and hormones play a role,” Shah says. But there are certain risk factors that tend to up your chances of taking a peek at your butt in the mirror and spotting some cellulite, including:

• Genetics (both being female and having a parent who had cellulite)
• A diet high in fat, carbohydrates, and salt, but low in fiber
• Lifestyle factors such as smoking, being sedentary, and lack of exercise (which results in low muscle tone)
• Poor circulation
• Hormonal imbalances or increased sensitivity to hormones
• Use of hormonal contraceptives
• Aging (as we age, the skin and connective tissues naturally weaken and lose elasticity, Shah says)
• Weight gain (but even thin people can have cellulite, Shah is quick to point out)

Of course, that all begs the question: What can you do about it?

Cellulite Treatments

If you have cellulite and it doesn’t bother you, you can stop reading right now. Okay, well hold up—not quite yet.
The truth is, cellulite is normal, Beverly Hills plastic surgeon Deepak Raj Dugar, MD, says. It’s not a disease. It’s not a reason to hit the emergency room. And while some of the potential causes (such as smoking or an unhealthy diet) can adversely impact your health, cellulite in and of itself is not going to hurt you and is not considered harmful to your health by the medical community.
If you want to let it be, there’s no reason to pay it any more attention. But what if you fall in the “I want it gone” camp?
There’s good news and bad news ahead. When asked if there are any means for cellulite treatment that are legitimate and backed by science, most doctors don’t pull any punches.
“Short answer is no,” Dugar says. “There have been no studies to ever show that a device, medication, or system was able to effectively reduce cellulite across the board.”
In fact, some body-contouring plastic surgery methods, such as liposuction, have actually been shown to make the appearance of cellulite worse. Okay, case closed, right? You’re stuck with orange peel thighs and cottage cheese tushie.
Not exactly. While there’s no magic pill that will address every single person’s cellulite issues, there are some options out there.
Here’s the real deal on the most popular cellulite treatments currently available.

Retinoid or Retinol Creams

Can cellulite treatment really be as easy as rubbing a cream on every day for a few weeks? Well, no, says Shah. “It won’t directly treat the cellulite, but [it] may improve skin texture and tightness, therefore reducing the appearance of cellulite.” Be wary of just any cream that you find in the drugstore or online that claims to get rid of cellulite, though. It’s only those with the active ingredients retinoid or retinol that offer that skin-tightening benefits.

Compression Stockings

Like creams, these seem like a fast and easy fix for cellulite woes, but they’re more cosmetic than a long-term solution, Shah says. Wearing support hose can reduce excess fluid, making the cellulite less apparent on your thighs, butt, and tummy. But once you’ve spent some time without that support, the dimpling effect will just return. The same goes for dry brushing and the “wraps” popular on Instagram. The compression effect can help in the short term, but it’s not a long-term cellulite treatment.

Cellfina

The first device to ever get FDA clearance for long-term treatment of cellulite literally cuts the connective tissue bands that pull down the skin and create the dimpled appearance of cellulite, Shah says. Performed by a doctor in an outpatient setting, Cellfina treatments use a small, needle-sized device that cuts those cellulite-causing bands just beneath the skin. The device is “minimally invasive,” according to the company, and side effects are typically limited to tenderness and bruising. The results are expected to last for up to a year, Shah says, although the company boasts patients can be cellulite free for as long as three years.

Cellulaze

Another treatment that can only be done by a doctor, Cellulaze is a cellulite treatment that’s performed in an office setting in an hour or two, allowing patients to go home immediately after treatment. “This [is] a laser treatment in which the laser is inserted just underneath the skin to cut the connective tissue bands that are causing the dimpled appearance,” Shah explains. Again, side effects tend to include tenderness and bruising, and the company notes there may be some leaking from the incision. Patients may have to wear compression garments for a short period of time after the procedure and avoid strenuous activity for as much as two weeks after treatment. The company behind the procedure promises results will improve over time and should last up to a year.

Other Laser Techniques

Cellulaze is a brand name (and one of the most popular treatments), but there are other radiofrequency lasers out there that are used to address the appearance of cellulite. Dugar says these devices use suction pulsing technology to help “separate the fibrous septa from the skin to reduce the herniation fat,” but warns that the efficacy of these is still low, and results are not permanent.

Fillers

Just as some people get fillers injected into their face to address fine lines and wrinkles, it’s possible to use injections to address cellulite. “These injectable treatments can be used to mask the appearance of cellulite by filling in the dimples,” Shah explains.

