If your hives don’t respond to over-the-counter treatments or do not go away within a few days, contact your doctor. In addition, if you experience dizziness, fainting, difficulty breathing, tightness in your throat, tongue or face swelling or wheezing with your hives, you should seek immediate medical attention according to Mt. Sinai Medical Center.
Acute hives, which occur after a trigger, such as an allergy to shellfish, happen anywhere from a few hours to a few days after exposure to the trigger and usually disappear within 24 hours. For chronic hives, the answer isn’t so easy. There isn’t any known cause for about 95 percent of chronic hives according to the American Osteopathic College of Dermatology. About one-half of people with chronic idiopathic urticaria also have autoimmune problems.
You may talk with your family doctor and an allergist according to the American College of Allergy Asthma and Immunology. Once illnesses that can cause hives have been ruled out, the doctor will perform a physical examination and ask questions about contact with substances that may have led to an allergic reaction. Your doctors may also do allergy tests, blood work or a skin biopsy according to the American Academy of Dermatology.
The best treatment for urticaria is to identify and avoid the trigger, if triggers are known. Over the counter anti-itch creams and antihistamines can also help control the itch and swelling.
About 50 percent of people with chronic idiopathic urticaria have angioedema, a rapid and potentially dangerous swelling around the mouth, throat, tongue, and eyes according to an article published in the Journal of Allergy & Therapy. If you experience symptoms of angioedema, seek immediate medical assistance. If you have chronic idiopathic urticaria you might be more at risk for other immune disorders, such as thyroid, lupus, celiac disease, type 1 diabetes, rheumatoid arthritis, Sjogrens disorder according to a report in NEJM Journal Watch.
In her article, chronic hives patient advocate Marisa Zeppieri-Caruana provides a comprehensive list of practical suggestions to manage hives, including medical related tips (working with the right allergist and learning about different treatments); alternative medicine-related tips, such as acupuncture and vitamin D supplements; and self-care strategies, such as stress-reducing techniques.
About 35 percent of people with chronic hives became symptom free within a year of the first appearance of hives according to report completed by Paul Schaefer, MD. PhD. Almost 30 percent more experienced some reduction of symptoms. For those with chronic idiopathic urticaria, 48 percent had a spontaneous remission.