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My daughter has had hives covering her body on and off for several months. The doctor said that hives usually last for a couple of weeks to a few months. My daughter has never had any allergies to food or anything else. What could have caused this, and what is the most effective treatment for hives? Hives known in the medical community as urticaria are very itchy spots, pink to red, that appear on the skin, feel raised up from the surrounding skin, and then disappear without a trace unless the person has scratched and damaged the skin.
An individual hive can range from the size of a pencil eraser to the size of a dinner plate. Hives are not rare, and most people experience a brief bout of them at least once in their lives. They typically last a few days or a week and then go away as suddenly as they came.
This can happen after someone has a mild infection, including everyday viruses, or in association with taking antibiotics. Hives can also be part of a more serious allergic reactionsuch as a reaction to a food, medicine, or insect sting. Anyone who develops hives plus other symptoms — such as difficulty breathing, dizziness or light-headedness, throat tightness, nausea or vomiting, or passing out — should be seen by a health care provider immediately.
Sometimes outbreaks of hives keep happening for weeks or months, as you describe in the case of your daughter. This condition is called chronic hives, or chronic urticariaand it's characterized by the presence of hives on most days of the week for six weeks or more. This disorder, less common than short-lived hives, affects about one in people. It is very distressing to the person who has it because it is uncomfortable, unpredictable, and interferes with sleep, school, and work.
However, it is almost never related to a more serious medical problem or to an allergy. Researchers do not know with certainty what causes chronic urticaria, but there are a couple of leading theories. One is that chronic hives are caused by changes in white blood cells called basophils. Another is that some people begin to make antibodies proteins that normally fight infections that cause cells mast cells to release natural chemicals.
These mast cells are in the skin, and the chemicals cause swelling in the skin around the cells, creating hives. However, a small number of unfortunate people have chronic hives for years on end. Many people with hives notice that the symptoms seem to be related to diet in some way, but testing for food allergy usually shows that a person with hives is not allergic to any food. This is because while some foods contain natural chemicals that aggravate hives, there are so many foods that do this that avoiding enough of them to make a real difference in the symptoms would be difficult and impractical.
People with hives almost always require antihistamines to control the symptoms. Antihistamines are considered the safest and most effective initial treatment. Certain antihistamines, such as cetirizine Zyrtecfexofenadine Allegraand loratadine Claritincause less drowsiness and dry mouth than others, such as diphenhydramine Benadryl and chlorpheniramine.
Doctors often need to combine different types of antihistamines or double the dose of one medicine. To figure out the right medication or combination of medications for your daughter, you'll need to discuss with her doctor her age and how well she responds to the various medications. If hives are still not controlled on full doses of two or more antihistamines, many doctors will add a medicine called montelukast Singulair for a month or so, and some patients then improve.
Every patient is different, though, and it can take weeks to find a set of medicines that work. The process can be frustrating, so be patient. I have had chronic hives for the past six months.
The only thing that controls them temporarily is prednisone. As soon as I am off of it, they come back with a vengeance within 24 hours or less. Is there anything else that might help?
I already take Zyrtec and Zantac. I am desperate and would appreciate any suggestions. Hives are raised, intensely itchy spots or patches that appear in crops, last for a few hours, and then resolve without leaving any residual marks on the skin.
They can range in size from as big as a pencil eraser to the size of a dinner plate. Hives can appear anywhere on the body, although the legs, arms, abdomen, armpits, and neck are the areas where they most commonly surface. Most people will develop hives at least once in their lives, and the trigger is often not obvious.
For a benign condition, hives certainly cause a lot of suffering for those that have them. As your doctor has probably mentioned, there is no identifiable allergy or underlying medical condition to explain chronic hives in about 85 percent of those who suffer from them. If you visit the message boards on this site, you will find plenty of people writing in under the thread titled, "Crazy Itching.
