Chronic Hives

Chronic hives, also known as chronic urticaria, is a condition characterized by recurrent itchy, raised welts on the skin that persist for six weeks or longer. The hives may appear suddenly, change size or shape, and fade and reappear in different areas of the body. In some cases, swelling of deeper skin layers, called angioedema, may occur alongside hives.

Chronic hives can significantly affect comfort, sleep, and quality of life. Unlike acute hives, which are often triggered by a specific allergen, chronic hives frequently have no clearly identifiable cause.

Symptoms

The symptoms of chronic hives may vary in severity and frequency and can come and go over months or even years.

Common symptoms include:

• Raised, red or skin-colored welts on the skin

• Intense itching that may worsen at night

• Hives that change location, size, and shape

• Swelling of lips, eyelids, hands, or feet

• Skin that blanches when pressed

• Burning or stinging sensation in affected areas

Individual hives usually fade within 24 hours, but new ones continue to form.

Causes

In many cases, the exact cause of chronic hives cannot be identified. When a cause is known, it is often related to immune system activity rather than an external allergen.

Possible causes include:

• Autoimmune reactions where the immune system attacks skin cells

• Release of histamine from mast cells without a clear trigger

• Underlying infections

• Hormonal changes

• Certain medications, such as nonsteroidal anti-inflammatory drugs

• Physical triggers like pressure, heat, cold, or exercise

Food allergies are less commonly responsible for chronic hives compared to acute hives.

Risk Factors

Several factors may increase the likelihood of developing chronic hives.

These include:

• Female sex

• Personal or family history of autoimmune diseases

• Existing allergies or asthma

• High levels of stress

• Recent or ongoing infections

Chronic hives can affect people of all ages, though it is more common in adults.

Complications

Chronic hives are usually not life-threatening, but they can lead to significant physical and emotional complications.

Potential complications include:

• Sleep disturbances due to persistent itching

• Anxiety or depression related to ongoing symptoms

• Reduced work or daily activity performance

• Angioedema causing discomfort or temporary functional limitations

Severe swelling affecting breathing requires immediate medical attention, although this is rare in chronic hives.

Prevention

There is no guaranteed way to prevent chronic hives, especially when the cause is unknown. However, certain measures can help reduce flare-ups and manage symptoms.

Helpful preventive strategies include:

• Identifying and avoiding known triggers

• Managing stress through relaxation techniques

• Avoiding tight clothing and extreme temperatures

• Using gentle, fragrance-free skin products

• Taking medications as prescribed by a healthcare provider

• Keeping a symptom diary to track possible triggers

With proper treatment and lifestyle adjustments, most people with chronic hives can achieve good symptom control and improved quality of life.