Brazilian Butt Lift

One of the most invasive cellulite treatments is less of a treatment and more of a way to mask the dimples by creating a barrier between the skin and the subcutaneous tissues below, Dugar says. A Brazilian butt lift involves liposuction, pulling fat from your flanks, abdomen, arms, and legs, and re-injecting that fat into your buttocks and thighs.
“When done properly, you can effectively create a barrier between the skin and the fibrous connective issues below, thereby reducing the appearance of the cellulite,” Dugar says. But, he warns, “this may only be temporary as studies have never shown that this is an effective treatment for cellulite. I have noticed that it can temporarily decrease the appearance of it.”

Diet and Exercise

No, it won’t eliminate all your cellulite, but it can have an impact, Shah says, at least on how your cellulite appears. “Being overweight may worsen cellulite because the more subcutaneous fat you have, the more likely it is to put stress on the connective tissue and bulge,” she explains.
Of course, cellulite can also happen in thin individuals, and exercise does not necessarily get rid of cellulite completely, but it can make it appear differently beneath the skin.
“As the connective tissue underneath the skin weakens or loses elasticity, it allows the fat to bulge,” Shah explains. “Strengthening the muscles in those areas will in turn tighten the skin (and burn excess fat overall), making the skin appear smoother and cellulite less noticeable.”
Any exercise is good exercise, but if you’re looking at your workout as a cellulite treatment, you’ll want to mix up your fitness routine.
“Combining aerobic activity with strength training is key to improving the appearance cellulite, and aerobic/cardio exercise alone is unlikely make much of a difference,” Shah says.
At the end of the day, cellulite may not be something that we can beat or even need to be that concerned about. But if you’re focusing on a healthy lifestyle, from diet to exercise to water intake to avoiding smoking, you may be able to help stave of developing more and help the cellulite that’s already there be just a little bit less apparent. If nothing else, a healthier lifestyle will equal a healthier you.

Stress: If you don’t have it, you’ve apparently found the pot of gold at the end of the unicorns’ rainbow. If you do—like most Americans—the phrase “cortisol levels” might have come up during one of your visits to your doctor’s office.
Cortisol is best known as “the stress hormone,” a chemical messenger the body produces when we’re feeling like we’re at the end of our rapidly fraying rope. It’s produced and secreted by a part of the body known by doctors as the HPA axis—a combination of the hypothalamus, pituitary gland, and adrenal gland that sends varying amounts of cortisol out to other parts of the body.
Linking cortisol to stress gives it a negative connotation, but in truth this hormone is not all bad, says David Cutler, MD, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California. In fact, Culter says cortisol is “essential in controlling our growth, organ development, immune functions, inflammatory response, and many other cellular activities.”
And while our cortisol levels do tend to spike when we’re stressed, cortisol production is part of the body’s functioning even when we’re having nice, normal, calm days (hey, they do exist!). Unfortunately, when your cortisol levels get out of whack, so can your body. Cortisol levels that are too high or too low can cause everything from extreme fatigue to blood pressure issues.
So how do you know if your cortisol levels are too high, too low, or just right? And is there really anything you can do about all that stress?
Sit down, chill out, and let’s do this.

What is cortisol, anyway?

Despite its colloquial name as the body’s stress hormone, cortisol is more aptly described by doctors as a steroid hormone, Cutler says—a complex molecule that has a variety of metabolic functions throughout the body.
“Its structure of carbon-containing rings is typical of steroid molecules,” Cutler explains, “And its functions can be mimicked by the synthetic cortisol hydrocortisone or other steroids.”
Yes, hydrocortisone, the tube of cream you grab at the drugstore when you’ve got an itchy rash, is related to cortisol. In the case of an allergic rash, smearing on a few dabs of hydrocortisone can tell the body to chill out and stop reacting to the allergen so you can get a little relief from all that itching. In the body, on the other hand, naturally produced cortisol helps to keep our systems in check, whether it’s maintaining the right levels of blood glucose or maintaining a healthy blood pressure. Basically, cortisol gives the body a little relief…from itching, and a whole lot more.
Much of what doctors know now about stress and the role cortisol levels play in the body’s response goes back to the 1930s and 1940s, when Hungarian endocrinologist Hans Selye explained the role the HPA axis plays in our fight-or-flight response to a problem. Selye found that corticoid hormones like cortisol were “indispensable for the maintenance of life and especially for the acquisition of adaptation to changes in the external or internal environment of the body.”

