9 Simple Tips for Managing Your Chronic Hives
by Marisa Zeppieri-Caruana Patient AdvocateChronic urticaria, or chronic hives, is a condition in which red, itchy welts break out on the skin and last six weeks or longer. In addition to causing physical symptoms including pain, itchiness, and noticeable hives that can range in size, chronic hives can also prompt feelings of anxiousness, frustration, and depression. Treatment and prevention approaches vary. Here are nine protocols to help you manage your condition.

Use Medication Options, If Applicable
There are many treatment options for chronic hives. Typically, a combination of short and long-acting antihistamines are used to help control outbreaks. Other possibilities include cortico-steroids, immunosuppressives, anti-IgE monoclonal antibodies such as omalizumab, and epinephrine. Work with your physician to determine which medications are best depending on the severity and longevity of your hives.
Recognize and Avoid Triggers
Chronic hives often have multiple triggers or often no specific triggers. Examples of possible triggers include stress, cold or hot temperatures, viruses, food, pet dander, medications, exercise, sun exposure, pollen, insect bites, tight clothing, and pressure on the skin. An allergist may help you gain insight into your potential urticaria triggers. Consider documenting your daily foods, medications, stressors, exercise, and exposure to hot or cold temperatures. Something completely unexpected could be triggering your urticaria.

Address Any Allergies
If your allergist suspects food, preservatives, pollen, or animal dander as the potential cause of your hives, consider a blood, urine, and/or skin-based allergy test. Depending on the severity of your hives, he or she may also recommend a challenge test or allergy shots. Challenge tests — typically done with food or a medication believed to be an allergen — are always performed under medical supervision with emergency medication on hand.

Pamper Your Skin
For dry or sensitive skin, consider moisturizing lotions that contain oatmeal, an anti-itch ingredient that can help soothe the skin. Other skin pampering ideas include taking a bath with colloidal oatmeal and applying cool compresses to calm irritated skin. Use different soap products that have natural ingredients and do not contain triclosan or sodium lauryl sulfate. You can also apply coconut oil or aloe vera to your skin.

Implement Stress-reducing, Alternative Therapies
Stress is tied intricately into urticaria outbreaks. Therefore, it is vital for anyone dealing with hives to implement stress-reducing practices, such as restorative yoga, deep breathing, meditation, or acupuncture. Consider downloading the Headspace or Calm app directly to your phone. These top-rated apps allow you to practice these techniques in the privacy of your own home at your own pace.

Ask About Vitamin D Supplementation
A 2014 study found that vitamin D supplementation can be a good immunomodulator add-on therapy (with allergy medication). Study participants were given either high doses of vitamin D or low doses along with the same allergy medication for a period of three months. Within the first week, the group taking the higher dose had a 33 percent decrease in body disruption and fewer days with hives. By the twelfth week, patients who took the higher dose saw a 40 percent overall decrease in symptoms.

Deal With Accompanying Emotions
Feelings of depression and anxiety are not uncommon with chronic hives. Adjusting to new limitations and realities are challenging, not to mention the physical appearance of hives and the medication side-effects. If you experience signs of anxiety or depression, speak with a psychologist or licensed mental health counselor who can help you process the emotions. You can also access therapists via the Internet or a mobile phone app from organizations like Betterhelp.com and Talkspace.com.

Reassess Your Skincare Products
Reassess all of the products that you use on your skin: your soap, lotion, deodorant, face cream, and perfume/cologne. Learn how to read labels and identify chemicals that are known to dry out or irritate skin, including propylene glycol, toluene, triclosan, formaldehyde, and sodium lauryl sulfate. Shop for organic products that contain natural ingredients and are created specifically for sensitive, dry, or irritated skin. I like S.W. Basics, ACURE, Avalon Organics, and Nourish Organics. Although some natural or organic products may still lead to skin irritation for some. It may take trial and error to determine what works best for you.
Practice Patience and Self-love
With chronic hives, it is crucial to practice patience and self-love, especially during times of outbreak. Recognize stressors in your life and strategize a way to decrease them. Take a little time off, whether it is reading for 30 minutes, taking a bath, listening to your favorite music, treating yourself to a pedicure, or taking a quick nap. Find ways to decompress and implement self-love into your regular routine. Your body will thank you.