Living with Chronic Hives: Sierras Story

The teen years are notoriously awkward, and for Sierra Ehrliech, dealing with chronic hives didn’t help. “They just started happening,” she says. “Sometimes my hives were stress-induced, but often I would just get itchy for no reason and freak out when I saw these big red welts on my skin.”

Ehrliech's experience of living with chronic hives isn't unique. Chronic idiopathic urticaria, the medical term for hives with no known cause that last for six weeks or longer, affects about 1.5 million people in the United States, according to the Asthma and Allergy Foundation of America.

Women are twice as likely as men to develop chronic idiopathic urticaria, and most cases appear between the ages of 20 and 40. Hives tend to begin with an itchy patch of skin and turn into swollen red welts, according to the American College of Allergy, Asthma & Immunology.

Gaining Control of Chronic Hives

Now 29, Ehrliech, a medical assistant at Mount Sinai Hospital in New York, has her chronic hives pretty much under control with a regular regimen of oral antihistamines, but this didn’t happen overnight. “I take an antihistamine every day at the same time, and I have been hive-free for a few months," she says. Histamine is a chemical released in the skin that can cause itching and welts. Antihistamines block the effects of histamine.

Before this reprieve, Ehrliech says, “I was constantly itchy, and not scratching was a daily fight for me.” Scratching can make the hives more likely to spread. “Instead, I used a lotion or an antihistamine cream whenever the itch was overwhelming," she says. "That helped a lot. I always make sure I have some type of cream close by, just in case.”

Ehrliech also learned what makes her hives worse and how to avoid those triggers. “I’m very sensitive to heat, so when I take a hot shower, my skin reacts,” she says. Now Ehrliech knows that she can only tolerate short, lukewarm showers. “I use an unscented soap for sensitive skin,” she says.

“Placing cool cotton cloths on the hives or taking cool showers can relieve the itching,” says Gary Goldenberg, MD, an assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York. Each person’s hives can have different triggers or aggravating factors, he says. “Even if your allergy testing comes back negative, keep a journal and see if any patterns emerge,” he says.

For Ehrliech, the only trigger for her chronic hives seems to be stress. “If I get stressed out at work because I have too much on my plate, a flare will happen,” she says. In these instances, she stops, takes a deep breath, and tries to calm down. “It’s mind over matter."

“Stress can make everything worse,” Dr. Goldenberg says. “Find something that helps you reduce stress in your life and do it on a regular basis, because this will likely help improve all aspects of your life — including hives."

Treating Chronic Idiopathic Hives

Various medications have been designed to block the immune response that causes hives. Learn about your treatment options.

Is It Hives or Something Else?

Many skin disorders can cause irritated, itchy rashes, making it difficult to distinguish between chronic hives and other skin conditions.

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