Everything You Need to Know About Chronic Hives
Allison Bush | June 24, 2015 Nov 7, 2016
Reviewed by Michael Lehrer, MD
What are hives (urticaria)?
Urticaria, which is the scientific name for hives, is an outbreak of red, swollen, and itchy welts that form on the skin. Hives appear suddenly and can appear anywhere on the body, including the face, lips, and throat.
What makes hives a chronic condition?
For some people, hives just don’t go away – or they recur frequently. Chronic hives, or medically chronic urticaria, last for months, and, in some cases, years. Although chronic hives are not life-threatening or contagious, the condition can cause distress, discomfort, and pain.
What causes chronic hives?
Chronic urticaria – hives that last six weeks or more – is often caused by a trigger that is difficult or impossible to identify. Chronic hives with no known cause may be diagnosed as chronic idiopathic urticaria (CIU).
How is chronic hives diagnosed?
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. About 15 to 20 percent of chronic hives cases are caused by physical triggers such as cold, heat, or exercise. However, in most chronic urticaria cases, routine blood tests and allergy tests are unable to determine the cause.
How are hives managed?
The best treatment for urticaria is to identify and avoid the trigger. In most cases of chronic hives when the cause is unknown, medications can be used to control symptoms and help prevent breakouts.
Which hive medications work best?
Traditionally, the first-line treatment recommended for urticaria is a non-sedating H1 antihistamine, such as: loratadine, fexofenadine, or cetirizine. These medicines, which block H1 receptors, can effectively reduce symptoms of hives with very few reported adverse effects. Other treatments include H2 antihistamines, corticosteroids, and injectable prescriptions.