Also, you can see that different treatments work for different people, and what seems to be a miracle treatment for one person has minimal effect on another. The bottom line is this: There are no magic cures for hives. Most of the time, people try various medications until they find some combination that works for them. The combination of Zantac ranitidine and Zyrtec cetirizine helps many people, although you may need to double the regular Zyrtec dose to 10 mg twice a day for decent relief.
The Zantac you take should be at least mg twice a day. In addition to this, some people benefit from 10 to 20 mg of doxepin before bed. Doxepin is an antidepressant when taken at higher doses, but at lower doses acts as a strong antihistamine. It is very sedating however, and some people feel groggy in the morning.
Another antihistamine that can be helpful is hydroxyzinetaken at a dosage of 25 mg every six to eight hours if needed, although it is also sedating.
Prednisone will calm down hives in most cases, but it can have severe side effects if taken continuously for months or years. Dramatic and sudden changes in medication often cause the hives to flare again, so sometimes I have success lowering the prednisone dose very, very slowly. For example, once you get down to 10 mg, try dropping one milligram every four days or so: in other words, 9 mg a day for four days; 8 mg a day for the next four days, etc.
Once you reach 4 or 5 mg, try changing to taking prednisone every other day for a week, and then stop. When lowering and stopping the prednisone, you also have to keep the antihistamines going at full strength, and if you're lucky, they will offer enough relief by themselves.
Make sure you are not inadvertently doing anything that could be aggravating the hives. Things that seem to aggravate hives and itching in most everyone include:. This list is just good to keep in mind if you have an itching problem, even if you can't control many of the things on it. Try to keep your eating and sleeping patterns as regular as possible.
I get hives after exercise. Is this some kind of allergic reaction? If it is, what can I do to treat or prevent it? There are many people who get hives and other allergic symptoms after exercising, a condition known as exercise-induced urticaria. Talk to your doctor about this condition, and he or she may recommend a quick-acting, non-sedating antihistamine that you can take prior to exercise.
Also, it may be worthwhile to work out with a buddy just in case the symptoms become more extensive than hives shortness of breathdizziness. Some patients with this condition carry auto-injectable adrenaline in case of a life-threatening allergic reaction.
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❿Prednisone for hives allergies.Treating Hives Effectively
Prednisone is a corticosteroid cortisone-like medicine or steroid. It works on the immune system to help relieve swelling, redness, itching, and allergic reactions. There is a problem with information submitted for this request.
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I have had chronic hives for the past six months. The only thing that controls them temporarily is prednisone. As soon as I am off of it, they come back with a vengeance within 24 hours or less. Is there anything else that might help? I already take Zyrtec and Zantac. I am desperate and would appreciate any suggestions. Hives are raised, intensely itchy spots or patches that appear in crops, last for a few hours, and then resolve without leaving any residual marks on the skin.
They can range in size from as big as a pencil eraser to the size of a dinner plate. Hives can appear anywhere on the body, although the legs, arms, abdomen, armpits, and neck are the areas where they most commonly surface.
Most people will develop hives at least once in their lives, and the trigger is often not obvious. For a benign condition, hives certainly cause a lot of suffering for those that have them. As your doctor has probably mentioned, there is no identifiable allergy or underlying medical condition to explain chronic hives in about 85 percent of those who suffer from them.
If you visit the message boards on this site, you will find plenty of people writing in under the thread titled, "Crazy Itching. Also, you can see that different treatments work for different people, and what seems to be a miracle treatment for one person has minimal effect on another.
The bottom line is this: There are no magic cures for hives. Most of the time, people try various medications until they find some combination that works for them. The combination of Zantac ranitidine and Zyrtec cetirizine helps many people, although you may need to double the regular Zyrtec dose to 10 mg twice a day for decent relief. The Zantac you take should be at least mg twice a day.
In addition to this, some people benefit from 10 to 20 mg of doxepin before bed. Doxepin is an antidepressant when taken at higher doses, but at lower doses acts as a strong antihistamine.
It is very sedating however, and some people feel groggy in the morning. Another antihistamine that can be helpful is hydroxyzine , taken at a dosage of 25 mg every six to eight hours if needed, although it is also sedating.
