Chronic urticaria (chronic hives)

Chronic urticaria lasts for at least six weeks or recurs over months or years. Treatment primarily focuses on finding ways to relieve symptoms.

In practice, medication may provide only partial relief, while lifestyle changes and adjustments to daily habits and diet play an important role in successfully managing chronic urticaria.

In some cases, hives initially cause itching and discomfort, prompting people to scratch their skin in an attempt to relieve the itch. Keeping the skin moisturized can help reduce itching. Here are some basic tips:

• Use mild, fragrance-free soap, as many soaps can dry out the skin and make it more susceptible to irritation.
• Avoid hot water.
• Limit showers or baths to no more than 10 minutes.
• Apply moisturizer immediately after bathing.
• Use a humidifier in the room.
• In addition, applying cool compresses during an episode of hives can help constrict blood vessels and reduce swelling. Most creams have limited effects because hives result from an internal reaction in the body, although certain products can help relieve itching.

Another important consideration is identifying the causes of chronic urticaria. Research suggests that chronic urticaria is often associated with triggers encountered in everyday life. Monitoring these triggers may help reduce prolonged episodes or frequent recurrences. Some common triggers include:

• Alcohol: Alcohol may worsen chronic urticaria. Drinking alcohol while taking medication that interacts with alcohol may also trigger hives.
• Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs): Pain relievers such as ibuprofen and naproxen may trigger or worsen hives. If an over-the-counter pain reliever is needed, acetaminophen may be an alternative.
• Tight clothing: Friction from clothing or pressure on existing welts may aggravate hives. Choose loose-fitting, lightweight clothing and avoid wool and other fabrics that may cause itching.

Doctors often recommend that patients with a history of chronic urticaria keep a diary documenting their symptoms, including what they were doing and eating before an episode occurred. This can be very helpful in identifying individual triggers and avoiding them in the future.

In some cases, hives may be a sign of a severe allergic reaction known as anaphylaxis. If any of the following symptoms occur alongside a rash, seek immediate medical attention for appropriate assessment and treatment:

• Difficulty breathing
• Throat tightness or hoarseness
• Swelling of the lips
• Nausea, vomiting, abdominal pain, or diarrhea
• Dizziness or fainting
• Irregular heartbeat
• Chest pain

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.