What Chronic Hives Are, Why They Last and How They Are Managed
Hives are called chronic when they come back on most days for six weeks or longer. Chronic hives are frustrating but, for most people, not dangerous, and they often settle on their own over months to a few years. Effective treatments exist for people who still have symptoms.
Chronic Spontaneous vs Chronic Inducible
Chronic urticaria splits into two groups. In chronic spontaneous urticaria, hives appear without a clear outside trigger. In chronic inducible urticaria, a specific stimulus such as cold, pressure or sunlight reliably causes them. Some people have both.
What Causes Chronic Hives?
In many cases no outside cause is found. Research points to the immune system as a major factor, and a portion of people have autoimmune activity affecting mast cells. Chronic hives are rarely caused by a food allergy. Read about autoimmune hives.
How Doctors Evaluate Chronic Hives
A history and exam are usually enough. Limited blood tests, such as a blood count and inflammation markers, are often done, with further testing guided by your symptoms. Extensive allergy testing is rarely helpful unless a trigger is suspected. Tracking symptoms with a score such as the UAS7 helps guide treatment.
Treatment Overview
First-line treatment is a daily non-sedating antihistamine, which may be increased up to four times the standard dose under a doctor’s guidance. If hives persist, add-on options include omalizumab (Xolair), dupilumab and remibrutinib in eligible adults. See chronic hives treatment for the full stepwise approach.
When to Call 911
Go to the emergency room or call 911 immediately if hives are accompanied by difficulty breathing, wheezing, throat tightness, swelling of the lips, tongue or face, light-headedness or a sense that something is seriously wrong. These are warning signs of anaphylaxis.
When to See a Doctor
See a doctor if your symptoms last more than a few days, keep coming back, cover large areas, or interfere with sleep or daily life. Dr. Tiffany Young founded the Hives Treatment Center in San Francisco, a practice focused on diagnosing and treating chronic hives.
Frequently Asked Questions About Chronic Hives
How long do chronic hives last?
Often one to five years, though some people clear sooner and a minority have symptoms longer.
Are chronic hives contagious?
No. Hives cannot be passed from person to person.
Can chronic hives go away for good?
There is no guarantee, but most people achieve good control and many go into remission.
Get Relief for Your Hives
You do not have to live with daily itching. Visit our hives treatment page to see the latest treatment options for your outbreak.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. If you think you are having a medical emergency, call 911.
