Materiały źródłowe

• #1 Chronic hives – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-hives/diagnosis-treatment/drc-20352723

  Chronic hives can go on for months and years. They can interfere with sleep, work and other activities. The following self-care tips may help you manage your condition: […] Avoid triggers. These can include foods, medicines, pollen, pet dander, latex and insect stings. If you think a medicine caused your welts, stop using it and contact your healthcare professional. Some studies suggest that stress or fatigue can trigger hives. […] Track your symptoms. Keep a diary of when and where hives occur, what you were doing, what you were eating, and so on. This may help you and your healthcare professional identify the thing that brings on symptoms for you.

• #2 10 ways to get relief from chronic hives

  https://www.aad.org/public/diseases/a-z/hives-chronic-relief

  Make an appointment to see a board-certified dermatologist. Most people who have hives are otherwise healthy, but its still helpful to see a dermatologist. Other skin conditions can look like hives. Your dermatologist can find or rule out possible causes, such as: […] Know that treatment can be effective when the cause(s) of your hives remains unknown. Its helpful to find out whats causing your hives, but sometimes, a cause cannot be found. About 50% of people who have chronic hives never find out whats causing their flare-ups. Even when you cannot find the cause, treatment can help you clear your skin and prevent new flare-ups. […] Follow your treatment plan. For treatment to be effective, its essential to follow the treatment plan your dermatologist creates for you. Treatment may fail to work when you take medication less often than prescribed. For example, if your dermatologist prescribes a daily oral antihistamine and you only take it when you have a flare-up, you may continue to get hives.

• #2 10 ways to get relief from chronic hives

  https://www.aad.org/public/diseases/a-z/hives-chronic-relief

  Understand that extensive allergy testing often does not find a specific cause or allergen. Many people believe that their hives would go away if they could just find out whats causing the flare-ups. Even when the cause remains unknown, treatment can clear your skin and keep it clear. […] Know that chronic hives may go away on their own. About half the people who have chronic hives will stop having flare-ups within 1 year.

• #3 Patient education: Hives (urticaria) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hives-urticaria-beyond-the-basics/print

  Chronic hives occur daily or almost daily and last longer than six weeks, sometimes for years. Chronic hives can be frustrating because they come and go and can interfere with sleep, work, or school. Hives affect how you look, and people may worry about being near you for fear that you have a contagious infection. […] However, it is important to remember the following: Hives are not contagious. Chronic hives are rarely permanent; almost 50 percent of people are hive free within one year. Chronic hives are rarely caused by allergies and are not life threatening. The bothersome symptoms of chronic hives are treatable in most people. […] In most cases of chronic hives, the cause is unknown. Researchers suspect that problems in the immune system play a role. […] Hives can be a sign of several other medical or autoimmune conditions, including thyroid or liver diseases, chronic infections, or lupus. Most people with one of these conditions will have other symptoms apart from hives.

• #4 Acute and Chronic Urticaria: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0601/p717.html

  Urticaria is caused by immunoglobulin E- and nonimmunoglobulin E-mediated release of histamine and other inflammatory mediators from mast cells and basophils. The mainstay of treatment is avoidance of triggers, if identified. The first-line pharmacotherapy is second-generation H1 antihistamines, which can be titrated to greater than standard doses. […] Methods of treatment for urticaria are the same for adults and children. The mainstay of treatment is avoidance of identified triggers. It is also recommended that patients avoid using aspirin, alcohol, and NSAIDs, as well as avoid wearing tight clothing, because these may worsen symptoms. […] Current guidelines suggest a stepwise approach to treating chronic idiopathic urticaria. As with acute urticaria, the first step is second-generation H1 antihistamines. For improved symptom control, the medication should be dosed daily, rather than on an as-needed basis.

• #4 Acute and Chronic Urticaria: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0601/p717.html

  Once symptoms are adequately controlled, physicians should consider stepping down treatment sequentially. Empiric elimination diets are not recommended. If an underlying cause of chronic urticaria is identified, the condition should be treated or the patient referred to an appropriate subspecialist.

• #5 CHRONIC URTICARIA AND TREATMENT OPTIONS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2807703/

  Chronic urticaria has a wide spectrum of clinical presentations and causes. Still, despite our best efforts no cause may be found in the majority of cases. The treatment options are: Primary prevention in the form of avoidance of aggravating factors; counseling; antihistamines; leukotriene receptor antagonists; prednisolone; sulfasalazine and a host of immunosuppressives like methotrexate, cyclosporine, omalizumab etc. […] There are number of aggravating factors that can be avoided by simple measures. The treating physician can identify the same with careful history taking. These include diet, drugs, alcohol, viral infections, local heat and friction, and mental stress. […] A clear explanation that CU is not allergic is important to address since inevitable conviction many patients hold that diet is a cause. Important information to patients must include useful websites and written information about the disease. Treatment plan should include treatment of identifiable cause, avoidance of aggravating factors, advice and written information about the condition, and antihistamines trial. […] In summary, methotrexate and autologous serum therapy are viable options in CU not responding to first and second line of treatments.

• #6 Chronic hives – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-hives/symptoms-causes/syc-20352719

  Chronic hives don’t put you at sudden risk of a serious allergic reaction, called anaphylaxis. […] To lower your likelihood of getting hives, use these self-care tips: […] Avoid known triggers. If you know what has triggered your hives, try to avoid that substance. […] Bathe and change your clothes. If pollen or animal contact has triggered your hives in the past, take a bath or shower and change your clothes if you’re exposed to pollen or animals.

