Hives, or urticarial, is a type of skin rash, with red, itchy bumps on the skin. Chronic hives are characterized as such because they typically last six weeks or longer. There are several causes for chronic hives and there are different treatment options available, depending on the cause that is identified. Chronic hives are among the most difficult to treat and prevent.

Causes
Chronic hives are not typically the result of an allergic reaction, although it is a major cause of an acute case, which lasts fewer than six weeks. The vast majority of chronic hives sufferers actually have an unknown cause. It is estimated that up to 40% of those suffering from chronic hives may have an autoimmune condition such as autoimmune thyroiditis.

Studies have shown that almost one-third of patients develop auto-antibodies that are directed at FceRI, a receptor that is located on skin mast cells. Chronic hives can be caused by the chronic stimulation of this receptor.

Chronic hives have also been linked to stress. There is medical evidence that demonstrates a link between chronic hives and poor health, as well as poor emotional well-being. Post-traumatic stress disorder and stressful life events such as divorce, death in the family, etc. could also cause chronic hives.

Symptoms
The symptoms of chronic hives appear on the skin as red, raised bumps that are extremely itchy and uncomfortable. They usually occur in batches on the skin. They can vary in size, from a millimeter to over a couple of centimeters in diameter. It typically affects the throat, arms, legs and trunk area. It is estimated that up to 16% of the population can suffer from an outbreak of chronic hives in their lifetime.

The onset is normally sudden, with no prior warning. They can also cause swelling in the lips, tongue and face. The welts can change their appearance fairly quickly; ie. The size, location and shape can appear bigger, smaller, etc.

Treatment
Chronic hives can be difficult to treat and control. Some medications have been known to lose their effectiveness and some drugs become treatment-resistant. Knowing what triggers an outbreak could help prevent them, and some chronic hive outbreaks clear up on their own, without any need for treatment. Some triggers are, however, hard to identify and there are instances where there is no clear trigger, and therefore treatment and prevention are made more difficult.

Antihistamines can help relieve symptoms such as itching. Anti-itch lotions and salt baths may also be helpful in reducing some of the discomfort of chronic hives. As with most conditions, prevention can be the best treatment. Proper diet and exercise may also help to prevent outbreaks. Avoiding stressful situations can help as well, although this is not always possible. Corticosteroids may also be prescribed by a medical doctor in severe cases. If chronic hives present a life-threatening situation, there may be injections of epinephrine that are needed.

Wearing loose-fitting clothing that doesn’t put pressure on the skin will help to ease discomfort. Other methods include keeping the skin cool, and avoiding alcohol.

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