Hives that come and go every day: causes and treatment


Hives are itchy, bumps on the skin. Some people have hives that go away on their own. However, when a person has hives that come and go every day, they can get chronic hives.

Doctors diagnose chronic urticaria in people who have had it for at least 6 weeks. Each hive typically lasts 24 hours before disappearing. usually, the condition has no identifiable cause, but sometimes it does.

Some people suffer from chronic hives because of an underlying disease. Therefore, it is important for individuals to speak with a doctor about repeatedly returning hives.

Keep reading to learn more about the symptoms, causes, diagnosis, and treatment of hives that come and go on a daily basis.

Chronic urticaria is a condition that causes hives that keep coming back. Each lasts less than 24 hours, and as old beehives wither, new ones appear.

Unlike acute urticaria, which comes on suddenly and goes away quickly, chronic urticaria can occur almost daily for 6 weeks or more. In some cases, the symptoms can interfere with daily activities and affect sleep.

Chronic urticaria appears to be the same as acute urticaria. The only difference is that the symptoms come and go instead of flaring up and then disappearing.

Hives are itchy, welts on the skin that may be red or the same color as a person’s skin. They turn white when a person presses them. Hives can grow anywhere on the body, move around and change shape. They can also appear and disappear suddenly.

Hives usually don’t break the skin, but it can cause bleeding if a person scratches them.

There can be several causes of chronic urticaria, but the trigger is unknown in the majority of cases.

Chronic idiopathic urticaria

The medical name for chronic urticaria that does not have a clear trigger is chronic idiopathic urticaria.

According to American College of Osteopathy in Dermatology (AOCD), the immune system is overactive in about half of people with chronic idiopathic urticaria. Doctors consider these cases to be autoimmune because they originate from the immune system attacking healthy tissue.

However, a research paper 2021 note that certain bacteria, viruses or parasites are also associated with cases of chronic urticaria. Researchers haven’t proven that these organisms cause hives, but they can trigger the immune system, which could lead to hives as part of its response to infection.

Bacterial infections associated with chronic urticaria include:

Viral infections associated with the disease include:

Parasitic infections associated with chronic urticaria include:

Autoimmune conditions

Some cases of chronic urticaria can result from an underlying autoimmune disease. Research has found that 9.8% of people with chronic urticaria also have autoimmune hypothyroidism. Other conditions associated with chronic urticaria include:

Physical stimulation

A small percentage of chronic urticaria cases come from physical stimulation. This is called physical urticaria. The The most common the trigger scratches or rubs the skin firmly.

Other physical triggers can understand:

  • exercise
  • cold temperatures
  • hot temperatures
  • sunlight
  • vibration
  • pressure


As with acute urticaria, chronic urticaria can also occur due to an allergy. However, unlike acute hives, it is a rare cause of chronic urticaria.

Some common allergens that can trigger hives include:

  • certain foods
  • food additives and preservatives
  • latex
  • medications

Drug reactions can occur at any time after someone starts taking one. Some common triggers understand:

Diagnosis of chronic urticaria can begin with seeing a primary care physician, allergist, or dermatologist. They will examine the hives and ask the person questions to rule out common causes, such as a drug reaction.

Depending on the circumstances, the doctor may order diagnostic tests. This could include allergy tests or blood tests to look for markers of inflammation or celiac disease.

If the hives are not always apparent, it can help for a person to take pictures to show to a doctor at the appointment. Keeping a journal of when the hives appear and any possible contributing factors can also help. Users can follow:

  • food they eat
  • the drugs they take
  • exposure to physical stimuli, such as the sun, friction, or pressure on the skin

In cases where there is no clear cause, treatment focuses on controlling the hives. A Review article 2021 lists the following treatment options:

  • Second generation H1 antihistamines: This is the first-line treatment for chronic urticaria and includes drugs such as cetirizine and loratadine. Routine use of first generation H1 antihistamines, such as diphenhydramine (Benadryl), is not recommended by doctors due to side effects.
  • Omalizumab (Xolair): If a person does not respond to first-line treatment, practitioners may add this drug for second-line treatment. It is a monoclonal antibody, which blocks the action of substances in the body that produce hives.
  • Cyclosporine (Gengraf): Doctors may prescribe it when a person does not respond to a combination of an H1 antihistamine and omalizumab.
  • Corticosteroids: Short-term use of these anti-inflammatory drugs may be an option for relieving flare-ups of chronic urticaria.

In cases where hives have a known trigger, avoiding the trigger is another important part of treatment.

Chronic urticaria may go away. A prospective cohort study found that 35% of participants with chronic urticaria had no symptoms after 1 year, and 29% experienced a reduction in symptoms during this time.

Among people with chronic idiopathic urticaria, 48% experienced remission within 3 years. However, only 16% of people with physical urticaria experienced remission within 3 years.

If a person has hives for 6 weeks or more, the Association of the American Academy of Dermatology recommends consulting an allergist, dermatologist or certified primary care physician.

If someone has severe hives inside their mouth or airways that affect breathing, call 911 or the nearest emergency service number. This could be a sign of a serious allergic reaction, or anaphylaxis, which can make it difficult to breathe.

Symptoms of anaphylaxis include:

  • rapid or shallow breathing
  • a rapid heartbeat
  • wheezing
  • dizziness
  • clammy skin
  • anxiety or confusion
  • loss of consciousness

Hives that come and go daily for at least 6 weeks may meet the criteria for chronic urticaria. Most cases do not have an identifiable cause, but they are associated with an infection, autoimmune disease, allergy, or physical cause in some people.

Physical urticaria can occur due to exercise, vibration, or exposure to hot or cold temperatures. However, chronic idiopathic urticaria is more common.

Doctors treat this disease with drugs to control the symptoms. Evidence indicates that after 1 year, a significant proportion of people with chronic urticaria experience remission or reduced symptoms.

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