• #7 Chronic Spontaneous Urticaria Treatment

  https://www.webmd.com/skin-problems-and-treatments/features/csu-meds-lifestyle

  Most people with CSU take medications called antihistamines, and these usually control symptoms. But its crucial that you take them consistently, exactly as prescribed, says Jacquelyn Sink, MD, a dermatologist at Northwestern Medicine Regional Medical Group in Chicago. Erratic, as-needed dosing or inconsistent use of antihistamines may contribute to breakthrough symptoms, she says. […] Even if you dont take antihistamines, its important to follow the treatment plan your doctor recommends as closely as you can. If you dont, it wont be effective. […] Aivaz recommends adding any of these second-tier medications to the antihistamines youre already taking, rather than replacing them. […] Beyond taking medications, one of the best things you can do when it comes to managing CSU is to avoid anything that seems to set off a flare. Sink says some common triggers that can make CSU worse include:

• #7 Chronic Spontaneous Urticaria Treatment

  https://www.webmd.com/skin-problems-and-treatments/features/csu-meds-lifestyle

  People with CSU often dont want to be on medications for months or years, especially because of the side effects and risks, Aivaz says. Diet changes can be helpful. Some doctors recommend a low-pseudoallergen diet. […] Talk to your doctor about whether this diet might be a good option for you to try. […] If stress is a trigger for you, try adding relaxation techniques into your day to help you unwind and calm down. […] Some research shows that vitamin D supplements could help CSU. A 2018 review of 17 studies noted that people with CSU were more likely to lack enough vitamin D. It also found that taking a high dose of vitamin D supplements for 4 to 12 weeks may improve CSU symptoms in some people. Talk to your doctor about whether this might work for you. […] Sink recommends support groups as a great resource for people with CSU. These can be online discussion boards, social media groups, or local in-person groups. Not only can you connect with others who understand what youre dealing with, but you can also gather helpful advice and tips on managing your condition.

• #8 Update on the Treatment of Chronic Urticaria | Actas Dermo-Sifiliográficas

  https://actasdermo.org/en-update-on-treatment-chronic-urticaria-articulo-S1578219014001127

  Chronic spontaneous urticaria, also known as chronic idiopathic urticaria or simply chronic urticaria, is a common disorder that has a prevalence in the general population that ranges between 0.5% and 1%. This condition negatively affects the patient’s quality of life and has considerable impact on direct and indirect health-related costs. Chronic urticaria is difficult to manage. Nonsedating H1 antihistamines are the first line of therapy, but fewer than 50% of patients experience relief at recommended dosages. Although guidelines call for increasing the dosage when response is inadequate, some patients still do not achieve adequate control of symptoms. New treatment alternatives, with proven efficacy under the standards of evidence-based medical practice, must therefore be developed. […] In the treatment of urticaria it is important to avoid possible nonspecific triggers or aggravating factors such as heat, stress, alcohol, and certain drugs, including acetylsalicylic acid, NSAIDs, angiotensin-converting enzyme (ACE) inhibitors (particularly if the urticaria presents with angioedema, with or without wheals) and codeine. Cooling, antipruritic lotions such as calamine or 1% menthol in aqueous cream can be applied.

• #9 Hives (Urticaria): Causes, Symptoms, and Treatment

  https://patient.info/skin-conditions/hives-inducible-urticaria

  Hives can be triggered by a number of different physical causes. The reason why a rash appears in affected people is not clear. The physical stimulus causes a release of histamine and other chemicals, which causes the rash. […] Once it is clear what causes the hives, it may be possible to avoid situations that trigger them. For example, dermographism can often be prevented by avoiding firm pressure against the skin as much as possible. In mild cases, no additional treatment may be needed. […] Various other factors may make symptoms worse (but are not the main trigger). The following are tips that some people have found helpful; however, there is little proof that they work in everybody: Try avoiding tight clothes if wheals occur at sites of local pressure, for example, under belts, under tight-fitting shoes, etc.

• #10 Chronic Urticaria Management & Resources – Allergy & Asthma Network

  https://allergyasthmanetwork.org/chronic-urticaria/management-and-resources/

  Chronic urticaria is a skin condition that often requires a management strategy to avoid triggers and control symptoms. Work with a healthcare provider to identify triggers and medications for the treatment of chronic urticaria. […] Patients with chronic urticaria should seek treatment from a healthcare provider. This can be a board-certified allergist, dermatologist, primary care doctor or other health professional with knowledge of the skin disease. […] Work together with the healthcare provider to come up with a treatment plan for managing chronic urticaria. If you have chronic idiopathic urticaria or chronic spontaneous urticaria, work with the healthcare provider to identify and avoid potential triggers. […] Self-management of chronic urticaria is important. The American Academy of Dermatology (AAD) has recommendations for what you can do at home to self-manage your hives. […] Keeping a journal may help you find the cause of acute or chronic hives. If you can avoid what triggers your hives, you can prevent new hives. […] Share your history of chronic hives with your doctor. […] How can I avoid chronic urticaria triggers?

• #11

  https://www.allergydoc.us/blog/how-to-manage-prevent-urticaria-practical-tips-for-relief

  Here are some effective strategies to consider: Try a pseudoallergen-free elimination diet to identify food intolerances that may trigger urticaria, as effects can take 10-14 days to appear. Staying hydrated and focusing on a balanced diet with anti-inflammatory foods can help reduce inflammation and support skin health. […] Incorporating mindfulness techniques such as yoga, meditation, and deep-breathing exercises can lower stress levels that worsen urticaria symptoms. Emotional stress can trigger hives, and Cognitive Behavioral Therapy (CBT) can help you develop effective coping strategies. […] Keeping a symptom diary is essential for managing chronic urticaria. It helps identify patterns and triggers by tracking symptoms’ frequency, intensity, and potential triggers such as activities, foods, and emotional states. Additionally, noting medication use and effectiveness can guide treatment adjustments for patients and healthcare providers.

