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Life with Chronic Idiopathic Urticaria

Updated on January 31, 2014

I Have What?

I have suffered with chronic hives for 23 years. I get hives from going into the sun, being in the cold, touching or being exposed to the full gambit of environmental allergens, heavy smells, physical activity, and stress. I have been allergy tested 4 times in the 23 years, and my scratch tests prove crushing each time. On paper, I am allergic to every environmental allergen regularly tested. Because I had so many reactions to food. I was tested for food allergies. My list of foods to avoid includes more than 18 foods and food types (dairy, gluten, fungi, etc,). I was also given a benign test with a sterile test needle, no histamine or other substance on the needle, which ended in my arm swelling.

After being tested, I wanted nothing to do with Western medical treatments fearing the effect medications would have on my body. Under the recommendation of my Naturopath, I took Quercetin and high doses of Vitamin C for many months, and it worked for a while, but it eventually stopped working and the hives came back with a vengeance. In fact, the respite only lasted a few months. While there are some people who can control their hives with these things and have no problems, I was not so lucky.

So, I reneged and went back to the allergist and Western medicine route. That is when I first heard the term Chronic Idiopathic Urticaria (CIU). On the advice of my allergist, I take large doses of antihistamines twice daily to help keep the hives under control, I also carry topical antihistamines with me at all times. Nevertheless, I break out in hives randomly throughout the day, everyday without fail. Everything is a potential irritant although it may not be a true allergy. I also see a chiropractor and massage therapist who try to work in conjunction with my allergist. While these things have not put my CIU in remission, they have gone a long way to make life more bearable.

UTHSCT Discussion of Chronic Hives

Acute v. Chronic Urticaria

Medically speaking, acute urticaria happens suddenly and lasts briefly. Having said that, briefly can vary from an hour to six weeks. The hives are swellings of the skin caused by the body's reaction to allergens. These allergens can be either environmental or consumed. For example, if I eat eggs my body becomes covered in hives, and I even have visible hives on my scalp and in my throat. That, for me, is step one in my body's rush toward anaphylaxis.

Chronic Idiopathic Urticaria (CIU) is long-lasting, more than 6 weeks. It too comes on fast, but is very persistent and may last for years. There is no one trigger for CIU because it is an auto immune response to your own body. Likewise, there is no hard and fast reason for the auto immune response. It is believed that CIU occurs in people prone to hives, after an illness triggers immune response.


Severe outbreak of hives.
Severe outbreak of hives. | Source
Reddish Hives.
Reddish Hives.
This is an example of hives on olive skin that shows how close to skin tone hives may be.
This is an example of hives on olive skin that shows how close to skin tone hives may be.

What Causes Hives?

After having chronic hives for many, many years, I have become accustomed with reading journal articles and magazine articles, as well as online article about hives. These articles have taught me a number of things.

The first thing to understand is what hives are. Urticaria is the medical term for a common skin condition that is also known as hives, wheals, welts, plaques, and rash. Hives in their various sizes are flat-topped inflammations of the skin, that are typically described as causing itching, burning and stinging. The degree to which they itch, burn, or sting may vary, as may the color. The example above is bright pink, but hives may also be red or almost skin toned at their lightest. Hives come on fast and resolve themselves within hours, this is not the case in chronic hives.

Hives develop when the immune system releases chemicals that cause inflammation in the skin. The most common chemical associated with hives is histamine. Despite the fact that they are caused by the release of chemicals by immune system, the trigger can be a number of things. Most hives come and go quickly. They can be triggered by drugs, physical activity, heat, cold, pressure, foods, environmental irritants, contact with poisonous animals and plants, stress, the sun, scratches, and any number of other things. Even water and bodily fluids have been known to cause hives.

Drug-induced hives are caused by the chemical components in drugs, and the possible side effect is listed on the bottle or in the drug description given with a drug. Pain medications like Codeine, psych medications like Lamictal, and many other drugs list rash as an indication of allergy toward the drug. Some, like Lamictal, even list fatal rash as a potential side effect.

Exercise-induce hives are caused by the body when there is physical exertion. Walking briskly, running, even swimming have caused hives of this nature. Sadly, a person with exercise-induced hives can die because of the condition and should avoid exercise. While it is not a good excuse for normal people to stave of exercise in these people it can be a matter of life and death.

Heat- or cold-induced hives, though cause by opposite temperatures, are essentially the same thing. They are caused by contact with or exposure to heat or cold. For example, and this is not meant as a joke, a good friend is Native Alaskan. She has cold-induced hives and has moved south because of it.

Pressure-induced hives are caused by extended pressure on the body. These are rare, but from what I have been told they are not dangerous.

