What Are Hives Or Urticaria
Hives or urticaria are a type of rash consisting of itchy, swollen, red welts. The itching may be mild or severe. Foods, medications, infections, exercise, scratching, alcoholic beverages, emotional stress and many other factors may worsen hives. The condition affects an estimated 20 percent of the population at one time or another in their lives.
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.
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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.
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Cause Of Hives With Thyroid Disease
Autoimmunity is thought to be one of the most common causes of chronic hives.
Autoimmune diseases are those in which the body’s immune system mistakenly attacks its own cells and tissues. It does so with immune proteins called autoantibodies that cause chronic or recurrent attacks known as flares.
In the case of autoimmune thyroid disease, the thyroid gland is the target of the assault.
During an autoimmune flare, the spontaneous release of autoantibodies can trigger the release of another protein known as immunoglobulin E . IgE is the antibody responsible for allergic reactions, such as hives or rash.
Not all autoimmune diseases trigger an IgE response. Those that do produce autoantibodies that target a specific proteinâcalled a high-affinity IgE receptorâfound in tissues under the skin. The autoantibodies “turn on” these receptors, triggering the production of IgE and the chain of events that lead to allergies.
Chronic hives may occur in tandem with an autoimmune flare or when the disease is subclinical . During subclinical episodes, even low levels of autoantibodies can trigger an IgE response.
While Hashimoto’s thyroiditis may increase the risk of chronic hives, not everyone who has Hashimoto’s will get hives. This suggests that other environmental or genetic factors may contribute to the risk.
What Are Chronic Hives
Chronic hives are itchy, raised, red bumps or welts that appear on your skin at least twice per week. These welts, also called wheals, are chronic when they last more than six weeks.
You may hear this condition called chronic idiopathic urticaria:
- Chronic: A symptom or condition that persists even with treatment.
- Idiopathic: The symptom or condition occurs for no known reason. It comes on suddenly.
- Urticaria: The medical term for hives, pronounced ur-tik-CARE-ee-uh.
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Hives Are Rarely Due To A Serious Underlying Disease
Whilst a clear cause of hives in not obvious in many cases, causes may include:
- Infection from a virus is the most common cause of hives in children, especially if they last for more than 24 hours.
- Contact allergy to plants or animals may cause localized hives.
- Allergic reactions to food, medicines or insect stings can appear as hives. They usually occur within one to two hours of exposure and disappear in most cases within six to eight hours.
An allergic cause for hives should be suspected if episodes are rare, short-lived and occur under specific circumstances, for example:
- Only when exercising.
- Always within two hours of a meal.
- When symptoms involving other organs occur around the same time, such as stomach pain, vomiting, difficulty breathing or dizziness.
- If hives occur with swelling of the tongue or throat, difficulty breathing or low blood pressure, anaphylaxis should be suspected. Urgent administration of adrenaline and medical assessment is required. Information about anaphylaxis is available on the ASCIA website.
Ongoing hives lasting days at a time are almost never allergic in origin, with the exception of some cases of allergy to medicines. Stress is a very rarely the cause of hives but may make the symptoms worse.
In some people hives are caused by physical triggers, including cold , heat, sunlight , vibration, rubbing or scratching of the skin , and delayed pressure , stress, alcohol, spicy food or coffee may cause symptoms.
Other Factors To Consider
Even if chronic hives dont have a clear cause, some exposures can make them worse or cause them to flare more often:
Physical triggers: Heat and cold, or even scratching, can sometimes lead to hives. These are known as physical hives . The most common type of physical hives are due to scratching, known as dermatographia.
Alcohol: Alcohol can also cause chronic hives to flare. Around 5% to 10% of people with chronic hives find that alcohol worsens their symptoms.
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Dietary Methods To Try
Common food allergies in some people include eggs, shellfish, peanuts, and other nuts. Spoiled fish can contain a high level of histamines, which may bring on hives.
If you or your doctor suspects that the hives are coming from a food allergy, they may order tests to confirm. You may be asked to keep a diary of everything you eat and drink.
