Daily recurring hives: Understanding origins and remedies
Chronic hives, also known as chronic idiopathic urticaria, are a persistent condition characterised by the recurrence of hives for at least six weeks. These hives can be unpredictable and may last for months or even years, causing daily or near-daily symptoms.
In many cases, the cause of chronic hives remains elusive despite thorough evaluation, making it an 'idiopathic' or spontaneous condition. However, research suggests that autoimmunity and immune dysregulation represent the leading understood causes of chronic idiopathic urticaria.
Autoimmune factors play a significant role in chronic hives. The body produces autoantibodies that activate mast cells, causing persistent hives, angioedema (swelling), and itching without identifiable external triggers. This is a common explanation for idiopathic chronic urticaria, especially when hives last more than six weeks and do not respond well to antihistamines.
Physical triggers such as cold, heat, pressure on the skin, sunlight, vibration, exercise, and dermographism (hives caused by skin stroking) can also provoke chronic hives in some patients. Emotional stress and hormonal changes may contribute to the onset or exacerbation of chronic hives, although the direct mechanisms are not always clear.
Certain medications, particularly nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naprofen, can trigger or worsen chronic hives in susceptible individuals. Underlying medical conditions such as thyroid disease, infections, cancer, and other autoimmune disorders have also been associated with chronic urticaria, suggesting systemic involvement in some cases.
When the first-line treatment with second-generation H1-antihistamines (such as cetirizine and loratadine) does not work, treatments like Omalizumab (Xolair), a monoclonal antibody that blocks the action of substances in the body that produce hives, may be used as a second-line treatment. In cases where a patient does not respond to a combination of an H1-antihistamine and Omalizumab, Cyclosporine (Gengraf) may be prescribed.
Diagnosing chronic hives may involve consulting a primary care physician, an allergist, or a dermatologist. Allergy testing, blood tests to detect inflammation markers, or tests for celiac disease or thyroid problems may be necessary.
It is important to note that allergies can also cause chronic hives, unlike acute hives. Common allergens include certain foods, food additives and preservatives, latex, and medications. In cases of severe hives inside the mouth or airways that affect breathing, immediate medical attention should be sought.
While it might not be possible to get rid of chronic hives, treatment options such as antihistamines, corticosteroids, and other drugs can help manage symptoms. Short-term use of corticosteroids may be an option to alleviate flare-ups of chronic hives, but they are not suitable for long-term use due to potential adverse effects.
In conclusion, chronic hives can be a challenging condition to manage, but understanding its potential causes and seeking appropriate medical advice can help in finding the most effective treatment approach. If you or someone you know is experiencing chronic hives, it is essential to consult a healthcare professional for a proper diagnosis and treatment plan.
- Chronic hives, a condition lasting six weeks or more, can be unpredictable and elusive, often stemming from autoimmune factors that activate mast cells or unidentified triggers.
- Research indicates that chronic hives are frequently linked to autoimmunity and immune dysregulation, as the body produces autoantibodies, causing hives, swelling, and itching.
- Physical triggers like cold, heat, or dermographism can also provoke chronic hives in some patients, while emotional stress and hormonal changes may contribute to their onset or exacerbation.
- Underlying medical conditions, such as thyroid disease, cancer, and autoimmune disorders, as well as certain medications like NSAIDs, have been associated with chronic urticaria, suggesting potential systemic involvement.
- When first-line treatment with antihistamines fails, medications like Omalizumab and Cyclosporine may be prescribed as second-line options to manage symptoms.
- Alholhas and healthcare professionals, such as primary care physicians, allergists, or dermatologists, play vital roles in diagnosing chronic hives and determining the most effective treatment approach for managing them.
