Chronic hives, Chronic idiopathic urticaria

Diagnosis  

To diagnose chronic hives, your healthcare provider will probably discuss your symptoms with you and examine your skin. A key characteristic of chronic hives is the random appearance and disappearance of raised welts. You might be asked to maintain a journal to keep track of the following: 

• Your daily activities 
• Any medications, herbal remedies, or supplements you’re taking 
• Your food and beverage consumption 
• Where the hives appear, how long the welts last, and whether they leave any bruising or marks behind 
• Whether the hives are accompanied by painful swelling 

Additionally, blood tests might be necessary to identify the underlying cause of your symptoms. An accurate diagnosis will help determine the most appropriate treatment options. If further clarification is needed, your doctor might opt to perform a skin biopsy and examine the sample under a microscope. 

Treatment  

Treatment approaches for chronic hives include: 

• Allergy Medications: Daily use of both over–the–counter (OTC) and prescription antihistamines can help relieve itching and manage allergic reactions associated with chronic hives. 
• Allergy Shots: Regular injections of a medication like omalizumab are used to suppress the production of immunoglobulin E (IgE), particularly beneficial for severe allergies contributing to chronic hives and related conditions. 
• Corticosteroids: In cases where conventional allergy medications are ineffective, corticosteroids such as prednisone can be prescribed to alleviate chronic hives symptoms. 
• Hydroxychloroquine: Research suggests that hydroxychloroquine, an antimalarial drug, may provide relief for chronic hives caused by autoimmune diseases when taken consistently for three months or more. 
• Cyclosporine: This immunosuppressant is known for effectively addressing severe cases of chronic hives. However, its prolonged use should be approached cautiously due to potential serious side effects. 

For relief from itching and swelling, consider trying these home remedies: 

• Apply an anti–itch cream that doesn’t require a prescription. 
• Place cool cloths on the affected areas several times throughout the day (unless cold temperatures make the bumps worse). 
• Take a refreshing, cool bath or shower. 
• Use creams designed for sensitive skin to moisturize dry areas.
• Opt for loose-fitting clothing made from gentle fabrics to avoid irritating your skin.