Living With Chronic Urticaria (Hives)

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While living with chronic hives can be difficult, uncomfortable, and painful, there are ways to cope. The majority of people with chronic hives develop hives with no external trigger. Talking with your doctor about a proper treatment plan can help you live well with the condition.

This article will discuss how chronic hives can impact your quality of life. Focusing on the emotional, physical, social, and practical aspects of your day-to-day life can help you manage the condition.

Doctor examines hives on a patient's arm.

Ivan Balvan / iStock / Getty Images

Hives commonly appear as itchy, raised bumps on the skin. They are often red and swollen and can vary in size from the smallest dots to large circles. Most hives resolve within two to three hours.

Urticaria, or hives, when chronic, can persist for weeks, months, or years. When hives are chronic, they are most commonly spontaneous and not caused by an allergen or external trigger.

They can also be related to underlying autoimmune diseases, such as thyroid disease. The majority of cases of chronic urticaria are benign and not associated with a more severe underlying condition.

Chronic hives are hives that occur at least twice a week and last for more than six weeks. Chronic hives can be divided into two groups:

  • Chronic spontaneous hives occur without a specific external trigger.
  • Physical hives occur due to an outside factor. Hives can be brought on by touching or scratching the skin, heat, cold, vibration, pressure, and the sun. Approximately 20% of cases of chronic hives fall into this category.

You may have one or a combination of the above types of urticaria.

When to Call Emergency Help

If you have hives along with difficulty breathing or swelling in the lips, this can indicate a life-threating reaction known as anaphylaxis and should be treated immediately.

Emotional

Living with a chronic condition can be draining and affect your emotional health. It is normal to want to return to your state of health before your diagnosis. Anxiety and depression are common with chronic hives.

You may be upset or feel exhausted by the amount of work it takes to manage your hives. You may even be embarrassed by your condition. All your feelings are valid when it comes to living with chronic hives.

Noting your feelings and talking about them with professionals or even close friends or family can help. While feeling sad, upset, and scared over a diagnosis is normal, you may be experiencing clinical depression if these feelings persist. Depression is treatable.

If you experience signs of depression, such as purposely withdrawing from activities and people you love or feelings of hopelessness, it’s important to talk to your doctor.

Taking care of your mental health as well as your physical health can help improve your quality of life with chronic hives.

Physical

The goal for treating chronic hives is to minimize symptoms and the effect they have on your life. Treatment for chronic hives includes medications, both over-the-counter and prescription.

Antihistamines are usually the first therapy used to provide symptom relief. Non-sedating antihistamines are available over-the-counter and are generally preferred over sedating ones so that you do not feel sleepy.

Perhaps you are in pain or don’t get enough sleep due to itching. Maybe you experience side effects such as drowsiness from your medications. All of these are concrete ways that the condition can affect your life.

Reach out to your physician with these concerns as well. There are treatments for chronic spontaneous urticaria that may be able to help you avoid these symptoms. Regardless of your treatment plan, it is important to follow your doctor’s advice and ask questions if you don’t understand something.

Physical Urticaria Triggers

Most people with chronic urticaria do not need to avoid one particular trigger. Physical urticarias have specific triggers, but these are much rarer. If you discover what triggers or exacerbates your symptoms, you can make plans to avoid it. However, avoidance may not always be possible.

For example, you may find that the sun triggers your symptoms. While you can avoid the sun to some extent by seeking shade or wearing protective clothing, it might be impossible to completely avoid it without making incredible sacrifices in your life.

For some people, stress, exercise, and heat can cause hives; this is called cholinergic urticaria. With medical treatment, most activities can be continued so that you don't have to give up movement that is important to your overall health.

Sometimes you need to find a balance between avoiding your triggers and your overall well-being. Do your best to avoid triggers, but know that your whole health needs to be considered when making any changes.

Social

Living with a chronic condition like hives can feel isolating. Sometimes it is difficult to fully express how much your condition affects your life. To those who don’t experience the same symptoms, hives might seem like a small inconvenience, but it is well known that chronic hives can greatly affect your quality of life.

Learning how to talk about your symptoms and how they affect your life may help others relate to how you feel. If you are embarrassed by your condition, talk to someone you trust. Let them know that you struggle with this.

If you feel overwhelmed, know that you are not alone. Surrounding yourself with people who understand what you are going through can help.

A quick online search can help you find a support group for people experiencing chronic hives. Even a look through social media can help you find a tribe of others going through the same thing.

Finding a therapist who has experience with patients who live with chronic illness can also be a great help.

Practical

Although it’s been reported that approximately two-thirds of patients living with chronic hives have their condition resolved within five years, living with chronic hives for any amount of time will require adjustments to your daily life.

Sometimes looking at your day-to-day activities and doing your best to reduce your exposure to triggers during activities such as exercise or work can help you feel in control of your condition.

Workplace Accommodations

Working with chronic hives can be embarrassing, especially if the hives are on your face or neck. They can also be distracting if they are causing pain or itching. Both of these can result in a loss of productivity.

If you have physical urticaria and know that there are triggers present in your workplace, you can reasonably ask for accommodations thanks to the Americans with Disabilities Act.

For example, if the sun is a trigger, it is perfectly reasonable to ask for a desk away from the window. Speaking up about your experiences and asking for help and accommodations can improve your quality of life.

Summary

Chronic urticaria can affect your daily life. Be aware of symptoms of depression, and seek care if they persist. Seek social support through friends, support groups, or a therapist.

The majority of people with chronic hives have no external trigger. If you have one of the more rare types of chronic hives that are caused by physical triggers such as temperature change, learn which situations to avoid.

 

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Fine LM, Bernstein JA. Guideline of chronic urticaria beyondAllergy Asthma Immunol Res. 2016;8(5):396-403. doi:10.4168/aair.2016.8.5.396

  2. Kayiran MA, Akdeniz N. Diagnosis and treatment of urticaria in primary careNorth Clin Istanb. 2019;6(1):93-99. doi:10.14744/nci.2018.75010

  3. Tat TS. Higher Levels of Depression and Anxiety in Patients with Chronic UrticariaMed Sci Monit. 2019;25:115-120. Published 2019 Jan 4. doi:10.12659/MSM.912362

  4. National Institute of Mental Health. Chronic illness and mental health: Recognizing and treating depression. Updated 2021. 

  5. Schaefer P. Acute and chronic urticaria: Evaluation and treatment. Am Fam Physician. 2017 Jun 1;95(11):717-724.

  6. Dias GA, Pires GV, Valle SO, et al. Impact of chronic urticaria on the quality of life of patients followed up at a university hospitalAn Bras Dermatol. 2016;91(6):754-759. doi:10.1590/abd1806-4841.20165071

  7. Hon KL, Leung AKC, Ng WGG, Loo SK. Chronic urticaria: An overview of treatment and recent patentsRecent Pat Inflamm Allergy Drug Discov. 2019;13(1):27-37. doi:10.2174/1872213X13666190328164931

  8. Equal Employment Opportunity Commission. Enforcement guidance on reasonable accommodation and undue hardship under the ADA. Updated 2021.