Cortisol Levels and Your Body

For the body to keep adapting to changes in its external and internal environment, cortisol levels have to change, Cutler says, and that’s usually normal. For example, cortisol may kick in as a response to any sort of stressor on the body,
Of course, this doesn’t just refer to “stress” as we’ve come to know it. Stress isn’t just your boss yelling at you or your child darting into traffic.
Stress can be getting extra busy in between the sheets, sending a message to your heart that it needs to increase the amount of blood it’s pumping to your heart, STAT! Stress can also come from that snacking on a pile of what you thought were gluten-free pretzels, only to find out you just “got glutened,” and knowing your celiac allergies are going to kick in, triggering an immune response.
“The transient rise or lowering of cortisol level is normal and in fact happens on a daily basis as cortisol levels peak upon awakening and bottom out shortly after bedtime,” Cutler explains. “They can also be affected by physical illness, fever, sleep deprivation, inflammation, pregnancy and emotional factors. In addition to internal factors, external factors such as diet, alcohol, caffeine, prescription medication, and nutritional supplements can also affect cortisol levels.”
You’ll notice some of these issues, including emotional factors, lack of sleep, and alcohol and caffeine usage can all be linked to what we traditionally think of as stress, while other factors are stressing the body in a more medical sense.
Semantics aside, when your body encounters stressors, cortisol comes out to play, helping the body keep its systems in check, and keeping your body healthy even in the face of an attack on the immune system. When everything seems okay, cortisol levels are then supposed to drop, increasing again only when they’re needed.
Unfortunately, cortisol levels don’t always work the way they should, says Carol Lourie, a naturopath and functional medicine expert who specializes in women’s health.
“Chronic stress is a contributing factor in elevated cortisol,” Lourie says. Other medical conditions that can increase cortisol levels are pregnancy, Cushing’s syndrome, Addison’s disease, pituitary or adrenal tumors, high blood pressure, obesity, and metabolic syndrome. Prolonged use of certain medical steroids such as prednisone or cortisone can also affect a person’s cortisol levels.

Addison’s Disease

If you have Addison’s disease, for example, your body may not produce enough cortisol and aldosterone (another steroid hormone), says Joseph Geskey, DO, an internal medicine specialist and vice president of medical affairs at OhioHealth Doctors Hospital in Columbus, Ohio. That lack of cortisol can result in a variety of gastrointestinal issues including nausea, vomiting, abdominal pain, diarrhea, muscle weakness, and weight loss.
When managed well, Addison’s sufferers can live a fairly normal life—in fact the most famous Addison’s patient might be President John F. Kennedy, whose disease was kept relatively secret until after his assassination, when an autopsy revealed his adrenal glands were almost nonexistent.

Cushing’s Syndrome

Patients who have Cushing’s syndrome are also affected by cortisol levels that are different from their peers’, but in their case, the cortisol levels are too high instead of too low.
“Cushing’s disease is caused by a tumor in the pituitary gland (located in the brain) that produces a chemical called ACTH (adrenocorticotropic hormone) that stimulates the adrenal gland to produce too much cortisol,” Geskey explains.
Cushing’s sufferers typically have round faces, extra fat on the back of the neck, stretch marks on the abdomen, easy bruising, and extra hair growth on face, neck, chest, and abdomen. If the tumor grows large in the pituitary gland, it can also cause vision loss, Geskey warns. Other complications of too much cortisol can be cataracts, [linkbuilder id=”336″ text=”diabetes”], hypertension, depression, and osteoporosis.

Signs Your Cortisol Levels Are Out of Whack

Despite the rather long list of conditions that might affect the body’s cortisol levels, there is some good news: Cortisol abnormalities are unusual according to Cutler. On the other hand, that also means doctors rarely test cortisol levels as part of an average physical or doctor’s visit.
“Because there is a very wide range of ‘normal’ levels of cortisol, as well as a certain degree of variability in these results, cortisol levels are generally not checked as part of a routine exam, but rather only if there is a high degree of suspicion of there being a cortisol abnormality,” Cutler explains.
So what sort of symptoms might prompt legitimate suspicion in you or your doctor? Lourie says it’s good to mention your concerns to your doctor if you have any of the following symptoms:

• Feeling you are overreacting to certain situations, have a very short fuse, or are easily angered
• Feeling anxious frequently for no apparent reason
• Feeling tired all the time no matter how much sleep you get
• Inability to relax and calm down, even during a restful moment
• Inability to sleep or waking up feeling unrefreshed
• Unexplained weight gain (without changing diet or exercise routine)
• Inability to lose weight (despite exercise and dedicated diet change)
• Unexplained acne
• High blood pressure
• Hormonal problems such as irregular menses or extreme cramping during menses

Many symptoms that would seem to indicate cortisol level abnormalities can be explained by other issues and will go away with treatment of said issues, but there are blood tests that can be done for cortisol levels to get to the bottom of the issue if other treatments don’t address the problem.
“Levels may seem abnormal when, in fact, there is no disease. And subtle symptoms may be found to be the result of cortisol abnormalities after more common causes have been excluded,” Cutler notes.