• #11

  https://www.allergydoc.us/blog/how-to-manage-prevent-urticaria-practical-tips-for-relief

  Here are a few helpful tips for coping with medication-induced hives: Track Reactions: Write down any new medications you take and note if hives appear soon after. Carry an Antihistamine: If you’re worried about hives from medications, keep an antihistamine handy for quick relief. Allergy Testing: Talk to an allergist to determine if a particular medication is causing your hives and explore other options. […] Consider the following tips to help manage hives triggered by environmental factors: Dress for Comfort: Wear layered clothing for temperature control and loose-fitting garments to reduce skin irritation. Avoid Extreme Temperatures: Stay indoors during extreme heat or cold. Hydrate: Drink plenty of water to keep your skin hydrated and less susceptible to irritation. […] Managing chronic urticaria involves lifestyle changes and symptom tracking, which can relieve symptoms and improve your quality of life.

• #11

  https://www.allergydoc.us/blog/how-to-manage-prevent-urticaria-practical-tips-for-relief

  Take a look at these practical tips for handling stress-related urticaria: Relaxation Techniques: Incorporate deep breathing, meditation, or yoga into your routine to calm your mind and body. Exercise Regularly: Engage in moderate activities like walking or swimming to relieve stress and boost overall health. Talk to Someone: Share your stress with a friend, therapist, or counselor for support. […] Explore these methods to identify and avoid foods that may provoke flare-ups: Food Diary: Track what you eat and when hives occur to identify patterns and triggers. Elimination Diet: With guidance from a professional, remove common culprits, then slowly reintroduce them to test for reactions. Consult an Allergist: If you’re unsure which foods are causing hives, consider allergy testing to identify specific sensitivities.

• #12 Hives (urticaria): Causes, pictures, and treatments

  https://www.medicalnewstoday.com/articles/157260

  Some tips for preventing hives include: […] using meditation and other relaxation techniques to manage stress […] keeping a diary to see if any particular triggers cause them […] avoiding those triggers […] taking over-the-counter antihistamines when the pollen count is high, if pollen may be a trigger […] talking to a doctor about whether medications may be responsible […] choosing mild or fragrance-free soaps, skin creams, and detergents.

• #13 Chronic Hives: Causes, Treatment, and How to Find Relief

  https://www.vucare.com/2021/10/12/chronic-hives-symptoms-causes-find-relief/

  While antihistamines are prescribed for acute hives, medications that alleviate redness and swelling may also be prescribed for chronic hives. […] Its important to remember that even without a known cause of your chronic hives, you can have effective treatment. […] While living with chronic hives may feel daunting, there are ways to help alleviate symptoms and prevent them from taking over your life. […] Hydrated skin is less prone to itchiness. […] Discuss vitamin supplements with your dermatologist. […] Extreme weather can be a trigger for your hives. So, dressing appropriately, whether its to keep your skin protected from sun exposure or harsh winds, can help prevent a flare-up.

• #14 5 Ways to Treat Your Chronic Hives: Catherine Fuller, MD: Allergy, Asthma, & Immunology Specialists

  https://www.drfullerallergy.com/blog/5-ways-to-treat-your-chronic-hives

  Because hives feel worse on drier skin, its vital to maintain well-moisturized skin with a fragrance-free, hypoallergenic lotion or cream. […] High-stress levels or anxiety can trigger or worsen many skin conditions, including chronic hives. If you frequently feel stressed or anxious, look for healthy ways to calm your nerves and emotions.

• #14 5 Ways to Treat Your Chronic Hives: Catherine Fuller, MD: Allergy, Asthma, & Immunology Specialists

  https://www.drfullerallergy.com/blog/5-ways-to-treat-your-chronic-hives

  One of the best ways to control chronic hives is to avoid known triggers or manage the health condition causing them. […] Most people with chronic hives find themselves in this situation. But even if you dont have triggers to avoid or manage, you can still attain relief with these effective treatment strategies: […] Chronic hive treatment usually begins with over-the-counter (OTC) anti-itch medications or antihistamines. […] When persistent hives dont respond to daily antihistamine treatment, a monthly injection of a medication called omalizumab (Xolair) is often the next best step. […] Oral corticosteroids like prednisone alter immune system function to reduce skin redness, swelling, and itching caused by chronic hives. […] When hive flare-ups occur, there are several ways to relieve the constant itch, redness, and swelling they cause.

• #15 Evaluation, diagnosis and management of chronic urticaria

  https://www.racgp.org.au/afp/2014/september/evaluation-diagnosis-and-management-of-chronic-urt

  Chronic urticaria can have a negative impact on a patients quality of life, affecting social function and emotional wellbeing. […] Patients should be educated on avoiding trigger factors and aggravating factors. The natural history and progression of the disease should also be discussed. Avoidance of NSAIDs and ACE inhibitors should be encouraged. Non-medicated lotions such as menthol in aqueous cream can alleviate symptoms. […] Histamine H1 receptor antagonists are the mainstay of treatment. […] Patients who are unresponsive to treatments should be referred to a specialist for alternative treatment options.