Food-induced hives are caused by food allergies, known or unknown. Any food allergen can cause hives, and the degree to which and what more occurs depends on the level of allergy. Hives can be a sign Anaphylaxis, an allergic reaction that can be fatal if not taken care of immediately.

Environmental irritant-induced hives can be caused by any environmental allergen or irritant a person is sensitive to. If, for example, a person is allergic to dogs and handles a dog, they can get hives as one of a list of possible reactions. Chemical irritants such as those found in common household cleaning products can cause hives, as can many other common products.

Poisonous plants and animals are a source of hives for some. Someone with bee allergies may produce large wheals, which eventually join together and continue to swell, if stung. Poison Ivy is an example of a plant causing hives. People believe touching the rash causes the rash to spread, but it is actually continued contact with the sap it produces.

Stress can also cause hives, and in some cases constant stress over long periods of time can lead to chronic hives. Not all bodies cope with stress the same.

Photosensitive- or solar hives are caused by exposure to the sun. These hives occur within minutes of sun exposure and last for hours. They can indicate other health conditions, for example Lupus, so if a person has frequent hives upon exposure to the sun it is important to get it check out.

Scratches that welt are said to be hives. Many people get this form of hives and it never dawns on us that it is more just the scratch causing the swelling. Even a sterile needle used during an allergy test can cause this form of hive.

While hives are fairly common, it is important to understand what may have caused the hives so as to avoid the irritant in the future. Those with extreme allergies should carry an Epi-Pen in case of anaphylaxis. Should anaphylaxis occur, get them to the hospital immediately!

Allergy Skin Testing

Why Allergy Testing?

Allergy testing may seem like a pain, but it can be very important. As shown in the video to the right , there are a number of environmental allergens that produce hives and are easily identified. Once identified these allergens are often easy to avoid, or if need be, remedy.

If a person is allergic to molds and mildews it is fairly easy to keep an environment free of these things. It may beg the question of why this particular allergy is mentioned. It is mentioned because there are easy ways to avoid or reduce molds and mildews that many people do not follow, like the ceiling fan in the bathroom. Turning it on while showering does more than keep the mirror clear, it also helps to ensure less mold and mildew build in the bathroom.

Dust mites are also a quick fix as they can be avoided by using dust mite resistant covers, changing the linens frequently and drying them on high heat after washing. They also say a messy bed is better for this purpose because dust mites do not like exposure.

Outdoor allergies are a bit harder to fix, and if you are prone to hives due to such allergies, it is important to get your allergy relief on board before heading outside. Solar hives, for example, may require a number of remedies at once. Before heading outside, a person with solar hives might want to don a light, white cotton or linen shirt to keep the sun from being directly on the skin. Likewise, antihistamines can be taken prior to exposure. Water-induced hives are another problem that can be avoided by using antihistamines. Antihistamines for these purposes are better if used at least 15 minutes before encountering the allergen. So, if a trip to the pool is planned, taking a non-drowsy antihistamine prior to can be a minor miracle once it has a chance to build up in the system.

Camping, gardening, and other outdoor activities can be daunting for the outdoor allergy sufferer. Long-term allergy treatment tends to be advised in these situations, but even with long-term relief aids on board a person allergic to outdoor allergens like grasses may get hives. Topical treatments are a fast fix for such outbreaks and are easily carried along.

Indoor/Outdoor allergies like insects and animals can be treated in a number of ways. Long-term relief options are good for allergens with which a person will be in constant contact; however, incidental contact needs to be treated when contact occurs. Those allergic to bees and wasps, depending on the degree to which they are allergic, will need to carry antihistamines in case stings or bites occur. They may also need to pack an Epi-Pen, or other epinephrine injection device, in order to treat a bite or sting.

Allergy Testing

Allergy testing on the back or arm may look like this. Not all doctors use the same method, some create grid lines on the back, others dots with corresponding numbers on paper, others just numbers, or in some cases they are numbers with stickers.
Allergy testing on the back or arm may look like this. Not all doctors use the same method, some create grid lines on the back, others dots with corresponding numbers on paper, others just numbers, or in some cases they are numbers with stickers.

Arm Test

This is a photo of an arm after an allergy test. The large area of positive allergies represents the common grasses, all of which belong to 3 groups.
This is a photo of an arm after an allergy test. The large area of positive allergies represents the common grasses, all of which belong to 3 groups. | Source

What do you do?

When you get hives, how do you treat them?

See results

Treatment Options

Everyone treats hives differently, and as a result everyone gets different results. Allergists suggest antihistamines, the type and dose administered or prescribed depend on the severity and length of time a person has hives. For example, Acute Hives that last only hours might be easily treated with short acting antihistamines. In fact, some might find relief for these short hive outbreaks using topical antihistamines, topical steroids, or even topical analgesic like Caladryl . That is why allergy tests are followed by Benadryl and topical Benadryl types medication and ointments.

