Chronic Hives (Chronic Idiopathic Urticaria): Symptoms, Causes, Treatment

What are the symptoms of chronic hives?

Chronic hives, also known as chronic urticaria, is a skin condition characterized by the presence of hives (raised, red, itchy welts) that persist for six weeks or longer. Symptoms of chronic hives can vary but may include:

1. Raised, red welts (hives) on the skin that may vary in size and shape.
2. Itching, which can be mild to severe.
3. Swelling (angioedema) of the skin, particularly around the eyes, lips, hands, feet, or genitals.
4. Burning or stinging sensation on the skin.
5. The appearance of new hives as old ones fade.
6. Hives that come and go, often lasting for days or weeks at a time.
7. Symptoms that may worsen with triggers such as heat, stress, exercise, or pressure on the skin.

Chronic hives can be uncomfortable and interfere with daily activities. In some cases, they may be accompanied by other symptoms, such as fatigue, difficulty concentrating, or sleep disturbances, due to the impact of itching and discomfort on overall well-being.

It’s important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment if you suspect you have chronic hives.

What are the possible causes of chronic hives?

The exact cause of chronic hives is often unknown, but several factors can contribute to the condition. Possible causes and triggers of chronic hives include:

1. Immune System Activation: Chronic hives are believed to involve an immune system response, where the body mistakenly identifies certain substances as harmful and releases histamine and other chemicals into the bloodstream, leading to the development of hives.
2. Allergies: Some cases of chronic hives may be triggered by allergic reactions to foods, medications, insect bites, pollen, or other allergens.
3. Autoimmune Disorders: In some cases, chronic hives may be associated with autoimmune disorders such as Hashimoto’s thyroiditis (hypothyroidism), Graves’ disease (hyperthyroidism), lupus, rheumatoid arthritis, Sjögren’s syndrome, and celiac disease, where the immune system attacks healthy cells and tissues.
4. Underlying Health Conditions: Chronic hives can sometimes be a symptom of underlying health conditions, such as thyroid disorders, hepatitis, or certain cancers.
5. Environmental Factors: Exposure to certain environmental factors, such as heat, cold, sunlight, water, or pressure on the skin (dermatographism), can trigger or worsen chronic hives.
6. Stress: Emotional stress or anxiety can trigger or exacerbate chronic hives in some individuals.
7. Infections: Chronic hives may sometimes be triggered by infections, such as viral or bacterial infections.
8. Medications: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), blood pressure medications, or antibiotics, can sometimes trigger chronic hives as a side effect.
9. Food Additives: Some food additives, such as preservatives or colorings, may trigger hives in sensitive individuals.

It’s important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment if you have chronic hives. Identifying and avoiding triggers, along with proper management, can help reduce the frequency and severity of hives outbreaks.

What is the treatment for chronic hives?

The treatment for chronic hives (chronic urticaria) aims to relieve symptoms and prevent recurrence. Treatment options may include:

1. Antihistamines: These are commonly used to reduce itching and hives. Non-sedating antihistamines are often preferred for long-term use.
2. H2 Antagonists: In some cases, H2 antagonists, such as ranitidine or cimetidine, may be used in combination with antihistamines to help control symptoms.
3. Corticosteroids: Short courses of oral corticosteroids may be prescribed for severe flare-ups, but long-term use is generally avoided due to side effects.
4. Leukotriene Receptor Antagonists: Medications such as montelukast may be used in some cases to help control symptoms.
5. Immunomodulators: Medications that suppress the immune system, such as cyclosporine or omalizumab, may be used in severe or refractory cases.
6. Avoiding Triggers: Identifying and avoiding triggers, such as certain foods, medications, or environmental factors, can help prevent hives outbreaks.
7. Stress Management: Stress can exacerbate hives, so stress-reduction techniques may be beneficial.
8. Cool Compresses: Applying cool compresses to the affected area can help reduce itching and swelling.
9. Avoiding Irritants: Avoiding harsh soaps, tight clothing, and other irritants can help prevent irritation of the skin.
10. Phototherapy: In some cases, ultraviolet light therapy (phototherapy) may be used to help reduce symptoms.

It’s important to work with a healthcare professional to develop a treatment plan tailored to your specific needs and to monitor your condition regularly. In some cases, chronic hives may resolve on their own, but for others, long-term management may be necessary.

How long do chronic hives last?

Chronic hives (chronic urticaria) are hives that persist for six weeks or longer. The duration of chronic hives can vary widely among individuals. Some people may experience episodes of hives that come and go over months or years, while others may have persistent hives that last for many years.

The course of chronic hives can also be unpredictable, with symptoms fluctuating in severity and frequency. In some cases, chronic hives may resolve spontaneously, while in others, long-term management may be necessary to control symptoms.

It’s important for individuals with chronic hives to work closely with a healthcare professional to develop a treatment plan tailored to their specific needs. Regular monitoring and adjustments to treatment may be necessary to manage symptoms effectively.