Hives (urticaria) are red, itchy bites that result from a skin reaction. The welts vary in size and appear and fade over and over in the course of the reaction.
The condition is considered to be chronic hives if the welts appear for more than six weeks and repeat frequently for months or years. Often the cause of chronic hives is not clear.
Chronic hives can be very uncomfortable and affect sleep and daily activities. For many people, antihistamines and anti-itching medicines are a relief.
Signs and symptoms of chronic hives are:
- accumulations of red or skin-colored welts (wheals) that can occur anywhere on the body
- Welds that vary in size, change shape, and over time Reaction repeatedly occur and fade.
- Itching, which can be severe.
- Painful swelling (angioedema) of the lips, eyelids, and neck
- The tendency for signs and symptoms to be associated with triggers such as heat, exercise, and stress.
- The tendency for signs and symptoms to persist for more than six weeks and to repeat frequently and unpredictably, sometimes for months or years.  Short-term (acute) hives occur suddenly and clear up within a few weeks.
When is a doctor to visit?
Contact your doctor if you have severe hives or hives that last for several days.
] See emergency doctor
Chronic hives Do not suddenly run the risk of a severe allergic reaction (anaphylaxis). If you experience hives as part of a serious allergic reaction, seek out an ambulance. Signs and symptoms of anaphylaxis include dizziness, difficulty breathing and swelling of the lips, eyelids and tongue.
The signs of hives appear when certain cells release histamine and other chemicals into your bloodstream.  Physicians often can not identify the cause of chronic hives or why acute hives sometimes become a long-term problem. The skin reaction can be triggered by:
- insects or parasites
- heat or cold
- alcohol or food  Pressure on the Skin through a Tight Cuff
In some cases, chronic hives may be associated with an underlying condition such as thyroid disease or rarely cancer.
Chronic hives do not expose you to a sudden risk of a severe allergic reaction (anaphylaxis). However, if you experience hives as part of a serious allergic reaction, seek emergency care. Signs and symptoms of anaphylaxis include dizziness, difficulty breathing and swelling of the lips, eyelids and tongue.
Your doctor will perform a physical examination and ask you a series of questions to try to understand the possible causes. Causes your signs and symptoms. He or she may also ask you to keep a journal to keep track of:
- What you do
- Any medications, herbal remedies or supplements you are taking.
- What you eat and drink.
- Where and how do beehives appear? long does it take a while for it to fade
- Whether your hives are associated with painful swelling
If your physical examination and medical history indicate that your hives are based on an underlying problem, your doctor may ask you to investigate , B. Blood tests or skin tests.
Your doctor will probably recommend that you treat your symptoms with home remedies such as over-the-counter antihistamines. If self-care does not help, talk to your doctor about which prescription drug or combination of medicines works best for you. As a rule, an effective treatment can be found.
Daily intake of non-skinny antihistamines blocks the symptom-producing release of histamine. They have few side effects. Examples are:
- loratadine (Claritin)
- fexofenadine (Allegra)
- cetirizine (Zyrtec)
- desloratadine (Clarinex)
If non-pervasive antihistamines do not help you, your doctor may increase the dose Or try the guy who makes people sleepy and is taken at bedtime. Examples are hydroxyzine pamoate (Vistaril) and doxepin (zonalone).
Ask your doctor before taking any of these medicines, if you are pregnant or breast-feeding, are chronically ill or are taking other medicines.
If antihistamines alone do not relieve your symptoms, other medicines can help. For example:
- histamine (H-2) blocker. These drugs, also called H-2 receptor antagonists, are injected or taken orally. Examples are cimetidine (Tagamet HB), ranitidine (Zantac) and famotidine (Pepcid).
- Anti-inflammatory drugs. Oral corticosteroids such as prednisone may be effective against swelling, redness and itching. These are usually intended for the short-term control of severe hives or angioedema, as they can cause serious side effects with prolonged ingestion.
- antidepressants. The tricyclic antidepressant doxepin (zonalon) used in cream form may help relieve itching. This medication can cause dizziness and dizziness.
- Asthma drugs with antihistamines. Medications that affect the effects of leukotriene modifiers may be helpful in the use of antihistamines. Examples are montelukast (Singulair) and zafirlukast (Accolate).
- Human-made (monoclonal) antibodies. The drug Omalizumab (Xolair) is very effective against a type of difficult to treat chronic hives. It is an injectable drug that is usually given once a month.
- Immuno-inhibiting drugs. Options include cyclosporine (Gengraf, Neoral, others) and tacrolimus (Astagraft XL, Prograf, Protopic).
Preparing for an appointment
You will probably first visit your family doctor. He or she may refer you to a specialist in skin diseases (dermatologist) or to an allergist.
In chronic hives, you should ask your doctor the following basic questions:
- What is probably the cause of my symptoms?  How long do these hives last?
- What types of tests do I need? Do these tests require special preparation?
- What treatments are available and which ones do you recommend?
- Do these treatments have side effects?
- Do I need prescription drugs or can I use over-the-counter medications to treat the disease?
- Does the prescribed drug have a generic version?
- I have other health problems. Is the treatment you recommend compatible with these conditions?
What You Can Expect From Your Doctor
Your doctor will probably ask you:
- What are the symptoms and when did you first experience them?
- Do you have tightness in the chest or throat, nausea or difficulty breathing?
- Have you had any virus or bacterial infections recently?
- What medications, herbal remedies and supplements do you take?  Have you tried new foods lately?
- Did you travel to a new location?
- Do you have hives or angioedema in your family history?
- What seems to improve or worsen your symptoms?
Lifestyle and home remedies
Chronic hives can take months and years. They can affect sleep, work and other activities. The following precautions may help prevent or relieve the recurrent skin reactions of chronic hives:
- Wear loose, light clothing.
- Avoid scratches or sharp soaps, lotion or anti-itch cream.
- Keep a diary of when and where hives occur, what you did, what you ate, and so on. This can help you and your doctor identify triggers.
- Avoid known triggers.
- Apply sunscreen before going outside.
Release date: 2007-06-22