Managing Cortisol Levels

If a cortisol level abnormality is suspected, a primary care doctor will typically refer a patient to an endocrinologist, says Muneer Imam, MD, lead physician at the CIIT Medical Center, Long Island. The endocrinologist will call for blood tests, typically performed early in the morning and later again in the day to address the fact that cortisol levels fluctuate through the day.
Imam says a normal cortisol level is 6.2 to 19.4 micrograms per deciliter. “Anything below or above is out of normal range.”
If the numbers aren’t in range, the next step is determining why levels are too high or too low.
In cases of Addison’s disease, medicine is typically required. Doctors will turn to a class of pharmaceuticals known as glucocorticoids to replace the cortisol and mineralocorticoids to replace aldosterone, Geskey says. If an Addison’s patient gets sick, they can suffer an adrenal crisis, in which case doctors may administer cortisol via an injection.
For Cushing’s syndrome patients, on the other hand, treatment can involve surgery, medication, and radiation therapy. Surgical removal of the tumor that causes the condition offers the only long-term cure, Geskey says.
Diet changes may also be recommended by your healthcare provider, as food can have an effect on cortisol levels for some people.
Addison’s patients are often directed to increase their calcium and vitamin D levels, as well as salt intake, Geskey says, while Cushing’s patients may be told to eat a diet with foods rich in calcium and protein, which can possibly prevent muscle and bone loss associated with having too much cortisol.
Even those who are otherwise healthy and whose levels are not severely off track may benefit from dietary changes. For example, Lourie says, “Fast food choices and chronic stress add up to elevated cortisol levels.”
She starts patients off with an anti-inflammatory diet, eliminating sugars, processed foods, alcohol, and coffee. “The focus is on lots of fresh vegetables, healthy fats, gluten-free whole grains, small amounts of organic chicken, meat, and fish, as well as fruits.”
If upending your entire diet isn’t in the cards, it’s still a good idea to simply increase the amount of healthy foods in your diet, Lourie says, as that can put your entire body on a track to better health.
For other people with cortisol level issues that aren’t directly related to a medical condition that needs to be treated, diet, exercise, and other lifestyle changes are all on the table. Stress in life, after all, is part of what can make your cortisol skyrocket, and with it the side effects of cortisol levels that are too high.
Stress reduction techniques such as meditation, yoga, and acupuncture have all been found to help reduce cortisol levels.
“Although they are different, one of the common denominators is they all lower the body’s sympathetic nervous system, the fight or flight response, and activate the parasympathetic nervous system,” Lourie explains. “This is the part of the body’s nervous system which is calming and encourages relaxation and joy.”
Even focusing on something calming such as an art class to take your mind off your day-to-day could have benefits. In one small study performed by researchers at Philadelphia’s Drexel University, cortisol levels were tested on a group of 39 healthy adults before and after a 45-minute art class. The results? Three quarters of the group saw a drop in cortisol after letting their creative juices flow.
Of course, any treatment approach should be discussed with your medical practitioner, but if lifestyle changes can reduce your stress, you may just kill two birds with one stone.
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So your skin is covered in itchy red welts, and you’re desperate for anything, ANYTHING to make it go away. Welcome to the world of allergies, where hives are an irritating side effect.
Although the name sounds like a place where bees live, hives can happen when you encounter just about anything you’re allergic to, not just stinging pests. And when those welts start to well up on your skin, you’re going to want to know how to get rid of hives from the comfort of your home—and how to do it fast!
So let’s do this, shall we?

How to Get Rid of Hives

Before you do anything to treat your hives, you need to know what you’re actually dealing with.
Are there red blotches that look like welts on your skin? Is it itchy? Try pressing on it. Does it blanch, or turn white when you press down, and then turn pink or red again when you let go?
If the answer to all three questions is yes, you’ve probably got urticaria, the medical term doctors use for hives. Unlike rashes, which tend to spread and don’t blanch when touched, hives tend to stick to one part of the body and blanch, says allergist Tania Elliott, MD, a spokesperson for the American College of Allergy, Asthma, and Immunology and chief medical officer at EHE. They can show up anywhere on the body, and the itch can be mild to severe, making you want to tear at your skin with sandpaper for some relief.
Now for the good news: Most people’s hives are acute, meaning they will go away within 24 hours. Fortunately, treating acute urticaria at home is fairly simple.
Elliott suggests hitting the pharmacy for a non-sedating or non-drowsy antihistamine. Brand name products like Claritin and Zyrtec or generic versions will all do the trick, taking the itch out of hives in about 20 minutes.
If you want to go the natural route, hit your kitchen. Grab a plastic baggie and fill it with ice cubes. Wrap the ice in a thin towel and place it up against the hives. Your body’s nerves will only be able to send one response to the brain, Elliott says, so your body will either process the cold or the itch. The cold from the ice will overwhelm and quell the itch, at least temporarily.
You can also apply some aloe vera to the affected area, according to esthetician Ildi Pekar. Not only is the aloe plant known for its skin-healing properties, it’s also naturally cooling, so it offers a similar sensation to ice without the need to hold a baggie full of ice cubes against your skin.
One important thing not to do? Don’t scratch furiously at your skin, no matter how much you are tempted. Deep scratching opens up the skin, which can lead to infection, taking a simple case of “treatable at home” hives into “it’s time to see the doctor now” territory.
Of course, if the hives aren’t your only symptom and you’ve got a fever and chills along with those red welts, don’t stick around the house. Call your doctor immediately. It may be nothing more than a simple virus that you’ll kick in 24 hours, but it’s better to be safe than sorry.
Elliott says, “If symptoms ever progress beyond the skin, such as difficulty breathing, swelling, feeling faint, or vomiting, that is a serious emergency and 911 needs to be called.”