• #16 How to Treat Hives? | Thomson Medical

  https://www.thomsonmedical.com/blog/hives-treatment

  Preventing hives involves identifying and avoiding the allergens that trigger them. […] For those with chronic hives, reducing stress and avoiding caffeine, alcohol, and tobacco may help decrease the frequency of outbreaks.

• #17 How to Prevent Hives (Urticaria): Reduce Your Risk

  https://www.health.com/hives-prevention-7255051

  Hives is an inflammatory skin disorder primarily characterized by the formation of itchy bumps called wheals on the skin. […] However, some types can be prevented, something which begins by understanding and avoiding the factors that trigger it. […] Preventive strategies for hives can be effective in reducing how often they occur and how severe your symptoms are. These can include medical evaluations and tests, adapting lifestyle habits, tracking triggers and avoiding them, and tending to your mental health. […] If you’re experiencing hives, a key to prevention is to seek out a medical evaluation to confirm your diagnosis. […] Tracking what may be setting flares off and working to avoid those things is an integral aspect of prevention. […] Making changes to your lifestyle habits may also prevent hives.

• #18 Urticaria Treatment & Management: Approach Considerations, Consultations, Prevention of Urticaria

  https://emedicine.medscape.com/article/762917-treatment

  Patients with acute urticaria should avoid any medication, food, or other allergen that has precipitated urticaria (hives) or other serious allergic reaction previously. Chronic urticaria is seldom related to food allergens, and complicated elimination diets are seldom of benefit. […] Control of chronic urticaria may be achieved with omalizumab, although anaphylaxis and angioedema are potential risks. Combined therapy with antihistamines or an immunosuppressive agent may be required. […] Patients with chronic or recurrent urticaria should be referred to a dermatologist or allergist for further evaluation and management.

• #19 Hives (Urticaria): Treatment Options

  https://www.health.com/hives-treatment-7097935

  Alongside your treatments, your healthcare provider may recommend taking vitamin D supplements as a complementary medicine to help manage symptoms of chronic spontaneous urticaria. However, limited research shows mixed results, and more research is needed to examine the effects of vitamin D on hives.

• #20 Urticaria: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0501/p1078.html

  Urticaria involves intensely pruritic, raised wheals, with or without edema of the deeper cutis. Treatment includes avoidance of triggers, although these can be identified in only 10 to 20 percent of patients with chronic urticaria. First-line pharmacotherapy for acute and chronic urticaria is nonsedating second-generation antihistamines (histamine H1 blockers), which can be titrated to larger than standard doses. […] Nonsedating antihistamines are the first-line treatment of urticaria and may be titrated to two to four times their normal dose, if necessary. […] The centerpiece of treatment is avoidance of known triggers. It is also recommended that patients avoid aspirin, alcohol, and possibly nonsteroidal anti-inflammatory drug use because these may worsen urticarial symptoms. […] A stepwise approach to treating chronic idiopathic urticaria, based on published treatment guidelines, is shown in Figure 9. Second-generation antihistamines are considered first-line therapy. For better symptom control, the medication should be dosed daily, rather than on an as-needed basis.

• #20 Urticaria: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0501/p1078.html

  If symptoms remain uncontrolled, there are several options. The patient can be switched to a different second-generation H1 blocker and titrated as necessary. […] After symptoms are controlled adequately, patients should be maintained on the regimen (excluding corticosteroids) for at least three months before considering titrating down and discontinuing medications.

• #21 Your Treatment Options for Hives

  https://www.webmd.com/skin-problems-and-treatments/hives-treatment

  With time, chronic hives (your doctor may call them chronic idiopathic urticaria – CIU, or chronic spontaneous urticaria – CSU) usually go away on their own. Theres no medication to cure them, but treatments can help ease your pain and discomfort. […] Its important to take these every day, not just when you have a breakout. […] If antihistamines dont help, your doctor might prescribe a corticosteroid. These drugs calm the immune system. That can make your hives less severe. […] Chronic hives can be difficult to treat. If there’s an underlying cause like a thyroid issue, taking care of that may ease the hives. […] When antihistamines and steroids dont work, there are a few more treatments that your doctor might suggest. […] Together, you and your doctor can decide the best treatment plan for your chronic hives.

• #22 Hives – Wikipedia

  https://en.wikipedia.org/wiki/Hives

  Prevention is by avoiding whatever it is that causes the condition. […] For cases that last more than six weeks, long-term antihistamine therapy is indicated. […] Treatment guidelines for the management of chronic hives have been published. […] According to the 2014 American practice parameters, treatment involves a stepwise approach. […] People who do not respond to the maximum dose of H1 antihistamines may benefit from increasing the dose further, then to switching to another non-sedating antihistamine, then to adding a leukotriene antagonist, then to using an older antihistamine, then to using systemic steroids and finally to using ciclosporin or omalizumab. […] Immunosuppressants used for CU include cyclosporine, tacrolimus, sirolimus, and mycophenolate.

• #23 What’s New in the Treatment of Chronic Urticaria? | MedPage Today

  https://www.medpagetoday.com/medical-journeys/urticaria/110399

  The mainstay of treatment for both children and adults continues to be the avoidance and elimination of triggers. […] Short-term prophylactic antihistamine treatment prior to trigger exposure is also useful in patients with chronic inducible urticaria (CIndU). […] Treatment step-down and assessment of spontaneous remission is recommended in patients treated with high-dose antihistamines who have complete disease control (UCT=16 or UAS7=0) for at least 3 consecutive months. […] When treatment step-down interferes with disease control, the guideline recommends reinstating antihistamines at the last dose that provided complete disease control. […] Currently, no clear consensus exists on how to step down and discontinue CSU treatments. […] This [lack of guidance] needs to change.

