Avoid known triggers
One of the best ways to control hives is to avoid known triggers, according to a report published in the June 2015 issue of the Journal of the European Academy of Dermatology and Venereology. To determine which triggers may be affecting you, the first step is to see your allergist. “We do allergy testing to see if your body is reacting to one of the many allergens that can cause hives,” says Dr. Anand. Some of these allergens are:
Some foods, especially peanuts, eggs, nuts, shellfish, and some food additives
Certain pain medications, such as aspirin and ibuprofen
Physical stimuli such as pressure, temperature, exercise, and sun exposure
Bacterial infections, including urinary tract infections
Viral infections, such as the common cold and hepatitis
Take your medications
Antihistamines are usually the first line of treatment for chronic hives. “I usually prescribe a long-acting antihistamine once a day first,” says Anand, “and if that doesn’t work, I’ll add a second one.” If antihistamines don’t help, your doctor may prescribe another medication. According to a study published in March 2013 in the New England Journal of Medicine, omalizumab, an injectable medication commonly used to treat asthma, was found to be effective in treating most people who did not respond to antihistamines. Other treatments your doctor might prescribe include corticosteroids (for short-term use only) or epinephrine injections (if you experience swelling in your lips or throat). To help boost the effectiveness of your treatment, always follow your doctor’s instructions when it comes to taking your medications, and don’t skip any doses. Talk to your doctor if you have any questions or concerns about your medication.
Soothe your skin
The drier your skin is, the itchier it feels, tempting you to scratch. But scratching is one of the worst things you can do, says Anand, because it can aggravate your hives. To calm the itching, keep your skin moisturized, she says. Taking frequent baths can also help reduce itching and scratching, according to the American College of Allergy, Asthma & Immunology (ACAAI).
In addition, cooling the affected area can feel soothing to your skin (as long as cold temperature isn’t one of your hive triggers). There are many ways to cool your skin, including:
Applying an anti-inflammatory medication or cream, as prescribed by your doctor
Positioning yourself in front of a fan
Applying a cold compress
Talk to your doctor about a vitamin D supplement
Adding a vitamin D supplement to your treatment plan may help reduce the symptoms of chronic hives, according to a small study published in January 2014 in the Annals of Allergy, Asthma & Immunology. In the two-year study, people with chronic hives who took a daily supplement of vitamin D3 along with their regular allergy medications experienced a decrease of 33 percent in their symptoms within the first week. More research is needed to confirm the benefits of vitamin D supplementation for chronic hives. Talk to your doctor about possibly adding a supplement to your treatment.