Hives are itchy red skin patches, or pale welts that erupt on the skin either in the size of a pinpoint or as big as a softball.  Hives can affect only one part of your skin, or cover your whole body.  Hives are usually a reaction your body has when it comes into contact with something that it is either allergic too, or causes your body to signal an autoimmune response.  If the cause of your hives is unknown then they are called idiopathic hives.  About 30-40 percent of idiopathic hives cases are caused by the body’s own immune system. 

If your hives last for longer than 6 weeks they are considered chronic.  Chronic hive causes are usually unknown.  Chronic hives are persistent even with treatment.  Chronic hives can last months or years.  They can come and go or be recurrent.  About half the people who have chronic hives, see their hives go away within a year even without treatment.  Autoimmune hives are when your immune system reacts and attacks your healthy skin.  Having autoimmune hives does not mean you have an autoimmune disease. 

 

Causes

Chronic hives are rarely caused by allergies, medication, or food allergies.  Usually if you have hives based on an allergen they are acute hives and start to go away within 24 hours of developing.  Chronic hives may be brought on by severe allergies that you are exposed to daily. 

Other causes could be a rapid change in your body temperature, or pressure on your skin.  Pressure on your skin could be caused by clothing that is too tight. 

Autoimmune diseases that can cause hives are celiac disease, dermatomyositis, diabetes, lupus, polymyositis, rheumatoid arthritis, thyroid disease, and vitiligo.  Other diseases that can cause chronic autoimmune hives are asthma, H. pylori bacterial infections, sinus infections, liver disease, lymphomas, and vasculitis. 

Knowing what is causing your hives can be hard to find out.  Hives can take up to 24 hours to develop after being exposed to something.  When it is caused by an autoimmune reaction it is even harder to pinpoint what may be causing the hives to appear. 

 

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Diagnosis

Diagnosing your hives may take more than one specialist to help you get to the root cause.  Doctors like a dermatologist, primary care physician, or an allergist are all options to help diagnose hives.  A blood test can be done to check for thyroid disease which is one of the main causes of chronic hives.  A blood test can also check for high levels of antibodies that would indicate other infections.  Allergy tests, such as a skin prick test can be done to check for allergens you may be unaware that you have.  Urine tests can check for bacterial infections.  A basophil histamine release assay is another type of blood test that can help measure the levels of histamine released from basophils.  The results of this test do not determine if you have an autoimmune disease that is causing autoimmune hives, but it is a test that is done to help research autoimmune hives.  An autologous serum skin test is another diagnosing tool to help detect autoantibodies released in response to histamine production.  

 

Treatment

Treatment for autoimmune hives is dependent on the severity and the cause.  If the cause is unknown, trying to ease symptoms may be the best option for treatment. 

If you suffer from hives due to an allergen, medication, or food, then it is best to stop consumption immediately and to start avoiding what is causing your hives.  When hives are present a great way to help ease pain is to take an oral antihistamine.  To help prevent hives from recurring, or from happening you can take over the counter allergy medications such as Claritin, Allegra, Zyrtex, Clarinex, or Xyzal.  Allergy shots can be an option.  Corticosteroids such as Prednisone can help ease symptoms.

Hydroxychloroquine is an antimalarial drug that has shown to be extremely effective in symptom relief for chronic hives for three months or more.

Cyclosporine is an immunosuppressant that can help clear up chronic hives, but it is not suggested to be used long term because of severe adverse side effects.

Other home remedies that may be helpful are over the counter anti-itch creams, calamine lotion.  Cool compresses can help ease pain, swelling, and itching.  Be sure to keep an eye on your hives though, in some cases cool temperatures can cause hives to worsen.  A cool bath or shower can also help with some relief.  Hypoallergenic lotions and creams to moisturize your skin.  Loose fitting clothing to help the skin breathe.  Reduce stress.  Make sure you are getting plenty of sleep. 

Chronic hives can be hard to find the cause for.  Sometimes the cause is never found.  When the hives show to be a response from your immune system they are autoimmune hives.  Most autoimmune hives clear up within the same year even if treatments are not working, or there are no treatments.  Chronic hives can be extremely bothersome and exhausting to deal with.  Finding ways to help ease and alleviate the symptoms can help them become more manageable.  If you suffer from any airway restriction along with hives make sure you seek medical attention immediately.  

 

 

 

 

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