Chronic Hives (urticaria) are a skin reaction that causes red or white itchy welts which vary in size and appear and fade repeatedly. It is a condition in which the welts last more than six weeks or recur over months or years. Chronic hives are usually not life-threatening, but the condition can be very uncomfortable and interfere with sleep and daily activities.

The cause of chronic hives is often unclear. Sometimes chronic hives are a sign of an underlying health problem, such as thyroid disease or lupus. Various treatments to relieve the symptoms are available. For many people, antihistamine and anti-itch medications provide relief from chronic hives.



Chronic hives symptoms are:

  • Welts that vary in size, change shape, and appear and fade repeatedly as the reaction runs its course,
  • Batches of red or white welts, usually on the face, trunk, arms or legs,
  • Itching, which may be severe,
  • Swelling that causes pain or burning, especially inside the throat and around the eyes, cheeks, lips, hands, feet and genitals,
  • Signs and symptoms flare with heat, exercise and stress,
  • Symptoms recur frequently and unpredictably, sometimes for a long time.



The welts that come with hives occur when certain cells release histamine and other chemicals into the bloodstream. But the skin reaction may be triggered by:

  • Infection,
  • Pain medications,
  • Insects or parasites,
  • Scratching,
  • Heat or cold,
  • Stress,
  • Sunlight,
  • Alcohol, food or food additives,
  • Pressure on the skin, as from a tight waistband,
  • Exercise.


Risk factors

Factors that increase your risk of developing chronic hives include being female, as women are affected twice as often as men and being a young adult.



The complications may include difficulty breathing and serious allergic reaction.

People with chronic hives may be at increased risk of developing these immune system disorders:

  • Thyroid disease,
  • Lupus,
  • Rheumatoid arthritis,
  • Sjogren's syndrome,
  • Type 1 diabetes,
  • Celiac disease.



Home remedies with antihistamines are usually recommended. If this does not help, prescription medication or combination of drugs may be advised.

Treatment of any underlying factors causing the symptoms of chronic hives and inflamed thyroid (thyroiditis) may best be helped by treating the thyroid problem.

Taking antihistamines pills daily helps block the symptom-producing release of histamine. The newer forms of the drugs (second-generation antihistamines) have fewer side effects, such as drowsiness, than older antihistamines. Older forms of antihistamine pills may be used, but only before bedtime, as they can cause drowsiness.

If antihistamines alone don't relieve the symptoms, other drugs that may help include histamine (H-2) blockers, anti-inflammation medications and antidepressants.

Several medications under study show promise for people whose chronic hives resist treatment such as an injectable asthma drug, asthma drugs with antihistamines, cyclosporine, tacrolimus and mycophenolate.



The following precautions may help prevent or soothe the recurring skin reactions of chronic hives:

  • Avoid scratching or using harsh soaps,
  • Wear loose, light clothing,
  • Cool the affected area with a shower, fan, cool cloth or soothing lotion,
  • Avoid known triggers, such as certain foods or additives, alcohol, pain relievers, heat, cold, exertion, and stress,
  • Keep a diary of when and where hives occur, what you were doing, what you were eating, and so on. This may help you and your doctor identify triggers.