For many people with chronic urticaria, or hives, the cause of their itchy, red skin is never known. It is medical mystery and because of this, there are a number of myths that are often believed as truth. Here, we look at three of those myths.
Myth: Chronic hives are an allergic reaction.
Facts: Chronic idiopathic urticaria (CIU) is a confusing condition. It looks like an allergic reaction. It acts like an allergic reaction. But it isn’t an allergic reaction. Previously, doctors might have chalked chronic hives up to an unknown allergy. Or, an allergy to something you can’t avoid, such as dust mites or grass pollen. It seems reasonable — constant exposure to an allergen could cause you to have regular flare ups of hives. Except this isn’t the case. When hives are caused by an allergen, the trigger is usually evident. You ate shellfish and shortly after broke out in hives. You pet a dog and hives appeared. But with chronic urticaria, there is no apparent cause.
Some patients become frustrated when their doctors can’t give them a reason for the hives. “Something must be causing this,” they think. Based on their doctor’s suggestion or their own research, they might start avoiding high-allergen foods, such as peanuts, soy, milk, spinach, and shellfish, but this usually doesn’t have an impact on the frequency of flares.
Between 30 and 50 percent of cases of chronic urticaria are caused by an autoimmune reaction in the body, according to Katherine E. Gundling, M.D., of the Division of Allergy and Immunology at the University of California. There might be a connection between thyroid autoimmune disorder and CIU, and if there is no discernible cause for your hives, you might want to request your doctor check your thyroid function. Unfortunately, for the rest of those with the condition, there is no discernible cause.
Myth: There isn’t any treatment for chronic hives.
Facts: There isn’t a cure for chronic idiopathic urticaria. Sometimes, it goes away on its own and you stop having flares several years after you started. At other times, you could continue to have breakouts of hives for many years. Because in many cases, there is no known underlying cause for the hives, treatment is aimed at controlling symptoms.
Your doctor might prescribe daily non-drowsy antihistamines or recommend over-the-counter allergy medications to help minimize flares of hives. Some people may need higher than normal doses of antihistamines or to have a stronger, drowsy formula antihistamine prescribed for bedtime.
In addition to antihistamines, the American Osteopathic College of Dermatology (AOCD) discusses a new treatment option, hydroxychloroquine, which was originally used to treat malaria, but has been found to be helpful in treating symptoms of some autoimmune disorders. The AOCD indicates that in a clinical trial, 83 percent of people who used this medication saw improvement or cleared completely after using the medication for at least 90 days. Another medication, used to treat psoriasis, cyclosporine, has also been found to be effective. However, there are significant side effects if it is used long-term.
Myth: Chronic urticaria is a nuisance but it doesn’t affect quality of life.
Facts: Living with chronic hives isn’t easy. You live with the uncertainty of not knowing when the hives will show up. Each morning you wake up and check your body. You never know what might trigger your hives. Because of this, you might avoid social gatherings to not be embarrassed by your appearance or have to leave quickly when a hives flare occurs. You are self-conscious and might have low self-esteem.
Treating chronic hives also takes time and money. In the beginning, you might be sent for allergy tests to rule out an allergic reaction. You might have numerous doctor appointments. During flares, you might head back to the doctor or miss work. Chronic urticaria, like any chronic illness, takes a toll on your wallet, your self-confidence, and could cost you your job because of missed time.
One symptom of autoimmune disorders that causes impairment is fatigue. During flares you aren’t only fighting the itchiness or the burning sensation, you are flat out tired. Some days it might take everything to drag yourself out of bed to go to work or take care of your family.
To people looking in from the outside, an outbreak of hives might seem like a nuisance. But for those suffering from chronic hives, the uncertainty, self-consciousness, fatigue, and time spent at doctors (or in bed) can cause great emotional distress.
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Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral Therapy, Essential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.