Prednisone will calm down hives in most cases, but it can have severe side effects if taken continuously for months or years. Dramatic and sudden changes in medication often cause the hives to flare again, so sometimes I have success lowering the prednisone dose very, very slowly.
You're likely to start by seeing your primary care doctor. In some cases when you call to set up an appointment, you may be referred immediately to a skin disease specialist dermatologist or to an allergy specialist.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Diagnosis To diagnose hives or angioedema, your doctor will likely look at your welts or areas of swelling and ask about your medical history.
Treatment If your symptoms are mild, you may not need treatment. Request an Appointment at Mayo Clinic. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry.
By Mayo Clinic Staff. Share on: Facebook Twitter. Show references AskMayoExpert. Mayo Clinic; Kang S, et al. Urticaria and angioedema. In: Fitzpatrick's Dermatology.
❾-50%}Hives and angioedema - Diagnosis and treatment - Mayo Clinic
Certain antihistamines, such as cetirizine Zyrtec , fexofenadine Allegra , and loratadine Claritin , cause less drowsiness and dry mouth than others, such as diphenhydramine Benadryl and chlorpheniramine. Doctors often need to combine different types of antihistamines or double the dose of one medicine. To figure out the right medication or combination of medications for your daughter, you'll need to discuss with her doctor her age and how well she responds to the various medications.
If hives are still not controlled on full doses of two or more antihistamines, many doctors will add a medicine called montelukast Singulair for a month or so, and some patients then improve. Every patient is different, though, and it can take weeks to find a set of medicines that work.
The process can be frustrating, so be patient. I have had chronic hives for the past six months. The only thing that controls them temporarily is prednisone. As soon as I am off of it, they come back with a vengeance within 24 hours or less.
Is there anything else that might help? I already take Zyrtec and Zantac. I am desperate and would appreciate any suggestions. Hives are raised, intensely itchy spots or patches that appear in crops, last for a few hours, and then resolve without leaving any residual marks on the skin.
They can range in size from as big as a pencil eraser to the size of a dinner plate. Hives can appear anywhere on the body, although the legs, arms, abdomen, armpits, and neck are the areas where they most commonly surface. Most people will develop hives at least once in their lives, and the trigger is often not obvious.
For a benign condition, hives certainly cause a lot of suffering for those that have them. As your doctor has probably mentioned, there is no identifiable allergy or underlying medical condition to explain chronic hives in about 85 percent of those who suffer from them.
If you visit the message boards on this site, you will find plenty of people writing in under the thread titled, "Crazy Itching. Also, you can see that different treatments work for different people, and what seems to be a miracle treatment for one person has minimal effect on another. The bottom line is this: There are no magic cures for hives. Most of the time, people try various medications until they find some combination that works for them.
The combination of Zantac ranitidine and Zyrtec cetirizine helps many people, although you may need to double the regular Zyrtec dose to 10 mg twice a day for decent relief. The Zantac you take should be at least mg twice a day. In addition to this, some people benefit from 10 to 20 mg of doxepin before bed. Did the Pandemic Change Our Personalities? Unlocking the Power of Our Emotional Memory. Our Brains Use Quantum Computation.
Explore More. Food Preservative Enhances Schizophrenia Treatment. Living Well. View all the latest top news in the environmental sciences, or browse the topics below:. Keyword: Search. With the addition of prednisone, the relief scores were actually worse. Levocetirizine — better known by the brand name Xyzal — is a non-sedating antihistamine that lasts 24 hours. It got federal approval earlier this year to be sold over the counter.
So maybe, I wondered, I didn't need to take those slightly scary steroids after all? The French study was small -- just patients with basic hives, no puffiness of face or feet — but high quality: patients were randomly assigned to steroids or placebo, and "blind" to which they got. On the other hand, hives can be a little scary too: They can — rarely — progress to a potentially life-threatening anaphylactic reaction. So couldn't steroids help prevent that? What does this study mean for the next time you or I see those nasty itchy red bumps breaking out?