Food additives and salicylic acid have been shown to bring on hives in some people. Aspirin and other nonsteroidal anti-inflammatory drugs have been reported to worsen outbreaks of hives in
Capsaicin: The Only Effective Treatment For Chronic Cannabis Use
Capsaicin, a chemical found in chili peppers, is the only cannabis-related treatment that has been shown to be effective for chronic head and neck pain caused by chronic cannabis use. CHS is characterized by chronic pain in the face and neck as a neurological disorder. CHS symptoms can range from mild discomfort to severe pain. Capsaicin is a chemical found in chili peppers that has been shown to be effective in treating shingles and other conditions. Capsaicin is found in chili peppers. Capsaicin, a natural pain reliever, can relieve CHS symptoms. Capsaicin, when activated by TRPV1, can aid in the treatment of CHS symptoms. It is a protein that causes pain sensation by binding to pain receptors. When TRPV1 is activated, the pain associated with CHS can be alleviated. Capsaicin has been shown to be extremely effective and inexpensive in the treatment of CHS. Capsaicin, on the other hand, must be used in conjunction with other treatments, such as hot showers and baths, to promote TRPV1 stimulation. If you have CHS, you should consult with your doctor to determine the best course of treatment.
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What Are Chronic Hives Treatments
Treatments for chronic hives include:
- Allergy medications: Daily over-the-counter or prescription allergy medications like antihistamines relieve itching and reduce or prevent allergic reactions.
- Allergy shots: A monthly injection of a drug called omalizumab blocks your bodys production of immunoglobin E . People with severe allergies can make too much IgE, leading to problems like chronic hives and asthma.
- Steroids: Corticosteroids like prednisone can ease symptoms that dont respond to allergy medicines.
- Hydroxychloroquine: A study found that 8 in 10 people with autoimmune disease-induced chronic hives got symptom relief after taking hydroxychloroquine , an antimalarial drug, for three or more months.
- Cyclosporine: This immunosuppressant is highly effective at clearing up severe chronic hives. But it can cause serious side effects when taken for too long.
Whats The Difference Between Hives And Chronic Hives
Chronic hives are different than acute hives:
- Acute hives start to fade within 24 hours . They are gone within six weeks. A recent viral infection often causes acute hives.
- Chronic hives are visible at least twice per week for more than six weeks. Some chronic hives last for months or years. The cause is often unknown.
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Finding A Specialist To Treat Csu
Specialists who focus on chronic spontaneous urticaria include allergists, who specialize in allergies and immune system diseases, and dermatologists, who specialize in medical conditions that affect the skin. Seeing a specialist about your symptoms can help determine a diagnosis.
Download the CSU treatment discussion guide to help start your conversation with a specialist.
IMPORTANT SAFETY INFORMATION & INDICATION
What is XOLAIR? XOLAIR® for subcutaneous use is an injectable prescription medicine used to treat chronic spontaneous urticaria , chronic hives without a known cause) in people 12 years of age and older who continue to have hives that are not controlled with H1 antihistamine treatment. It is not known if XOLAIR is safe and effective in people with CSU under 12 years of age.XOLAIR is not used to treat other forms of hives.
What is the most important information I should know about XOLAIR? Severe allergic reaction. A severe allergic reaction called anaphylaxis can happen when you receive XOLAIR. The reaction can occur after the first dose, or after many doses. It may also occur right after a XOLAIR injection or days later. Anaphylaxis is a life-threatening condition and can lead to death. Go to the nearest emergency room right away if you have any of these symptoms of an allergic reaction:
Do not receive and use XOLAIR if you are allergic to omalizumab or any of the ingredients in XOLAIR.
How should I receive and use XOLAIR?
Can Hives Occur Anywhere Else
Hives can also cause deeper swellings in the skin and mucosa, this is called angioedema. These swellings are often bigger, last longer, may itch less, sometimes hurt or burn and respond less well to antihistamines. Large swellings over joints, for example, can cause pain that feels like arthritis, even if the joint is not involved. Angioedema most frequently affects the face and lips. Although hives and facial swelling can be uncomfortable and cosmetically embarrassing, they are not usually dangerous. Information on angioedema is available on the ASCIA website.
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How Do I Get Rid Of My Chronic Hives
Ironically, with everything we know about chronic hives, most cases go misdiagnosed by dermatologists that do not specialize in hives or the causes are simply never identified. Even when the underlying causes of chronic hives is not known though, certain hives treatments have proven to be effective at eliminating chronic hives outbreaks. Unfortunately, most doctors will simply offer antihistamine medications, which only treat the symptoms and not the hives themselves. This is why antihistamines are poor substitute for a real hives cure.
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.
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Its Rare But Acute And Chronic Hives Can Both Lead To Life
In the majority of cases, acute hives will go away on their own and do not pose a serious threat to your health. But sometimes, acute hives can be a sign of a more threatening problem.
