Chronic Urticaria (Hives): Symptoms, Treatment, and First Aid Awareness
Chronic urticaria is defined as recurring, itchy skin rashes (hives) that come and go for six weeks or longer. The exact cause is often unknown, which can make the condition frustrating for those affected.
In some individuals, chronic urticaria may also be accompanied by intermittent swelling of the lips, tongue, eyelids, or other areas of the body, a condition known as angioedema. Symptoms are often well controlled with antihistamines, although flare-ups can still occur.
Common Treatment Options for Chronic Urticaria
Antihistamine Tablets
Histamine release beneath the skin is the primary trigger for urticaria. Antihistamines work by blocking the effects of histamine, helping to reduce itching, redness, and swelling.
For many people, daily or as-needed antihistamines provide partial or complete symptom relief. A healthcare provider may recommend adjusting the dose or type depending on symptom severity.
Ways to Soothe the Rash
Supportive skin care can significantly reduce discomfort:
- Cooling creams such as menthol in aqueous cream can relieve itching
- Calamine lotion may help soothe irritated skin
- A lukewarm (tepid) bath or shower, especially before bedtime, can reduce itching and improve sleep
- Avoid scratching, which can worsen inflammation and prolong symptoms
Avoiding Triggers and Worsening Factors
In some cases, a trigger such as a specific food, medication, or physical stimulus may be identified. If a trigger is known, avoidance can reduce flare-ups. However, many individuals are unable to pinpoint a specific cause.
Factors known to worsen chronic urticaria include:
- Tight or restrictive clothing
- Overheating or sweating
- Hot baths or showers
- Alcohol consumption
- Prolonged sun exposure
Keeping the body cool and comfortable often helps reduce symptom severity.
Steroid Use
Corticosteroids reduce inflammation and may be prescribed for short-term use during severe flare-ups. Due to the risk of significant side effects, steroids are not recommended for long-term management of chronic urticaria.
What Is Angioedema?
Angioedema is deeper swelling of the skin and tissues, often affecting:
- Lips
- Tongue
- Face
- Throat
Mild cases may respond to antihistamines. However, swelling involving the throat or difficulty breathing is a medical emergency. In these cases, epinephrine (EpiPen®) and immediate emergency medical care may be required.
First Aid & Training Disclaimer
This information is provided for educational and first aid awareness purposes only and is not a substitute for medical diagnosis or treatment.
St. Mark James Training, Canada’s largest 100% Canadian-owned and operated first aid and CPR training provider, teaches participants how to:
- Recognize allergic reactions and angioedema
- Respond to severe reactions and anaphylaxis
- Safely use epinephrine auto-injectors
- Determine when emergency medical care is required
To build confidence and practical skills, consider enrolling in Emergency First Aid, Standard First Aid and CPR/AED, or Anaphylaxis Training with St. Mark James Training at locations across Canada.