• #24 Using Xolair® (omalizumab) For Chronic Hives Treatment

  https://www.xolair.com/chronic-spontaneous-urticaria.html

  For people 12 years of age and older with chronic spontaneous urticaria (CSU) not controlled by H1 antihistamines. […] XOLAIR is the first FDA-approved biologic treatment for chronic hives with no known trigger. […] XOLAIR can help provide relief for itch and hives symptoms of CSU. […] XOLAIR targets IgE, which attaches to mast cells. Mast cells play an important role in CSU by releasing inflammatory substances, and inflammation is thought to play a role in CSU. […] XOLAIR is injected at home or in a doctors office on a monthly basis. […] XOLAIR may be approved by your doctor for self-injection with the XOLAIR prefilled syringe or autoinjector. […] XOLAIR should be given by your healthcare provider in a healthcare setting. […] Use XOLAIR exactly as prescribed by your healthcare provider. […] XOLAIR is given in 1 or more injections under the skin (subcutaneous), 1 time every 4 weeks. […] Do not decrease or stop taking any of your other hive medicine unless your healthcare providers tell you to.

• #25 CSU Chronic Hives Treatment | XOLAIR® (omalizumab)

  https://www.xolair.com/chronic-spontaneous-urticaria/about-chronic-hives/treating-chronic-hives.html

  Chronic spontaneous urticaria (CSU), also known as chronic hives, is diagnosed by ruling out other conditions. A doctor will start by reviewing your complete medical history, followed by a comprehensive physical examination. Additional testing may also be requested by your healthcare provider. […] Getting the right diagnosis may lead to a CSU treatment that works for you. Seeing a specialist, such as an allergist or dermatologist, is a proactive step in taking control of your chronic hives. […] Allergists diagnose and treat people with chronic hives. However, a dermatologist may diagnose and treat the condition as well. […] Antihistamines may not be enough for your chronic hives. If your doctor has increased your dose of over-the-counter (OTC) H1 antihistamines and you’re still not getting relief, XOLAIR may be able to help.

• #25 CSU Chronic Hives Treatment | XOLAIR® (omalizumab)

  https://www.xolair.com/chronic-spontaneous-urticaria/about-chronic-hives/treating-chronic-hives.html

  In clinical studies, XOLAIR helped reduce itch and hive symptoms. […] XOLAIR (omalizumab) for subcutaneous use is an injectable prescription medicine used to treat chronic spontaneous urticaria (CSU, previously referred to as chronic idiopathic urticaria (CIU), chronic hives without a known cause) in people 12 years of age and older who continue to have hives that are not controlled with H1 antihistamine treatment. […] When starting treatment, XOLAIR should be given by your healthcare provider in a healthcare setting. […] Do not try to inject XOLAIR until you have been shown the right way to give XOLAIR prefilled syringe or autoinjector injections by a healthcare provider. Use XOLAIR exactly as prescribed by your healthcare provider. […] XOLAIR is given in 1 or more injections under the skin (subcutaneous), 1 time every 4 weeks. […] In people with chronic hives, a blood test is not necessary to determine the dose or dosing frequency. […] You may not see improvement in your symptoms right away after XOLAIR treatment.

• #26 Chronic urticaria

  https://dermnetnz.org/topics/chronic-urticaria

  Identifiable triggers for urticaria should be avoided where possible. For example: […] The physical triggers for inducible urticaria should be minimised; see examples below. However, symptoms often persist. […] Some patients with inducible urticaria benefit from daily induction of symptoms to induce tolerance. Phototherapy may be helpful for symptomatic dermographism. […] Patients with chronic urticaria that has failed to respond to maximum-dose second-generation oral antihistamines taken for four weeks should be referred to a dermatologist, immunologist, or medical allergy specialist. […] Omalizumab is now regarded as the treatment of choice for antihistamine-resistant patients. […] Long-term systemic corticosteroids are not generally recommended, as high doses are often required to control symptoms of urticaria and they have inevitable adverse effects that can be serious.

• #27 The Best Options for Hives Treatment

  https://www.verywellhealth.com/treating-urticaria-83240

  If your hives are chronic, it is important to see a healthcare provider so you can learn the underlying cause. […] Chronic or treatment-resistant hives may benefit from Xolair (omalizumab), a biologic medication the Food and Drug Administration (FDA) has approved for treating refractory chronic hives. […] If your hives are caused by an autoimmune response, you won’t have any triggers to avoid. But many of the same tips for treating itchiness and swelling due to acute hives can still help, including cold compresses, wearing loose clothing and lightweight fabric, staying cool, and avoiding scratching. Medications like antihistamines and Xolair can also help people with chronic urticaria. […] Certain chronic types of urticaria may require different medications, particularly if the trigger is physical rather than allergic. Some of these include:

• #27 The Best Options for Hives Treatment

  https://www.verywellhealth.com/treating-urticaria-83240

  Hives are considered chronic if they last for more than six weeks. They’re thought to be caused by an autoimmune response, not an allergic one. Autoimmune means that the immune system is attacking healthy cells in the body as if they were invaders. This may be due to an autoimmune disease or an unknown cause. […] Autoimmune hives may improve by treating the underlying cause. For example, chronic urticaria is sometimes related to autoimmune thyroid disease. There is evidence that treating the thyroid condition may also improve urticaria symptoms. […] The best way to treat hives is to avoid getting them in the first place. If they’re caused by an allergic reaction or an environmental trigger, it is important to find out what those triggers are. Taking steps to avoid your triggers is the best thing you can do on your own to treat acute hives.