What causes hives anyway?

Now that you’re feeling better, it’s time to get to the root of the problem.
The American College of Allergy, Asthma, and Immunology estimates some 20 percent of the population will deal with urticaria at some point in their lives. The main cause for all those hives typically comes down to just three things: food, medication, or illness.
Yes, illness. While most people think of hives as a reaction to an allergen, sometimes they’re just the body’s way of reacting to the flu or another sickness.
“It’s the immune system getting funky and going awry, and the allergy system goes along for the ride,” Elliott explains. In other words? You aren’t allergic to anything, but your body is reeling from infection. That’s why if you show up at your physician’s office with hives, doctors will typically ask if you’ve just gotten over an illness or opt to run tests for flu, strep throat, and the like.
If you haven’t been sick and don’t sense you’re coming down with an illness, an allergy to food or medication is another likely cause. While your body can react to other allergens, typically airborne environmental allergens don’t cause hives, Elliott says. “You’d really have to be rolling in it [for that to happen],” she says. Instead, most environmental allergies cause contact dermatitis with a rash that doesn’t blanch and tends to spread.
With true hives, on the other hand, typically you’re dealing with something ingested or something already going on internally, she notes. In cases of ingested allergens, the allergy cells in your body get aggravated and then release a chemical called histamine, which causes swelling, itching, and redness.
The reaction typically kicks in within 15 minutes, Elliott says, but doctors advise you to look to medicines or food you ingested within the past six hours, as there can be a delayed response.
Look for patterns. Have you taken a new medicine that you’ve never taken before? Did you eat a new food? Have you had itchy welts after eating one specific food? If it happens more than once, start writing things down. If you do end up scheduling an appointment to see a physician, you’ll want to take a food diary with you when you visit the doctor.
If your hives are acute—which is the case for most people who experience hives—they will go away within 24 hours, and it’s unlikely you will need to see your physician. They may come back again when you eat that one food item or take that one medication, but they’ll likely disappear once again within 24 hours, provided you don’t have contact with that allergen again.
Other people have what are called chronic hives, meaning they stick around for at least six weeks. But you don’t have to wait that long to get some help: It’s when the hives just won’t go away after a week or two that the medical community recommends you visit an allergist.
During your appointment, they’ll run blood tests and sometimes targeted food allergen tests (if you notice, for example, that the hives have occurred after eating a specific food) to see if they can pinpoint the problem. Typically adults can account for their eating habits better than kids, Elliott says, so it’s rare for doctors to have to run extensive food allergy testing on grown-ups.
While you’re there, the doctor will also look for other issues going on in the body. On rare occasions, hives can be a signal that you’re fighting an autoimmune disease or even a blood cancer, but that tends to come with additional symptoms. Again, Elliott is quick to point out that this is rare, but if you’ve got joint pain along with the hives, for example, or extreme fatigue, your doctor may start digging deeper to determine whether the hives are part of a larger problem or if they exist on their own.
Some people may also suffer from hives that can be traced back to temperature triggers, says allergist Ashok Gandhi, MD, of the Marion Area Physician Group in Marion, Ohio. For some folks, that means they experience hives in the winter when their body gets especially cold. For others, they may have a hive flare-up in sunlight.
But the majority of chronic hives sufferers are in Hilary H.’s boat. The hives sufferer tells HealthyWay she has lived for years with what’s known as “idiopathic hives,” meaning doctors can’t figure out why the itchy red welts crop up on her body.
“They began appearing about four years ago, and after a few months of having me try a combination of steroids and antihistamines to keep them under control, my immunologist declared them chronic,” Hilary tells HealthyWay. “When the immunology resident delivered the news that they were chronic, she prescribed antihistamines and told me, ‘You will be taking these…for the rest of your existence.’ That phrasing still cracks me up!”
Chronic hives remain a mystery for doctors, even the experts in the allergy field. “In a lot of chronic cases, even after all the testing, we still cannot find the reasons for hives,” Gandhi explains.
It’s frustrating for patients, but Elliott likes to tell her patients that hives are similar to conditions such as high blood pressure in that regard. She says most people simply accept that there are many factors that could be causing their high blood pressure…and the same goes for hives. It doesn’t mean they can’t be treated, nor does it mean you can’t live a normal life. It just means you don’t know why you have the condition. Half of chronic idiopathic (unexplained) hives cases will go away within a year, Elliott adds.

