Managing Hives in the Workplace

by Marisa Zeppieri-Caruana Patient Advocate

Feeling your best while on the job is vital when it comes to your efficiency, rapport with clients and coworkers, and the ability to stay focused. But managing a long-lasting condition such as chronic urticaria can bring additional stressors to your workplace experience. Because there are so many triggers for chronic hives, treatment plans, prevention approaches, and workplace accommodations will be different for everyone. If you deal with chronic urticaria, learn how you can better manage the condition in the workplace.

Stressed out nurse.

How Chronic Hives Can Affect Your Work

With chronic hives, people experience itchy, red welts that can break out on any area of the skin and last for six weeks or more. The condition affects people on both physical and psychological levels, bringing pain, itchiness, and stinging along with feelings of anxiousness, worry, and even depression. When hives are noticeable on certain areas of the skin (for example, the face or neck) and cannot be covered up with clothing, interacting with others at work can also bring feelings of embarrassment or shame.

Construction worker sweating at work.

Limit or Avoid Triggers, If Possible

Although the majority of chronic hive cases are idiopathic in nature, meaning there is no specific cause, some people are able to trace flares to specific triggers. Although eating or coming into contact with certain foods may be the first trigger that comes to mind, you might be surprised to learn that other triggers such as extreme hot and cold temperatures, cold water, sunlight, and even stress can be responsible for an outbreak.

Woman scratching her neck at work.

Track All Possible Workplace Triggers

If you work in a job that causes you to be exposed to these types of triggers, consider keeping a journal that keeps a record of your activity before an outbreak occurs. Working with an allergist, and having a record of your potential triggers, may help you pinpoint the cause of hives, help you find a way to limit exposure, or identify a medical treatment that can reduce flare ups. Also, see our next slide on work accommodations that may help limit your exposure if you discover a trigger at work.

Employee asking HR for an accommodation.

Ask for an Accommodation, If Necessary

For people living with a chronic medical condition, the ADA – The Americans with Disabilities Act – requires employers to provide reasonable accommodations, or modifications to the work environment that allows an employee to continue performing his or her job. Each employer’s accommodations are different, but if you work in an environment where say, being exposed to certain chemicals or extreme temperatures is causing an outbreak, speak with your HR manager or boss to see if an accommodation could be made.

Coffee shop employee wearing comfortable clothes.

Take Your Clothing Into Consideration

Pressure on the skin from clothing and certain fabrics that raise our body temperature could be potential triggers. According to the ACAAI – The American College of Allergy, Asthma and Immunology - clothes that constrict, cause pressure, and even poor or tight fitting shoes can make hive outbreaks worse. Soft, loose fitting fabrics are your best choice if you suffer from chronic hives. Also, if you wear a uniform to work and believe it is contributing to outbreaks, this may be an area of accommodation to discuss with your employer.

First aid kit.

Have Treatment Options on Hand at Work

First line treatments usually include short and longterm antihistamines. Some people will also take cortico-steroids, immunosuppressants, anti-IgE monoclonal antibodies, or epinephrine. Whether you work part-time or longer 12-hour shifts, it is always a good idea to have extra medication on hand in case of a sudden and unexpected flare up at work. Also, speak with your doctor to learn which medications are best in an emergency or if hives cause swelling of your lips, throat, neck, or tongue.

Man explaining information to a coworker.

Educate Trusted Coworkers About Emergency Intervention

You may not want to share your medical information with your coworkers, especially if you are a private person or fear judgment about how it affects your work performance. That being said, you should consider letting a close coworker or supervisor know about your condition, which medications you take, and how they can help in an emergency situation. Some people with chronic hives carry an epi-pen in case of an emergency. In this case, be sure to explain how the epi-pen is used properly if you are unable to administer it to yourself at work.

Businessman going to a yoga class.

Take Advantage of Stress Relieving Opportunities

Some employers allow for gym, massage, yoga, or other health allowances to help employees combat stress and take better care of themselves. Ask your HR manager what health allowances your employer offers, if any, or if any health classes or events are available on-site. Stress relieving techniques such as restorative yoga, acupuncture, or mindfulness programs can help you better manage hives, as stress is intricately connected to outbreaks.

Woman talking to a mental health counselor.

Address Underlying Emotions

Living with any chronic condition can come with its challenges. While chronic hives will cause noticeable physical symptoms, it is important not to forget the invisible symptoms such as fear, anxiety, isolating oneself, and depression that can accompany the condition. If you are experiencing emotional distress, anxiousness, worry, or depression, reach out to a counselor or therapist that is experienced in working with people who live with chronic illnesses. Taking care of your mental health is just as important as your physical health when dealing with chronic hives.

Marisa Zeppieri-Caruana
Meet Our Writer
Marisa Zeppieri-Caruana

Marisa Zeppieri-Caruana is an author, journalist, former Mrs. New York, and founder of, a New York-based nonprofit and award-winning website for lupus patients. She is the author of Lupus: Real Life, Real Patients, Real Talk and travels around the U.S. speaking on the topic of autoimmune disease on a regular basis. In her free time, she is an avid baker with a love for food photography and styling. Currently finishing her memoir, Marisa resides in New York with her husband, mom, and rescued terrier, Bogey.