• #28

  https://link.springer.com/article/10.1007/s40265-025-02170-4

  Chronic spontaneous urticaria is a difficult-to-treat disease, with many patients failing to achieve complete disease control with second-generation H1-antihistamines and the anti-IgE antibody omalizumab. […] Remibrutinib, a Bruton tyrosine kinase inhibitor, and the anti-IL-4R antibody dupilumab are effective and safe for treating chronic spontaneous urticaria and are expected to receive approval for this indication. […] Other promising treatments in development for CSU include anti-KIT antibodies, e.g., barzolvolimab, JAK inhibitors, and MRGPRX2 antagonists. […] The need for effective treatment of CSU is high, and complete protection from wheals and angioedema is the goal of treatment according to the international urticaria guideline. […] Novel and more effective safe therapies are urgently needed.

• #28

  https://link.springer.com/article/10.1007/s40265-025-02170-4

  In these patients, a disease modifying treatment could induce long-term disease remission. […] Dupilumab is currently approved for the treatment of several type 2 inflammatory diseases including atopic dermatitis, asthma, and prurigo nodularis, and it was recently approved for the use in patients with CSU aged 12 years and older whose disease is not adequately controlled with existing therapy in Japan and the United Arab Emirates (UAE) and is also under regulatory review in the European Union and in the USA. […] Therapeutic inhibition of BTK has the potential to diminish activation of BCR and TLR signaling pathways and potentially reduce the expansion of B cell populations including autoreactive clonal B cells. […] The phase 3 program, consisting of two phase 3 trials (EMBARQ-CSU1 and EMBARQ-CSU2), will investigate the efficacy and safety of barzolvolimab in adult patients with CSU who remain symptomatic despite sgAH treatment, including patients with prior treatment with biologics.

• #28

  https://link.springer.com/article/10.1007/s40265-025-02170-4

  The drug pipeline in CSU is developing rapidly, with omalizumab biosimilars entering the market and novel small molecules and biologics becoming available in the next 12 years. […] Endotyping patients with CSU such as differentiating between autoimmune, autoallergic, overlapping, or non-FcRI receptor mediated forms along with identifying specific biomarkers such as total IgE and basophil tests will enable tailored treatments in the context of precision medicine, optimizing therapeutic efficacy. […] In the long term, more MC-specific approaches may further improve urticaria management.

• #29 Treatment options for difficult-to-treat chronic hives – Sharecare

  https://www.sharecare.com/skin-health/treatment-options-difficult-chronic-hives

  The initial steps for treating hives are avoiding triggers and taking medications called antihistamines. […] If symptoms do not respond to treatment with antihistamines, a healthcare provider may recommend a stronger-dose antihistamine, a different type of antihistamine, or another type of treatment. […] Other treatment options for chronic hives include corticosteroids, immunosuppressive drugs, a biologic therapy, and therapies for other conditions that may have a therapeutic benefit for chronic hives. […] Glucocorticoids are a type of corticosteroid, which is a type of anti-inflammatory drug. […] There is research that supports the idea that some cases of chronic hives are associated with abnormal immune system activity that causes an unnecessary inflammatory response. […] Therapies used to treat autoimmune disease are sometimes used to treat chronic hives, including immunosuppressive drugs.

• #29 Treatment options for difficult-to-treat chronic hives – Sharecare

  https://www.sharecare.com/skin-health/treatment-options-difficult-chronic-hives

  Any therapies that impact the way the immune system works come with a risk of serious side effects, which patients and their healthcare providers will need to consider before starting an immunosuppressive or a biologic therapy. […] There are a number of treatments for other conditions that may have therapeutic benefits for chronic urticaria, which may be prescribed off-label. […] Any medication should always be taken under the guidance of a healthcare provider.

• #30 Update on the Treatment of Chronic Urticaria | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-update-on-treatment-chronic-urticaria-articulo-S1578219014001127

  In November 2012, in Berlin, at the fourth consensus meeting to update the guidelines for chronic spontaneous urticaria, certain changes were introduced into the management algorithm for CU. As the algorithm only included those treatment options supported by a high level of recommendation, the use of dapsone and of the H2-antihistamines was withdrawn. In view of the failure of the use of the nonsedative H1-antihistamines at the approved doses, an increase of up to 4 times that dose was recommended. Omalizumab, ciclosporin A, and the antileukotrienes continue to figure as second-line treatment. These drugs are used in addition to the H1-antihistamines. However, reading of the entire guidelines is recommended as the use of other therapeutic options that do not figure in the algorithm is not rejected for certain patients.

• #30 Update on the Treatment of Chronic Urticaria | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-update-on-treatment-chronic-urticaria-articulo-S1578219014001127

  Chronic spontaneous urticaria, also known as chronic idiopathic urticaria or simply chronic urticaria, is a common disorder that has a prevalence in the general population that ranges between 0.5% and 1%. This condition negatively affects the patient’s quality of life and has considerable impact on direct and indirect health-related costs. Chronic urticaria is difficult to manage. Nonsedating H1 antihistamines are the first line of therapy, but fewer than 50% of patients experience relief at recommended dosages. Although guidelines call for increasing the dosage when response is inadequate, some patients still do not achieve adequate control of symptoms. New treatment alternatives, with proven efficacy under the standards of evidence-based medical practice, must therefore be developed. […] In the treatment of urticaria it is important to avoid possible nonspecific triggers or aggravating factors such as heat, stress, alcohol, and certain drugs, including acetylsalicylic acid, NSAIDs, angiotensin-converting enzyme (ACE) inhibitors (particularly if the urticaria presents with angioedema, with or without wheals) and codeine. Cooling, antipruritic lotions such as calamine or 1% menthol in aqueous cream can be applied.