How to treat the discomfort of hives.

Prednisone, a steroid, can keep hives at bay, Gandhi says, but it has drawbacks: Once you stop prednisone, the hives tend to come back. “Prednisone on a long-term basis also has a lot of side effects, so it’s not a real solution in terms of solving hives on a long-term basis,” he adds.
Doctors often turn to prescription-strength antihistamines to keep the redness and itchiness at bay. Medications such as Allegra or Zyrtec, which are available over the counter to be taken daily, are often increased to twice-a-day prescriptions to help get rid of hives. Zantac, an over-the-counter medication best known for treating acid reflux or heartburn, may also be added on for hives sufferers, as it’s been found to be effective for soothing urticaria.
If the hives don’t respond to the pill options, the next step is an injectable medication called Xolair, Gandhi says, which you receive at your allergist’s office. If you’ve heard your friends talking about their allergy shots, this is one of them. Because you have to return to the doctor’s office monthly, it can be inconvenient for patients, and it’s typically expensive, requiring prior authorization from insurance companies.
“It has its own set of side effects that one has to keep in mind,” Gandhi warns, “But it works pretty good for the hives which are not responding to any of the other [medications].”
Regardless of treatment, and regardless of the cause, doctors hope that the hives will eventually go away, and for most people they do, Elliott says. About half of chronic hives sufferers will see them simply disappear within a year. Others may see them go sometime within two years.
If they don’t disappear, and no other symptoms crop up that cause doctors to investigate further, a daily antihistamine regimen becomes a part of life. Even there, the news isn’t all bad.
Hilary has managed to get her hives under control with twice-daily Allegra, and she can go weeks without a hive popping up. Then again, it’s not all smooth sailing.
“Then suddenly something will set them off without warning, and I’ll add another antihistamine (Zyrtec or Pepcid),” she says. “Typically that gets them back under control within a day or so.”
“Usually any individual hive or patch of hives doesn’t last for more than 24 hours, although more might crop up that will also last 24 hours,” she adds. “ If they’re really itching or painful, I find that cooling my skin off can provide quick temporary relief. So I might run my hands under cold water or take a cool shower or hold an ice pack on them to take the edge off. That really helps!”

Never again!

If you can determine the trigger for your hives, you’re in luck. A specific food or medication can be avoided, which means you can avoid future flare-ups.
Sometimes your allergist may recommend a low histamine diet as well, Elliott says, as histamine is contained in a variety of foods.
“Ever get an itchy mouth from eating pineapple? That’s because it’s high in histamine content!” she notes. “Other foods to avoid [include] alcohol, aged cheese, processed meats, and dried fruit.”
All that said, sometimes hives show up only once, never to return again. Unless you’re seeing them repeatedly, the experts say you can often keep on living life the way you always have without fear of a recurrence.

If you’ve ever woken up with a stomach that feels like it’s housing an expanding balloon, you know all too well that bloating is no fun. That bloated feeling in your stomach can make you feel like crawling back in bed instead of heading out for the day.
But with recent warnings from British doctors that some women are confusing the symptoms of ovarian cancer with bloating during their menstrual cycle, a lot more of us are on edge about that full-belly feeling.
So when are you experiencing normal bloating, and when do you need to call the doctor? And if it’s just a bloated stomach, do you know how to get rid of bloating with fast home remedies that will have you getting on with life in 24 hours (or less)?
We talked to the experts to get you the answers you need.

What’s going on?

