long lasting hives

Overview

Long-lasting hives are raised, itchy patches on the skin that keep coming back for 6 weeks or more. They are often called chronic hives or chronic urticaria.

Yes. Chronic hives affect about 1 in every 100 people at some point in their lives.

They can start at any age, but are more common in adults between 20 and 40 years old. Women are affected about twice as often as men.

Symptoms

Common symptoms

• Raised, red or skin-colored welts that feel very itchy
• Welts that turn white when pressed in the centre
• Welts that come and go, often within a few hours
• A warm, stinging or burning feeling in the affected skin
• Swelling of the deeper skin, especially around the eyes and lips

Symptoms in children

• Children experience the same itchy welts as adults, but may not describe itching as clearly.
• Hives can be harder to spot on darker skin tones, where they may appear as slightly darker or lighter patches.
• Children with chronic hives may feel frustrated or cry more because of the constant itch.

Symptoms in older adults

• Older adults may have drier skin, which can make the itching feel worse.
• Hives may be mistaken for other skin conditions, such as eczema or drug rashes.
• Older adults are more likely to be taking medicines, which can occasionally cause hives as a side effect.

Causes

Main causes

• In most cases, no single cause can be found. The hives happen because the skin's immune cells release histamine, a chemical that makes blood vessels leak fluid into the skin.
• Sometimes chronic hives are linked to an overactive immune system or an autoimmune reaction in which the body attacks its own skin cells.
• In some people, physical triggers make hives worse, such as heat, cold, pressure on the skin, exercise, or stress.
• Certain infections, such as a cold or a sinus infection, can sometimes start a bout of chronic hives.

Risk factors

• Being a woman, especially between the ages of 20 and 40
• Having a history of allergies, eczema, or autoimmune conditions like thyroid disease
• High levels of stress or recent emotional upset
• Sensitivity to heat, cold, pressure, or sunlight

When to see a doctor

See a doctor urgently if:

• If hives are accompanied by warning symptoms like dizziness or lip swelling, get urgent medical help.
• If you have painful hives that don't settle, or if you feel unwell with fever or joint pain, see a doctor promptly.

Book a routine appointment if:

• If the hives have been coming and going for more than 6 weeks, book a routine appointment.
• If you have tried simple measures like anti-itch creams and they haven't helped, see your doctor.
• If the hives are affecting your sleep, your work, or your mood, it is worth getting support.

Diagnosis

A doctor will usually diagnose long-lasting hives by looking at your skin and asking about your symptoms, how long they last, and what makes them better or worse.

Tests that may be done

• In most cases, no tests are needed.
• If the doctor suspects an underlying condition, they may arrange blood tests, such as a full blood count or checks for thyroid or autoimmune activity.
• Allergy tests are not usually helpful for chronic hives, unless you have a clear reaction to a specific trigger.

What to expect at your appointment

Your doctor may ask you to keep a diary of your hives, noting when they appear, what you were doing, and any medicines you took. Many people never find a single reason, and that is normal.

Treatment

Treatment focuses on controlling the itch and reducing the number of hives. The good news is that most people get good relief with simple measures and, if needed, medicines that calm the immune system's histamine release.

Self-care at home

• Apply a cool, damp cloth to itchy areas for 10–15 minutes at a time.
• Wear loose clothing made of soft cotton to avoid rubbing the skin.
• Keep your bedroom cool and avoid hot showers or baths.
• Use a gentle, fragrance-free moisturiser to soothe the skin.
• Try not to scratch; keep nails short and tap the skin instead of scratching.

Medical treatments

Doctors often start with a non-drowsy antihistamine tablet, taken every day. If that doesn't help enough, they may suggest increasing the dose or adding other treatments, such as medicines that calm the immune system or, for severe cases, monthly injections. Always follow your doctor's advice and never change a dose without discussing it first.

When is surgery considered?

Surgery is not used to treat long-lasting hives.

Living with this condition

Living with hives can be unpredictable, but a daily routine that keeps your skin cool and calm can help. Tracking your hives in a diary can also help you spot patterns, such as times of day or situations that make them worse.

Lifestyle tips

• Learn simple relaxation techniques, such as deep breathing, to help manage stress.
• Sleep in a cool, well-ventilated room, and choose comfortable bedding that doesn't overheat you.
• Avoid clothing that is tight or scratchy, such as wool or synthetic fabrics against the skin.

Diet and exercise

There is no special diet that cures hives, unless you have noticed a clear link to a particular food. Regular exercise is fine, but try to keep cool and don't rush into vigorous activity if heat makes your hives worse.

Mental health and emotional wellbeing

Living with a visible, itchy skin condition can be stressful and may affect your confidence. It's completely normal to feel frustrated or anxious. If you're struggling with low mood or find yourself withdrawing from daily life, talk to your doctor. And if you're ever in crisis, please contact your local mental health crisis helpline or go to your nearest emergency department.

Prevention

Because the cause is often unknown, chronic hives can't always be prevented. However, once you identify your personal triggers — such as heat, cold, pressure, or stress — you can reduce flare-ups by avoiding them.

Complications

If left untreated

• The main risk is poor quality of life, including lost sleep, difficulty concentrating, and emotional distress.
• A small number of people develop deeper swelling (angioedema) in the face, lips, or throat, which can be uncomfortable and occasionally dangerous.
• Very rarely, hives can be a sign of an allergic reaction that leads to anaphylaxis, which is a medical emergency.

Long-term outlook

Most people with long-lasting hives improve within 1 to 2 years, and sometimes sooner. Even when the hives continue, treatment can usually keep them under control, allowing you to live a full and active life.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.