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Chronic urticaria (commonly known as hives or nettle rash)

October 8, 2001


Dear Allergy Nurse

What can I do? I have been breaking out in hives for almost 2 years no matter where I am. Every night its worse but it happens in daytime too. -- Tammy, Virginia

Approximately 20-25% of the population will experience at least one episode of hives in their lifetime. Hives that persist off and on for six weeks are considered chronic.

One patient I remember developed hives every time she went into the meat cooler. The answer for her was obvious: avoid exposure to cold. Other patients aren't so fortunate. For them, hives occur for no apparent reason.

Hives can be caused by foods or food additives, medications, skin contact with certain substances, insect bites or stings, infections, exercise, cold, heat, sunlight, scratching, or pressure to skin. Professionals disagree as to whether stress can cause hives.

Hives can develop quickly into a more serious condition called angioneurotic edema. The skin swells, and the airway may be obstructed. If you have hives that are spreading, obtain medical help immediately.

When foods are suspected, physicians I've worked for have often prescribed a very strict elimination diet and gradually returned foods, one by one, noting any reaction. We give injections for several types of insect stings. I've seen physicians prescribe maximum doses of two or three different antihistamines daily with good success.

Chronic hives usually go away after a few years. Meanwhile talk with your physician about the best treatment for you.


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References:

  1. Tips to Remember: Allergic Skin Diseases, American Academy of Allergy, Asthma, and Immunology
  2. Urticaria-Hives, American Academy of Dermatology