When a person has an allergic reaction to a medication, food, or something in the environment, the result is often hives. Hives are itchy, raised welts that develop on the skin. They can be quite uncomfortable, interfering with sleep and normal activities.
At Rendon Center, our board-certified dermatologists help our patients deal with chronic hives.
What Are Hives?
Hives, clinically known at urticaria, are red, itchy welts that result from a skin reaction. The welts vary in size and appear and fade repeatedly as the reaction runs its course.
If the patient has these welts for more than six weeks and if they recur frequently over months or years, this is considered chronic hives.
What Are the Symptoms of Chronic Hives?
Most of us have had a reaction to a chemical or other substance that created acute hives that lasted a few days to a couple weeks. Chronic hives are much more involved. These are the signs and symptoms of chronic hives:
- Batches of red or skin-colored welts that can appear anywhere on the body
- Welts that vary in size, change shape, and appear and fade repeatedly as the reaction runs its course
- Itching, which may become severe
- Painful swelling, known as angioedema, of the lips, eyelids, and inside of the throat
- A tendency for these symptoms to flare with certain triggers such as heat, exercise, and stress
- Symptoms that persist for more than six weeks and can recur for months or years
What Causes Hives?
Hives usually are caused by an allergic reaction to something you have encountered or swallowed. These allergens would pollen, animal dander, foods, and such. When you have these reactions, your body begins to release histamines into your bloodstream. Histamines are chemicals your body produces in an attempt to defend itself against infection and other outside intruders. In some people, these histamines can cause swelling, itching, and the other symptoms.
Allergies aren’t always to blame, however. Hives can be triggered by completely different things such as stress, exercise, or even hot and cold temperatures.
The welts that come with hives arise when certain cells release histamine and other chemicals into your bloodstream. It’s not clear why a case of acute hives can sometimes turn chronic. These skin reactions have a trigger. These triggers may be…
- Pain medications
- Heat or cold
- Insects of parasites
- Alcohol or food
- Pressure on the skin, as from a tight waistband
Do Hives Occur More During Allergy Season?
If you are prone to developing hives when a yearly pollen source, such as elm trees, comes out, then you are more likely to develop the welts and itching during these times. But that only applies to hives triggered by a single allergen or a couple different allergens. These wouldn’t be considered chronic hives because the welts and rashes will go away as the allergen does.
Other causes of hives aren’t tied to allergy season.
Are Hives Contagious?
People can feel the urge to stay away from a person suffering from hives. The redness, welts, and swelling can appear to be contagious. That is not the case at all. Hives cannot be contacted from another person. It is simply the result of the individual’s reaction to the trigger.
How Are Hives Treated?
The first course of treatment with your Rendon Center dermatologist will likely be recommended home treatments, such as over-the-counter antihistamines. If these prove ineffective, we will move to prescription medications.
Beyond antihistamines, these medications may include:
- Histamine blockers — Also called H-2 receptor antagonists, these medications are injected or taken orally.
- Anti-inflammation medications — Oral corticosteroids, such as prednisone, can help lessen swelling, redness, and itching, but they are not for long-term use due to potential side effects.
- Antidepressants — The tricyclic antidepressant doxepin can be helpful for itching when used in cream form.
- Asthma drugs with antihistamines — Medications that interfere with the action of leukotriene modifiers can be helpful when used with an antihistamine.
- Monoclonal antibodies — The drug omalizumab is very effective when treating difficult-to-treat chronic hives. It is given in monthly injections.
- Immune-suppressing drugs — Various options work to calm the overreaction to histamines in hives.
How Can I Try and Manage Hives Moving Forward?
It’s important for patients with chronic hives to avoid the behaviors, substances, or triggers that are causing their reactions. These are some precautions that can help patients prevent or soothe the recurring skin reactions of chronic hives:
- Wear loose, light clothing
- Avoid scratching
- Use mild soaps
- Soothe the affected area with anti-itch cream, a fan, cool cloth, lotion, or a cool bath
- Keep a diary of when and where hives occur, what you were doing, what you were eating, and other details. This can help us to identify your triggers.
- Avoid known triggers
- Apply sunscreen at all times when planning to go outside