• #31 Urticaria (Hives): a complete overview — DermNet

  https://dermnetnz.org/topics/urticaria-an-overview

  Chronic urticaria may be spontaneous or inducible. Both types may co-exist. […] Identified triggers should be eliminated if possible (eg, drug or food allergy). Avoidance of relevant type 1 (IgE-mediated) allergens clears urticaria within 48 hours. […] The physical triggers for inducible urticaria should be minimised; see examples below. However, symptoms often persist. […] Some patients with inducible urticaria benefit from daily induction of symptoms to induce tolerance. Phototherapy may relieve the itch of symptomatic dermographism. […] Patients with chronic urticaria that has failed to respond to maximum-dose second-generation oral antihistamines taken for four weeks should be referred to a dermatologist, immunologist or medical allergy specialist. […] Long-term systemic corticosteroids are not recommended, as high doses are required to reduce symptoms of urticaria and they have inevitable adverse effects that can be serious.

• #32 Novartis says drug helps control chronic hives in studies | BioPharma Dive

  https://www.biopharmadive.com/news/novartis-remibrutinib-hives-urticaria-remix-studies/690397/

  Novartis on Wednesday said its experimental treatment for a disease that causes chronic hives succeeded in the initial part of two Phase 3 studies. […] Researchers tested the drug, remibrutinib, in patients with chronic spontaneous urticaria who didnt respond well enough to the usual treatment of antihistamines. After 12 weeks, patients in both studies had a meaningful and significant improvement in symptoms without significant side effects, Novartis said. The trials will continue for 52 weeks. […] If approved, remibrutinib would offer a simple and effective oral option, Novartis said.

• #33 Hives (Urticaria) | Causes, Symptoms & Treatment

  https://acaai.org/allergies/allergic-conditions/skin-allergy/hives/

  Chronic hives occur almost daily for more than six weeks and are typically itchy. Each hive lasts less than 24 hours. They do not bruise nor leave any scar. They typically do not have an identifiable trigger. […] If your hives last more than a month or if they recur over time, see an allergist, who will take a history and perform a thorough physical exam to try and determine the cause of your symptoms. A skin test and challenge test may also be needed to identify triggers. […] Antihistamines – available either over the counter or by prescription – are a frequently recommended treatment for hives. They work by blocking the effect of histamine, a chemical in the skin that can cause allergy symptoms, including welts. […] If the cause of hives can be identified, the best treatment is to avoid the trigger or eliminate it.

• #34 Treating Chronic Hives: What Your Dermatologist Recommends

  https://www.srderm.com/2021/07/15/treating-chronic-hives/

  Make an appointment with your board-certified dermatologist. They can help rule out possible causes and recommend a personalized treatment plan. […] Track flare-ups. This can help you narrow-down triggers. […] Avoid stressors. Hives can be triggered by stress. […] Follow your treatment plan. Even when the cause of hives is unknown, treatment can be effective. Be sure to follow your prescribed treatment to ensure its success. […] If treatment doesn’t aid your symptoms, talk to your dermatologist. They can try a different medication or dosage to help your treatment plan succeed.

• #35 Chronic Hives: Symptoms, Treatments, Complications

  https://www.everydayhealth.com/hives/chronic-hives/

  Your doctor will also most likely test for autoimmune issues. […] Fortunately, even though the struggle may be long, all hope is not lost in the quest to put chronic hives to bed. […] The American Academy of Allergy, Asthma, and Immunology reports that in about one-half of patients, the hives will be resolved in one to two years, while 80 to 90 percent of hives sufferers will see visible improvement within five years.

• #36 Hives Care for Children and Adults | UPMC in Central Pa.

  https://www.upmc.com/services/south-central-pa/allergy-asthma-immunology/allergies/hives

  Chronic hives could be caused by allergies, but also could be caused by underlying chronic conditions. […] Blood tests for chronic hives. Blood tests measure the amount of immunoglobulin E (IgE) antibodies in your blood that are specific to certain allergens. […] If you are experiencing chronic hives that have not responded to antihistamines or steroid medications, our specialists offer Xolair/Omalizumab shots that may help to control chronic hives. […] Our specialists provide the education and information you need to manage your hives, including training on administering emergency medications and making recommendations for how you can prevent hives and avoid triggers.

• #37 What Causes Hives and How to Get Rid of Them – Riverchase Dermatology

  https://www.riverchasedermatology.com/blog/how-to-get-rid-of-hives-at-home-and-prescription-treatments/

  Hives treatment aims to reduce the inflammation caused by the release of histamines. […] If you have chronic hives, your dermatologist may refer you to an allergist to be tested for allergies, or to another doctor to be tested for underlying diseases, including autoimmune diseases. Some autoimmune diseases, such as lupus, can make you more susceptible to hives. […] Chronic hives is often treated with antihistamines. If they don’t help enough, your dermatologist may suggest adding UV light therapy, also called phototherapy. An injectable medication called omalizumab is another option. It works by blocking the action of an immune substance called immunoglobulin E, which plays a role in hives. […] If all else fails, immunosuppressant drugs may be prescribed to prevent the immune system from overreacting to hives triggers. These drugs can have serious side effects, so they usually aren’t prescribed unless you haven’t responded to other treatments. Examples of immunosuppressants used to treat hives include cyclosporine, methotrexate and hydroxychloroquine (Plaquenil).