First, as always, ask your doctor if you're in any doubt: Is this hives? Should I be seen? Editorializing here, but if you can't send a smartphone photo to your primary care office, something's wrong. Rade Vukmir. Both say the study is unlikely to shift the current standard practice of offering both an antihistamine and a steroid — and often a Pepcid or Zantac as well, which block an additional kind of histamine, Vukmir said, for a " punch.
But each found value in it nonetheless. Hsu Blatman says that for patients with relatively mild cases of hives, the study underscores the option of simply taking antihistamines at home. But if you continue to have symptoms or it doesn't seem like it's turning around, then you should be seeking medical advice. She called the study "nicely done," and further evidence that histamine is a key element in the hives allergic reaction, "so it makes sense that if you take an antihistamine, that that would help with blocking the histamine, which is what's really driving that itch.
But, I asked her, doesn't it make sense that if an allergic reaction like hives is an overreaction of the immune system, and steroids ratchet down the immune system, they should be helpful against hives?
To diagnose hives or angioedema, your doctor will likely look at your welts or areas of swelling and ask about your medical history. You may also need blood tests or an allergy skin test. If your symptoms are mild, you may not need treatment. Hives and angioedema often clear up on their own. But treatment can offer relief from intense itching, serious discomfort or symptoms that persist.
For a severe attack of hives or angioedema, you may need a trip to the emergency room and an emergency injection of epinephrine — a type of adrenaline. If you have had a serious attack or your attacks recur despite treatment, your doctor may have you carry a penlike device that will allow you to self-inject epinephrine in emergencies. There is a problem with information submitted for this request. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID, plus expertise on managing health.
To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices.
You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
You're likely to start by seeing your primary care doctor. In some cases when you call to set up an appointment, you may be referred immediately to a skin disease specialist dermatologist or to an allergy specialist. Mayo Clinic does not endorse companies or products.
Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Diagnosis To diagnose hives or angioedema, your doctor will likely look at your welts or areas of swelling and ask about your medical history. Treatment If your symptoms are mild, you may not need treatment. Request an Appointment at Mayo Clinic.
Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. By Mayo Clinic Staff.
Share on: Facebook Twitter. Show references AskMayoExpert. Mayo Clinic; Kang S, et al. Urticaria and angioedema. In: Fitzpatrick's Dermatology. McGraw-Hill; Accessed Aug. Hives urticaria. American College of Allergy, Asthma, and Immunology.
Ferri FF. In: Ferri's Clinical Advisor Asero R. New-onset urticaria. Zuraw B, et al. An overview of angioedema: Clinical features, diagnosis, and management. American Academy of Dermatology. Thompson DA. American Academy of Pediatrics; Briggs JK. In: Triage Protocols for Aging Adults. Wolters Kluwer; Kelly AP, et al. Drug eruptions. McGraw Hill; Hereditary angioedema: Acute treatment of angioedema attacks. Biology of wounds and wound care. McGraw-Hill Education; Accessed May 27, Related Hives on brown skin Hives on white skin.
Despite standard use for the itching associated with urticaria (commonly known as hives), prednisone (a steroid) offered no additional. "Prednisone is a strong and great drug for certain problems, but it is no better than antihistamine treatment for patients who are itching with. Prednisone provides relief for inflamed areas of the body. Prednisone is a corticosteroid (cortisone-like medicine or steroid). It works on. Despite standard use for the itching associated with urticaria (commonly known as hives), prednisone (a steroid) offered no additional relief to. Conclusion: The addition of a prednisone burst improves the symptomatic and clinical response of acute urticaria to antihistamines. Patients' conditions. Hives and angioedema often clear up on their own. Mayo Clinic does not endorse companies or products. An overview of angioedema: Clinical features, diagnosis, and management. This site complies with the HONcode standard for trustworthy health information: verify here. You can try subscribing here or try again later. Accessed May 27,The baffling, itchy red welts began in early fall, cropping up in odd places: on my torso why would a mosquito bite a spot that wasn't exposed? Every day or two, a new one would appear; some in clusters and others alone; some as small as pimples, but one swelling almost to the size of a ping pong ball. Finally, I went to urgent care. It took a seasoned doctor about 10 seconds to diagnose me with hives: the often-mysterious allergic reaction that affects about one-fifth of us at some time in our lives.