Swelling in the eyes, lips, hands, feet, or genitals can be a sign youre experiencing angioedema, which is a complication that occurs when fluid buildup in the skin causes deep swelling. Angioedema is generally treated with a combination of antihistamines and oral corticosteroids with the goal of decreasing swelling.
Finally, while hives dont put you at an increased risk of anaphylaxis, which is the name for a life-threatening allergic reaction, they are one of the first signs that such a reaction may be taking place. In addition to the skin changes, you might notice swelling on the body, lightheadedness, abdominal pain, feeling faint, and shortness of breath. Consider these symptoms an emergency, and call 911 as soon as possible.
During the attack, youll likely be treated with epinephrine, oxygen, antihistamines, cortisone , and a beta-agonist to help you breathe and reduce your bodys allergic response. In most cases, the best way to protect yourself against anaphylaxis is to avoid the trigger altogether and carry an adrenaline autoinjector, such as an EpiPen, so you can administer epinephrine in case of an emergency.
With additional reporting by Moira Lawler.
Treatment Options For Chronic Hives
If your hives are mild or infrequent, you might not need treatment. But treatment could be helpful if your hives are severe, frequent, or get in the way of your everyday life. Over-the-counter antihistamines are the medication of choice for chronic hives. Some common options include:
Diphenhydramine and other older antihistamines can be effective for flares, but they can also make you sleepy.
Famotidine is often used for stomach problems, but its also a type of antihistamine that can help control hives.
For hives that dont get better with antihistamines, there are prescription treatment options. Some examples are:
Singulair is an oral medication thats often used for allergies and asthma but can also be helpful for hives.
Xolair is a monthly injected medication that can help treat very severe or stubborn hives.
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What Is The Fastest Way To Cure Chs
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There is no one-size-fits-all answer to this question, as the best way to treat CHS may vary depending on the individuals unique situation. However, some possible methods of treatment include: reducing or eliminating cannabis use, managing nausea and vomiting with antiemetics, staying hydrated, and getting plenty of rest. If symptoms are severe, hospitalization may be necessary.
Preparing For Your Appointment
Get the most out of your appointment by thinking about questions you might have in advance. Below is a sample of information to prepare. Download the full discussion guide so you know what to expect.
- Ive seen several doctors about my condition and theyve told me…
- Describe my average hive itch intensity …
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Ask About Vitamin D Supplementation
A 2014 study found that vitamin D supplementation can be a good immunomodulator add-on therapy . 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.
Advancing Our Understanding Of Hives
Senior members of our physician staff have worked and studied with some of the pioneers in the field of hives and manage care for hundreds of patients annually. Together with other leading researchers, our clinicians and scientists have advanced the understanding of the behaviors and causes of hives and developed breakthrough treatments.
We treat all types of hives, including those associated with:
- Food, drug and environmental allergies
- Non-immunological sources, in which patients come in contact with certain foods, food preservatives or chemicals, resulting in contact dermatitis
- Systemic autoimmune illnesses
- Viral infections
- Hormonal aberrations
Additionally, we treat patients with chronic hives conditions, such as urticarial vasculitis, and those who experience hives in conjunction with other allergies, such as asthma and angioedema.
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Where Do Hives Develop On The Body
Hives can develop anywhere on your skin. For most people, hives appear on one or more of these areas:
If you have hives, they may appear in one area like your back or cover much of your skin.
Hives can also develop on soft, moist tissue that lines your eyelids, mouth, and other areas. The medical name for this moist tissue is mucous membrane.
Some people always get hives in the same place on their body
This usually happens when something triggers hives like medication, stress, or sunlight.
When hives develop in the same place every time, this is called fixed hives.
Does Covid Cause Hives In Adults
Yes. COVID-19 is associated with a rash in many people diagnosed with the virus. The hives form in different patterns, including patches, itchy bumps, and blisters that look like chicken pox. Most people who have the rash find it lasts about eight days. COVID-related hives often itch, and some may require medical treatment.
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How Is Chronic Idiopathic Urticaria Diagnosed
When you and your doctor are unable to identify whats causing your chronic hives, its likely chronic idiopathic urticaria.
On your first visit to the doctor, you may be asked the following questions to try to pinpoint whats causing the hives:
- When and where on the body do hives occur?
- Is there any swelling?
- How long do symptoms last?
- What were you doing at the time hives occurred?
- What medications are you taking?
- Are there any other symptoms?
A blood test can help with diagnosis since blood cells in CIU patients often manufacture enormous amounts of histamine.
Your doctor will also ask what foods you were eating at the time of symptoms to determine if a food allergen caused your hives.