• #38 Chronic Hives (Chronic Idiopathic Urticaria): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22900-chronic-hives-chronic-idiopathic-urticaria

  Chronic hives (chronic urticaria) are red, itchy skin welts that last more than six weeks. Antihistamines, steroids and immunosuppressants can soothe the hives. […] Treatments for chronic hives include: Allergy medications: Daily over-the-counter (OTC) or prescription allergy medications like antihistamines relieve itching and reduce or prevent allergic reactions. […] You can try these steps at home to ease itchy skin and soothe inflammation: Apply an OTC anti-itch cream. Place cool compresses on the hives several times a day (unless cool temperatures make hives worse). Take a cool bath or shower. Use hypoallergenic lotions and creams to moisturize dry skin. Wear loose-fitting clothes made with soft fabric that wont irritate your skin. […] Chronic hives (chronic urticaria) can be itchy and uncomfortable. However, treatments like antihistamines, steroids and even immunosuppressants can help. You can also take steps at home to ease itching and swelling.

• #39 Hives: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/hives-treatment

  Hives can require emergency care. […] For many people, hives are mild. If you have a mild case, it will likely go away in a few days. To get relief until then, dermatologists recommend that you take an antihistamine (non-drowsy, 24-hour relief) and use these home remedies. […] When treating hives, the goals are to: Control the itch, Prevent new hives (existing hives go away on their own), Avoid what’s causing the hives (when known). […] Your treatment plan will be tailored to your needs and may include one or more of the following: Soothing anti-itch lotion or cream, Antihistamine, Corticosteroid, Light therapy, Omalizumab, Desensitization. […] A treatment plan often works best when you follow these dermatologists at-home tips.

• #40 How Do You Treat Chronic Hives?Share to Facebookprint pageBookmark for latercaret iconFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon

  https://chronic-hives.com/treatment

  Treatment of chronic hives usually includes medicines and lifestyle changes. There is no cure for chronic hives. The goal of treatment is to reduce symptoms and improve quality of life. […] The goals of chronic hives treatment are to: Relieve symptoms, Reduce the burden on daily life, Minimize side effects of medications, Improve quality of life, Reduce duration of the disease. […] Some studies have shown that certain lifestyle changes can help treat chronic hives. However, evidence for many of these methods is limited. Talk to your doctor before trying any lifestyle changes. They can suggest ways to do them safely. Possible lifestyle changes include: Protecting your skin from sun exposure, Vitamin D supplementation, Diet modifications, such as a low-histamine diet, Relaxation and mindfulness techniques, Avoiding triggers, Wearing loose clothing, Using certain types of soap and soothing skin products.

• #41 Chronic Hives: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.chronic-hives-care-instructions.uf7064

  Avoid whatever you think may have caused your hives, such as a certain food or medicine. But you may not know the cause. […] Your doctor may suggest a nondrowsy antihistamine, such as loratadine (Claritin), to help control the hives. Be safe with medicines. Read and follow all instructions on the label. […] Your doctor may prescribe a shot of epinephrine to carry with you in case you have a severe reaction. Learn how to give yourself the shot, and keep it with you at all times. Make sure it has not expired. […] If your doctor prescribes another medicine, take it exactly as directed.

• #42 Chronic spontaneous urticaria – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_spontaneous_urticaria

  A two-pronged strategy has been proposed for the treatment of chronic spontaneous urticaria. First, the underlying cause(s) and/or eliciting trigger(s) must be established and eliminated. Pharmacotherapy is the second, and its goal is to relieve symptoms. […] According to current guidelines, a therapeutic approach should be implemented in three steps: (1) taking a second-generation antihistamine once daily; (2) increasing the daily dose of the second-generation antihistamine up to four times; and (3) pursuing off-label therapy with cyclosporine A or montelukast or add-on therapy with omalizumab, which is an approved treatment option for CSU. […] Although removing the cause is the ideal course of action, this may not be feasible in many situations.

• #43 Chronic Hives Treatment

  https://allergylosangeles.com/allergy-blog/stepwise-approach-to-chronic-urticaria/

  Chronic hives can be a difficult disease to treat. Studies have shown that many cases have no known cause (idiopathic). At that point, the chronic hives are treated with medications to reduce the occurrence. […] Fortunately, if the medication guidelines are followed as described above, many times the chronic hives can be well controlled and in many patients spontaneous resolution may occur. […] All patients: Avoidance of triggers. […] Step 1– Nonsedating second or third generation antihistamines taken up to 4 times a day. (i.e. Claritin, Zyrtec, Allegra, Xyzal, Clarinex) Decrease the dose as tolerated. […] Patient response to step 1 is approximately 45%. […] Step 2– Omalizumab 300 mg monthly (Xolair). If no response after 3 injections, (some studies say up to 6 injections) proceed to step 3.

• #44 Patient education: Hives (urticaria) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hives-urticaria-beyond-the-basics

  Hives usually respond well to treatment, which includes medicines and avoiding whatever triggered the hives. […] The first treatment for hives is to figure out what is triggering your hives and then avoid that trigger. Even if you cannot figure out the trigger, hives usually disappear over days or weeks. […] Chronic hives are rarely permanent; almost 50 percent of people are hive free within one year. […] The bothersome symptoms of chronic hives are treatable in most people. […] In most cases of chronic hives, the cause is unknown. Researchers suspect that problems in the immune system play a role. […] If your hives do not get better with the treatments discussed above, other treatments are available.

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