Longer-term bouts of hives are treated differently. Long-lasting antihistamines that build up in a person's system as a good means of treating hives lasting longer than a few days. It can take up to two weeks for a long lasting medication like Zrytec to build up in the system and provide a reasonable amount of relief. Some doctors prescribe a larger dosage of these medications and/or a more frequent dosage.

There are natural remedies as well. For example, baking soda and water that will take the itch out of hives but will not resolve the problem. Epsom salt and water baths or oatmeal baths are also recommended and can be very helpful, Some people use nettles and other astringents to calm a case of hives, while others turn to a variety of other herbs that grow in the everyday herb garden. To cool the itch, burn, and sting of hives, some prefer aloe. These are all great immediate treatments and are a welcome relief when a case of hives sets in.

There are certain foods that can be eaten to help the body stave off hives. Of these citrus and nightshades like tomatoes seem to be the most often recommended. Anything with a lot of Vitamin C is a good bet to help keep hives under control. If you are among those that believe Vitamin C only comes in citrus form, it may be good to know that strawberries, raspberries, tomatoes, some forms of melon, some peppers, and leafy greens also contain Vitamin C. Of course, it is important to note that any of these can also be the cause of hives. Always, know the cause of the hives before you try the treatment.

There are alternative medicines that treat and maintain control over hives. Quercetin is very highly recommended and controls hives well after your body is saturated with it. Quercetin calms hives fairly quickly, but to stave off long-term bout of hives it is important to keep taking it. You may find yourself taking more than the recommended dose in order to control the hives though. Some probiotics also provide relief from hives. acidophilus is often recommended as an alternative treatment for hives because it works to clean toxins out of the body.

There is professional relief in both traditional and alternative form. There are immunologists located everywhere; however, there are immunology centers that are more geared for CIU. The most highly recommended Immunology Centers in the country include the Asthma, Allergy, and Immunology center at University of Wisconsin, the Allergy and Clinical Immunology Department at National Jewish, Pediatric Allergy and Immunology at Johns Hopkins, the Mayo Clinic, and the Pathology and Immunology department at Baylor University.

Alternative medical practices to treat hives include Ayurvedic Medicine, Chiropractics, Acupuncture, Acupressure. Kinesiology, Naturopathy, and Lymphatic Massage Therapy. It may seem counter intuitive to visit these professionals for something like hives, but it can and does help. As with other treatments, results are not 100%. Each case of hives differs and each person's response to treatment differs as well.

While there are certainly more treatments out there, and this discussion does not include and exhaustive list of things discussed, it is a place to begin the journey to finding a remedy for CIU should you suffer. It is also worth looking into integrative treatments that use both Eastern and Western medicine to treat CIU.

Drug Vacuum

As mentioned earlier, many of the drugs prescribed are short-term fixes for a long-term problem. Even when prescribing high doses of common long-lasting antihistamines, doctors know it is possible that a person's body may eventually become immune to the benefits of the drug. So, like any other vacuum, drug companies are trying to fill the need for remission by creating new and better drugs. Whether or not the drug is proven effective, or will be covered by health insurers, is debatable for all new drugs.

It's A Wrap

If you think you may have CIU

  • Talk to your doctor
  • Get allergy tested to identify and possible culprits
  • Ask as many questions as you need about triggers and treatments
  • Consider treatment options
  • Follow the treatment path that is best for you
  • Practice avoidance by taking precautions before you interact with possible triggers

Need Relief?

Twinlab Quercetin Plus C -- 50 Capsules
Twinlab Quercetin Plus C -- 50 Capsules

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    • john000 profile image

      John R Wilsdon 

      3 years ago from Superior, Arizona

      Understanding a rather frequent condition is important. This hub explains a lot. Doctors will admit that the number one thing to control and treat with urticaria is the "itching". It seems the rest of standard treatment then falls into place. You cannot cure anything when you are scratching at it. Thanks for taking the time to write about this.

    • sachamike profile imageAUTHOR

      Sacha Mike 

      4 years ago from Washington

      There are so many other immunology centers I did not list, but these are listed as the top few. In my case, my allergist belongs to the UW group, and I am lucky to work with him in dealing with this. I published the hub to let others know they aren't crazy, and it does exist regardless of the fact they haven't found a definite cause. I am glad, however, that it helps others to understand a condition they may not have otherwise come across. Perhaps at some point you will meet someone with CIU and be able to empathize :)

    • RTalloni profile image


      4 years ago from the short journey

      It was interesting to learn about CIU and your experience with it as I had never heard of this disease before. Posting the info on the CIU geared immunology centers is useful to those in need.


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