He prescribed an over-the-counter antihistamine, Benadryl, and a steroid, prednisone. I knew vaguely that steroids were not-to-be-taken-lightly drugs. They carry the potential for significant side effects: 'roid rage, blood sugar spikes, long-term risk of infection and bone loss. But this was a "Make it stop! The treatment worked beautifully, ending the itch and beating down the swelling within a day or two.
I never did figure out what triggered the hives. Hold The Steroids. The press release about the Annals Of Emergency Medicine study included this:. With the addition of prednisone, the relief scores were actually worse. Levocetirizine — better known by the brand name Xyzal — is a non-sedating antihistamine that lasts 24 hours. It got federal approval earlier this year to be sold over the counter.
So maybe, I wondered, I didn't need to take those slightly scary steroids after all? The French study was small -- just patients with basic hives, no puffiness of face or feet — but high quality: patients were randomly assigned to steroids or placebo, and "blind" to which they got.
On the other hand, hives can be a little scary too: They can — rarely — progress to a potentially life-threatening anaphylactic reaction. So couldn't steroids help prevent that? What does this study mean for the next time you or I see those nasty itchy red bumps breaking out? First, as always, ask your doctor if you're in any doubt: Is this hives?
Should I be seen? Editorializing here, but if you can't send a smartphone photo to your primary care office, something's wrong. Rade Vukmir. Both say the study is unlikely to shift the current standard practice of offering both an antihistamine and a steroid — and often a Pepcid or Zantac as well, which block an additional kind of histamine, Vukmir said, for a " punch. But each found value in it nonetheless. Hsu Blatman says that for patients with relatively mild cases of hives, the study underscores the option of simply taking antihistamines at home.
But if you continue to have symptoms or it doesn't seem like it's turning around, then you should be seeking medical advice.
She called the study "nicely done," and further evidence that histamine is a key element in the hives allergic reaction, "so it makes sense that if you take an antihistamine, that that would help with blocking the histamine, which is what's really driving that itch.
But, I asked her, doesn't it make sense that if an allergic reaction like hives is an overreaction of the immune system, and steroids ratchet down the immune system, they should be helpful against hives? The steroid "is trying to help decrease that inflammation kind of slowly," she said. So for patients who may have a bigger presentation, the steroids can be helpful in that way.
Vukmir said the study offers more fodder for a discussion between doctors and patients as they consider the options. In the wake of the study, he said, his script might sound like this:. You know, normally we would prescribe steroids in this situation. It's been done for years. There's a good track record. Some people get a little concerned about steroids. So there is this other alternative: There's a new study that said maybe we don't need to give steroids, in that you don't get better that much more quickly.
And we can try that approach, and I might use a higher dose of the antihistamine. He might also suggest that the patient call him if there's a problem, and that he could still phone the steroid prescription in to the pharmacy.
And medicine is always trying to improve, in part by reexamining current medical dogma, as this French study did. I'm leaning toward skipping the steroid, at least at first, if I get another hives attack. But one lingering concern: The study did find that in one patient among the 50 who got a placebo rather than a steroid, the hives progressed to an anaphylactic allergic reaction. Vukmir said he wasn't sure the report was a full-fledged anaphylactic reaction, and in any case, there's usually good warning: The classic anaphylactic reaction, he said, typically occurs within 20 minutes, and involves a blood pressure drop or significant breathing problems.
So if you're prone to hives, would you try skipping the steroid yourself? The good news is that hives usually pass on their own anyway — they're "self-limiting," in medical parlance. The better news is that whether you take steroids or not, the risks they'll turn life-threatening are exceedingly low. And maybe the best news is that in current medical culture, you're likely to have a choice. Skip to main content. Listen Live. It's Boston local news in one concise, fun and informative email Thank you!
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