Hives are diagnosed as chronic when they last for at least six weeks. Individual outbreaks occur every day. This can go on for weeks or months. Some people continue to have outbreaks for years; others may have outbreaks for several years and then it goes away.
One potential complication of chronic hives is angioedema. This is when there is a swelling of the deeper layers of the skin. It can affect the eyes, lips, genitals, hands and feet. There is a 40 percent incidence rate of angioedema in those with chronic spontaneous hives, according to the World Allergy Organization. It can usually be treated with antihistamines and steroids, but if the symptoms interfere with your daily life, you should contact your doctor.
There is no known cause or explanation for chronic idiopathic hives. It is not an allergy or caused by any specific trigger, according to the Asthma and Allergy Foundation of America (AAFA). Many people have a hard time accepting that there are no causes and continue to look for one, using elimination diets, changing soaps and detergents, or making other lifestyle changes without finding a reason.
Lab tests are used to rule out other medical conditions, such as rheumatologic disease, chronic infections, thyroid disease, and other hormonal disorders. Routine allergy skin tests might be done if there is a question whether allergies are causing the hives. If all possible causes are ruled out, your hives are considered idiopathic.
Hives are not contagious. They cannot be passed from one person to another. For many people with chronic hives, an underlying autoimmune disorder is the cause. For others, the cause is never known. No matter what the cause, remember: hives are not contagious.
One-time and chronic allergic hives often have triggers such as stress, allergies, or skin trauma. However, with chronic idiopathic hives the cause is unknown. Therefore, you won’t know any specific triggers. This is part of the frustration of living with CIU.
Treating chronic hives usually starts with over-the-counter antihistamines to help relieve itching. Prescription antihistamines can be used if over-the-counter doesn’t offer enough relief. Doctors might also prescribe steroids for short-term relief. Cyclosporin, a medication to treat psoriasis and kidney transplants, can clear the hives but it does have significant side effects if taken for a long time. The goal of treatment is usually to suppress the hives from returning.
There are some things you can do to help relieve the discomfort of chronic hives. Wear loose, comfortable clothing to avoid irritation or pressure on your skin. Frequent baths may help reduce itching, but avoid hot water and harsh soaps. Use cool compresses to reduce itching and inflammation. Always make sure to use sunscreen when going outdoors.