The potential triggers for hives are numerous, which can make pinpointing the exact cause challenging. In fact, over half of all cases have no identifiable cause. However, there are specific subtypes of chronic hives, collectively known as chronic inducible urticaria, each with its own distinct triggers:
The primary goal of treating hives is to relieve itching and help prevent relapses. Keeping a journal to track potential triggers can be useful in identifying the specific cause. If any are discovered, avoidance becomes essential.
For medical management, oral antihistamines are typically the first line of treatment. Common over-the-counter, non-drowsy options include loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra), while the sedating option diphenhydramine (Benadryl) can be used as needed. Prescription antihistamines, such as hydroxyzine (Atarax) and desloratadine (Clarinex), are also available for more persistent cases.
Topical anti-itch creams offer temporary relief and may contain ingredients like pramoxine, calamine, or menthol. In certain cases, topical steroid creams, lotions, or ointments can be prescribed, and oral steroids may be recommended briefly for severe outbreaks.
Treating chronic urticaria is often complex and may require different strategies. When antihistamines and topical treatments are not effective, immunosuppressant therapies may be considered under the supervision of an allergist to help reduce the heightened immune response.
It’s essential to seek emergency care immediately if hives are accompanied by symptoms like swelling around the lips or mouth, difficulty swallowing or breathing, dizziness, or a rapid heartbeat. These can signal a serious reaction needing urgent treatment.