Bloating is uncomfortable, and it can send folks running for their doctors’ offices, but it’s not technically a disease. Instead, bloating is a symptom that can accompany various diseases and conditions. It can be a sign that you’ve eaten too much, had too much to drink, or even inhaled too much air.
If you were to describe what it means to feel bloated, words like bleeech and ugh would fit in nicely. But medical practitioners—not surprisingly—have a more clinical vocabulary when it comes to defining bloating.
“Bloating is a sensation of fullness in the upper abdomen,” says Alexandra Guillaume, MD, director of the Gastrointestinal Motility Center at Stony Brook Medicine and assistant professor in the Long Island, New York, university’s department of medicine.
That sounds simple enough, right? If the top of the belly feels extra full, you’re bloated.
But that’s where the simplicity ends and the confusion can begin.
That feeling of increased abdominal pressure is often accompanied by what’s called “abdominal distentions,” or a visible enlargement of the waistline. As anyone who has a pair of Thanksgiving pants knows, sometimes the two go together, sometimes they don’t. But it turns out you don’t need that distended-belly look to feel absolutely miserable…or to be bloated.
In one study published in the medical journal Gastroenterology, researchers measured abdominal girth in relation to pressure complaints, and just 48 percent of patients with bloating had measurable distention in their torsos. The other 52 percent were still bloated, but doctors couldn’t see the physical signs on the outside. And theirs wasn’t the only study to come to this conclusion.
What’s more, while some people experience bloating and gas at the same time, the two don’t have to go hand in hand.
“Bloating can be the result of having an increased or intolerable amount of gastric and/or intestinal gas, as some individuals experience the symptom of bloating with normal amounts of gas,” Guillaume says. Then again, bloating can be the result of anything from increased fluid in the abdomen to bowel wall inflammation to what Guillaume calls “malabsorbed food substrates” (parts of the food that haven’t broken down and been absorbed into the body yet).
In other words: You can be bloated without flatulence or burping, and you can have gas without being bloated.
So how do you know it’s really bloating and not, say, gas or weight gain that’s affecting your abdomen? And how do you know it’s not that virus that’s been going around your office?

Let’s start with where it hurts.

“Most people feel this sensation between the belly button and up to the middle of the rib cage,” says Boston-based dietitian Kate Scarlata, author of The Complete Idiot’s Guide to Eating Well with IBS. Gas, on the other hand, tends to occur in the large intestine or lowest segment of the gastrointestinal (GI) tract.
Another defining feature of bloating? There are just a handful of typical causes:

Swallowed Air or Aerophagia (Excessive Swallowing of Air)

We need air to breathe, but there really is too much of a good thing, Guillaume says. Excess swallowing can occur when you’re sucking on hard candies, chewing gum, or experiencing anxiety, which may cause you to suck in large amounts of air.
“Carbonated beverages such as soda, seltzer, and beer can also generate excess gastric and intestinal air,” Guillaume warns, adding, “This is usually brief.”
The good news? All that extra air may cause bloating, but it’s typically easily expelled, so you can get rid of bloating fast.
“Air advancing from the stomach into the upper small bowel is usually promptly cleared,” Guillaume says. “Carbon dioxide and oxygen rapidly diffuse through the intestinal wall. Nitrogen gas is poorly absorbed, but is rapidly propelled towards the colon and expelled through the anus.”
In other words, you’ll probably burp and fart it out.

Food Intolerance and Carbohydrate Malabsorption

If you’ve ever felt like your dinner just didn’t agree with you, you might be right. Food doesn’t have to be spoiled or laced with a toxin to bother our systems. Nor does it have to be unhealthy.
Eating a lot of fiber or carbohydrates such as bran, cabbage, beans, broccoli, or similar foods can all cause discomfort in your abdomen.
Bloating after a meal can also be a sign of a food intolerance or disease, Guillaume warns.
If you experience bloating after consuming lactose, your body may be lacking the enzyme lactase, which is required to digest lactose, a sugar found in milk, certain cheeses, or ice cream. People with undiagnosed celiac disease may also bloat as their body struggles to absorb wheat, barley, and rye products.
Some foods, known as FODMAPs, are also common culprits when you’re feeling bloated. Carbohydrates found in everyday—and relatively healthy—foods like apples, pears, watermelon, wheat, cauliflower, onion, garlic, to name a few, FODMAPs are rapidly fermented by gut microbes and can also pull water into the gut, Scarlata says.
“The aftermath of excess water and/or fermentation of these carbs in the gut can contribute to the sensation of bloating in those with FODMAP sensitivities,” she warns.

Underlying Constipation

If you’re feeling “backed up,” that general feeling of pressure may, well, back up, spreading from the intestines north into the abdomen. Not surprisingly, this can be tied to foods as well, as excessive amounts of fiber can cause simultaneous constipation and bloating.

Small Intestinal Bacterial Overgrowth (SIBO)

This condition occurs when there’s an excess of normal bacteria in the small intestine. “These intestinal bacteria play a key role in bloating and flatulence through carbohydrate fermentation and gas production,” Guillaume says. “Patients with altered anatomy due to surgery, those with diabetes, or those with certain rheumatologic disease may be at an increased risk of bacterial overgrowth in the small intestine.”

