Chronic Hives
Hives are also known as urticaria, inflammation of the skin triggered by an immune response releasing Histamine. Hives are described as itchy red bumps or welts that appear on the body. About 20 percent of Americans have hives at some time in their lives. Although they are often uncomfortable and sometimes painful, hives are not contagious
There are two types of urticaria: Acute and chronic.
Acute Urticaria are hives that last < 6 weeks. Chronic urticaria are hives that last >6 weeks.
What are common causes of hives?
Foods and additives, especially peanuts, eggs, nuts and shellfish
- Medications such as aspirin and antibiotics (especially penicillin and sulfa)
- Insect stings or bites
- Heat, exercise, pressure, cold water, sun exposure.
- Infections including the common cold, urinary tract infections, strep throat, infectious mononucleosis and hepatitis, or other viral infections
In most of these cases, the hives resolve when the cause is avoided, removed or treated.
How can I identify the causes of my hives?
In some cases the cause is obvious – a person eats peanuts or shrimp, and then develops hives within a short time. Because there are so many possible causes for hives, other cases require detective work by the patient and physician.
Sometimes the cause of chronic hives cannot be identified despite detailed history and testing. This condition is called idiopathic urticaria or ‘hives with no cause.” The immune system is the cause of about 50 percent of hives that are not identified. In other cases, chronic hives may be associated with thyroid disease, other hormonal problems, or rarely cancer. In most cases, chronic hives will gradually disappear over time.
What is the treatment for hives?
The team at Breathe Easy Allergy and Asthma can perform the necessary History and Physical to help identify triggers. In many cases skin prick testing or lab testing is indicated to help exclude other causes. A regimen of antihistamines can help keep hives under control. Severe episodes of hives may require short courses of steroids or immune modulator medication. A new monthly injection called xolair may also be used if you fit the criteria.
When hives involve swelling of the tongue or trouble breathing, immediate evaluation in the emergency room is required and you will be prescribed an epinephrine self-injector will be prescribed for you to carry.
Treatment for Chronic Spontaneous Urticaria- dupixent and cyclosporine. More therapeutic options are being evaluated by the FDA!
Causes of CSU or CIU
- Idiopathic
- Mast cell activation syndrome (MCAS)
- Mast Cell Disorder.
If you need more information about how to treat hives or have any questions, your allergist will be happy to answer them.