Treatment Options for Chronic Hives
Chronic urticaria, or hives, is the occurrence of hives for at least six weeks. Many people have what is known as idiopathic chronic urticaria — which is now being referred to as Chronic Spontaneous Urticaria — meaning that the cause of the hives is unknown and the hives seem to occur spontaneously. Because of this, treatment is based on symptom control, according to a 2015 report completed by the Standards of Care Committee of the British Society for Allergy and Clinical Immunology.
H1 antihistamines, which block histamines in the body, are an effective treatment option for some people with chronic hives, according to a study published in the journal Clinical and Translational Allergy. Researchers began with one dose of an antihistamine a day and found that some people required four times that dose for symptom relief. Even at the higher dose, some people in the study did not respond to the treatment at all.
Chronic hives may be an autoimmune reaction in some people. For them, immunosuppressant medications may be of benefit. According to a report published in the World Allergy Organization Journal, it can take up to three to five weeks for the benefit to be noticeable. Immunosuppressant medications do have side effects. You should be closely monitored by a doctor when taking these types of medications.
Oral corticosteroids, when used for short-term use of three to five days, may help in controlling acute symptoms according to a 2015 report completed by the Standards of Care Committee of the British Society for Allergy and Clinical Immunology.
There are a few other medications, such as leukotriene receptor antagonists and cyclosporine, which can be tried if other treatments are not successful, according to a 2015 report completed by the Standards of Care Committee of the British Society for Allergy and Clinical Immunology.
Avoidance of triggers
Although the underlying cause of chronic hives may be unknown, some people experience outbreaks from certain triggers, such as heat or consumption of NSAIDS. When those triggers are known, steps should be taken to avoid them, according to a 2015 report completed by the Standards of Care Committee of the British Society for Allergy and Clinical Immunology.
Eating a low-histamine diet
Eating a low-histamine diet may decrease symptoms and improve quality of life, according to a study published in Dermatology News. A low-histamine diet omits food such as cheese, preserved meats, strawberries, raspberries, citrus fruit, bananas, kiwis, plums, papaya, and alcohol. It includes foods such as dairy, vegetables, fresh meat, eggs, bread, pasta, rice, and certain varieties of fish. Note that many physicians do not recommend this diet due to limited data on efficacy.
High doses of vitamin D were found to significantly reduce symptoms of chronic hives according to a study completed at the University of Nebraska Medical Center. This was especially true when vitamin D was added to anti-allergy medication. People in the study who received the most benefit took 4000 IUs for three months.