Itchy, raised bumps on the skin are known as hives. Some people experience a flare-up of hives that subsides on its own. Chronic hives, on the other hand, are hives that come and go on a daily basis.
Chronic hives are diagnosed by doctors in people who have had them for at least 6 weeks. Each colony lasts for around 24 hours until it vanishes. Usually, there is no identified reason, however this is not always the case.
Chronic hives are a symptom of an underlying disease in some people. As a result, it is critical for people to discuss with a doctor about recurring hives.
Continue reading to discover more about the causes, symptoms, diagnosis, and treatment of hives that appear and disappear on a daily basis.-
Chronic hives
Chronic hives are a type of hives that reappear on a regular basis. Each one lasts for less than a day, and as old hives fade away, new ones emerge.
Chronic hives, unlike acute hives, which appear suddenly and go rapidly, can persist virtually everyday for up to 6 weeks. Symptoms might obstruct everyday activities and disrupt sleep in certain circumstances.
What causes chronic hives?
Chronic hives can have a variety of causes, but in the vast majority of cases, the cause is unclear.
Chronic idiopathic urticaria
Chronic idiopathic urticaria is the medical term for hives that have no clear cause.
The immune system is hyperactive in nearly half of people with chronic idiopathic urticaria, according to the American Osteopathic College of Dermatology (AOCD). These cases are classified as autoimmune by doctors because they are caused by the immune system attacking healthy tissues.
However, according to a study published in 2021, some bacteria, viruses, and parasites are linked to persistent hives cases. Researchers haven’t shown that these organisms cause hives, but they might activate the immune system, causing hives as a result of the infection’s reaction.
Bacterial infections linked to persistent hives include the following:\
- streptococci
- staphylococci
- Yersinia
- Helicobacter pylori
- Mycoplasma pneumoniae
The following viral infections are linked to the disease:
Parasitic infections associated with chronic hives include:
- Entamoeba spp.
- Giardia lamblia
- Anisakis simplex
Autoimmune conditions
Chronic hives may be caused by an underlying autoimmune disease in some cases. According to studies, 9.8% of people who have persistent hives also have autoimmune hypothyroidism. Other health problems linked to persistent hives include:
Physical stimuli
Physical stimulation causes a tiny percentage of chronic hives cases. Physical urticaria is the name for this type of urticaria. Scratching or rubbing the skin forcefully is the most typical cause.
Other physical triggers may include:
- exercise
- cold temperatures
- hot temperatures
- sunlight
- vibration
- pressure
Allergies
As with acute hives, chronic hives can also occur due to an allergy. However, unlike acute hives, this is a rare cause for chronic hives.
Some common allergens that can trigger hives include:
- certain foods
- food additives and preservatives
- latex
- medications
Reactions to medications can happen at any time after someone starts taking one. Some common triggers include:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin
- beta-lactam antibiotics
- vancomycin
- opiates
Symptoms
Chronic hives resemble acute hives in appearance. The main difference is that instead of flare-ups and subsequent resolution, the symptoms come and go.
Hives are itchy, raised skin welts that can be red or the same color as the person’s skin. When someone presses on them, they turn white. Hives may appear anywhere on the body, change shape, and travel around. They can also arrive and vanish at any time.
Hives do not normally break the skin, but if scratched, they might cause bleeding.
Diagnosis
Consult your primary care physician, an allergist, or a dermatologist to diagnose persistent hives. They’ll look at the hives and interrogate the client to rule out common causes like a drug response.
The doctor may request diagnostic tests depending on the conditions. Allergy testing or blood tests to detect inflammatory markers or celiac disease are examples.
If the hives are not always visible, taking images to show a doctor during the visit may be beneficial. Keeping a note of when the hives develop and any probable causes may also be beneficial. People can keep track of:
- food they eat
- medication they take
- exposure to physical stimuli, such as the sun, friction, or pressure on the skin
Treatment
Treatment focuses on managing the hives in cases when there is no definite reason. The following therapy possibilities are listed in a review article from 2021:
- Second-generation H1-antihistamines: Drugs like cetirizine and loratadine are used as the first-line therapy for persistent hives. Due to adverse effects, doctors do not advocate using first-generation H1 antihistamines like diphenhydramine (Benadryl) on a regular basis.
- Omalizumab (Xolair): If a patient does not respond to the first-line treatment, doctors may prescribe this medicine as a second-line treatment. It’s a monoclonal antibody that prevents the body from producing chemicals that cause hives.
- Cyclosporine (Gengraf): When a patient does not react to a combination of an H1-antihistamine and omalizumab, doctors may prescribe this.
- Corticosteroids: The use of these anti-inflammatory medicines for a short period of time may be an option for treating persistent hives flare-ups.
Avoiding the trigger in situations where the hives have a recognized cause is an important element of therapy.
Is it possible to get rid of persistent hives?
Chronic hives can go away. A prospective cohort research revealed that after one year, 35% of people with chronic hives had no symptoms and another 29% had a reduction in symptoms.
Within three years, 48 percent of people with idiopathic chronic hives had gone into remission. Only 16 percent of individuals with physical hives, on the other hand, had remission after three years.
When should you seek assistance?
The American Academy of Dermatology Association suggests seeing a board-certified allergist, dermatologist, or primary care doctor if hives flare up for more than six weeks.
Call 911 or the number for the nearest emergency department if someone has severe hives within their mouth or airways that are preventing them from breathing. This might be an indication of anaphylaxis, a severe allergic response that makes breathing difficult.
Anaphylaxis symptoms include:
- fast or shallow breathing
- a fast heartbeat
- wheezing
- lightheadedness
- clammy skin
- anxiety or confusion
- loss of consciousness
Conclusion
Chronic hives are defined as hives that come and go on a daily basis for at least 6 weeks. In most cases, there is no known cause, but in certain people, it is linked to an infection, autoimmune disorder, allergy, or physical reason.
Exercise, vibration, or exposure to hot or cold conditions can cause physical hives. Chronic idiopathic urticaria, on the other hand, is more common.
Medications are used by doctors to manage the symptoms of this condition. Evidence suggests that a significant number of people with chronic hives will have remission or a reduction in symptoms after a year.
Sources
- https://www.aad.org/public/diseases/a-z/hives-chronic-relief
- https://www.ncbi.nlm.nih.gov/books/NBK555910/
- https://www.medicalnewstoday.com/articles/hives-that-come-and-go-daily
- https://acaai.org/allergies/allergic-conditions/skin-allergy/hives/
- https://allergyasthmanetwork.org/news/ask-the-allergist-hives-that-keep-coming-back/
- https://www.aafp.org/afp/2017/0601/p717.html
- https://www.aocd.org/page/Urticaria