Hormones

No, you’re not imagining that puffy feeling in the lead-up to your period. “Feeling bloated is a real concern in the week prior to actually menstruating,” says Latasha Murphy, MD, an OB-GYN at the gynecology center at Mercy Medical Center in Baltimore. The reason? Your hormones fluctuate. “The progesterone drops and the estrogen levels rise,” Murphy explains. “This can lead to sluggish bowel motility and water retention that leads to the bloating sensation.”
Although those are the most typical causes, Guillaume says if you’re trying to figure out if you’re feeling uncomfortable because you’re coming down with that virus that’s been floating around your office or just feeling bloated, it may be both! Because bloating is a symptom and not a disease, it can be a precursor to worse symptoms ahead.
“An acute infectious enteritis may be associated with severe bloating and distention in the early stages, even before diarrhea occurs,” Guillaume warns.
That said, if you’re feeling abdominal pain that’s accompanied by fever, vomiting, diarrhea, weight loss, joint pains, or an abnormal rash, it’s wise to call your doctor. Those symptoms can be a sign of trouble.

Fight the bloat.

Let’s face it: No matter what’s causing it, you want to get rid of that bloated-belly sensation as soon as possible.
How to do it—and how fast it can be done—comes down to the cause. That bloating from slurping down a soda too fast during your super short lunch break can disappear on its own in less than an hour.
If a virus is causing the bloat, you might just have to wait it out, as viral conditions typically have to run their course.
If the problem is your impending period, it’s time to get up and move, and change up what you’re eating and drinking. Exercise will promote bowel motility, Murphy says, which can help you feel less backed up, and drinking a lot of water can help, too.
Abdominal massage can help move the gas into the lower GI tract so that it is easier to pass, Scarlata advises, and there are medicines that can help get things moving, too.
“The herbal supplement Iberogast can help the intestinal move more efficiently, lessening bloating,” Scarlata notes, “Some find simethicone supplements helpful. Simethicone reduces the surface tension of gas bubbles, making the gas bubbles smaller and easier to move through the GI tract for elimination.”
If you’ve been eating any gas-inducing foods (beans, cabbage, and the like), cutting back can help you fight the bloat. But sometimes figuring out just what is making it happen can require a bit of trial and error…and hyper vigilance.
“Maintain a food journal for at least one month and list what you experience after eating a variety of foods and food groups,” Guillaume suggests. “Also, be cognizant of your bowel habits and pattern and how this affects your perception of bloating or visible abdominal distention.”

When to Call the Doctor

If you’re feeling bloated after one meal or days before you’re expecting your period, there’s likely no cause for concern. Occasional bloating happens.
It’s when you feel bloated for days on end or there are other symptoms—such as fever, diarrhea, vomiting, feeling a constant need to urinate or defecate—that you need to call your doctor.
Among the diseases that may be causing bloating along with these symptoms are celiac disease, ovarian cancer, and irritable bowel syndrome.
Although those sound scary, frequent bloating is not always a sign of serious disease. It could simply be an indicator that you have a food intolerance. Treating it could be as simple as cutting a single food out of your diet, which is why it’s important to keep a food journal and bring it with you to your doctor’s office.
“Measures to reduce bloating should be determined and implemented depending on the cause of bloating,” Scarlata notes. “It really is not a one-size-fits all approach. [You need to] work with a healthcare provider to better gauge the reason for the bloating to develop a more tailored approach to treatment.”

Bye Bye, Bloating

Let’s face it: Life is a lot easier if we just avoid bloating altogether. While that’s not always possible (see also: disease causes), there are some preventative measures that work for a number of cases.
If you regularly suffer from menstrual bloating, increasing your water intake and cutting gassy foods from your diet in the days leading up to your period can help, Murphy says, along with kicking your exercise routine into high gear.
If you don’t have a diagnosed food intolerance but know that eating a hot dog smothered in onions is going to make you gassy (and bloated), you can avoid the food entirely. Or you can indulge your cravings while trying to stave off the bloat with a dose of an over-the-counter remedy such as simethicone (aka Gas-X) or alpha-d-galactosidase, the generic of Beano.
If you’re looking to go in the opposite direction by upping the healthy quotient on your foods, dive into fibrous eats with a dose of caution. It’s good to increase bran foods and beans, but do so slowly, lest your new health kick make you feel like Violet Beauregarde from Willy Wonka.
Probiotics work for some folks as well, but Guillaume warns that the data in medical literature is mixed, and there’s no consistent evidence that shows that probiotics are effective at relieving bloating, distention, or flatulence.
One piece of advice that doctors routinely give patients when advising on general health applies when it comes to bloating, too: Exercise regularly and maintain a healthy weight.