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Chronic Hives Treatment

For most people, treating hives is relatively easy -- you simply avoid whatever causes the rash. But for those who suffer from chronic hives -- for whom those itchy, nasty welts keep appearing for no apparent reason -- treatment isn't so simple. In fact, there's no cure for chronic hives. But some treatments can offer relief.

  1. Treating The Cause

    • If your hives last longer than a few weeks and you can't figure out what's triggering them, it's time to see your doctor. The cause may be something that's more difficult to pinpoint, or you may have an underlying condition, such as an autoimmune disorder. Sometimes treating the cause can help relieve chronic hives symptoms.

    Treating Symptoms

    • In many cases of chronic hives, no trigger can be found. For those cases, treatment starts the same way as acute treatment, but it can go on indefinitely, or as long as the itching lasts.

    Antihistamines

    • Whatever the cause, your doctor may start by prescribing an over-the-counter oral antihistamine, such as loratadine (Claritin) or cetirizine (Zyrtec). If the hives don't clear up, a prescription may be in order. Some newer medications such as Desloratadine (Clarinex) and Levocetirizine (Xyzal) have been shown to be effective in combating chronic hives symptoms. All of these can have side effects and some can make you drowsy. If you're pregnant, nursing, have a chronic condition or take other medications, check with your doctor first.

    Background

    • Antihistamines work by shielding the receptor cells in your body from chemicals -- called histamines -- responsible for allergy symptoms (http://health.discovery.com/centers/articles/articles.html?chrome=c02&article=LC_55¢er=p01).

      When histamines are constantly being released, as in the case of chronic hives, you may need to take antihistamines every day to keep the welts under control. You may find that one antihistamine works, or you may need a combination of medications.

    Treatment Combinations

    • If hives don't respond completely to antihistamines, don't be surprised if your doctor suggests you supplement with heartburn medicine. Some hives sufferers find relief by taking one of these, called H2 antagonists, in combination with antihistamines.They can include cimetidine (Tagamet), ranitidine (Zantac) and famotidine (Pepcid AC) (http://www.mayoclinic.com/health/chronic-hives/DS00980/DSECTION=treatments-and-drugs).

    Severe Cases

    • When chronic hives are so severe that they don't respond to any of these treatments, some doctors may prescribe a short course of oral corticosteroids, such as prednisone. Because they can have serious side effects, this type of treatment is usually stopped quickly. Some doctors may also prescribe the tricyclic antidepressant doxepin (Zonalon) because of its antihstamine properties. For chronic sufferers who have repeated, severe attacks, some doctors recommend carrying an EpiPen. Because this means patients must self-inject, full training is required.

    Topical Treatments

    • Even with all of these treatments, some people still suffer. Some find that an oatmeal bath followed by a topical lotion such as Sarna (available at drug stores), can offer some mild, temporary relief from the itching.

    Future Treatments

    • For those who still can't get any relief, hope is on the horizon. Research is ongoing into treatments including the immune system suppressant Cyclosporine. Two other medications are currently being studied for effectiveness in beating hives, including Omalizumab (Xolair) and Montelukast (Singulair).

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