Persistent Itchy Skin and Recurring Hives: Understanding Origin and Remedies
Chronic hives, also known as chronic spontaneous urticaria (CSU), is a distinct medical condition that can cause itchy skin and raised welts on the skin. If you've been experiencing persistent itchiness and the appearance of welts, this article aims to provide you with a comprehensive understanding of the condition.
Symptoms and Diagnosis
The symptoms of chronic hives include itchy skin, welts, and in some cases, angioedema - a type of fluid buildup under the skin. For a person to meet the criteria for chronic hives, the symptoms must occur every day, or on most days, for a minimum of 6 weeks. To diagnose chronic hives, doctors will perform a physical examination of the skin and ask questions to determine the cause or trigger.
Causes
The causes of chronic hives can be idiopathic (no identifiable cause) or physical (triggers can be identified). These triggers can include certain foods, physical touch, UV light, medications, infections from bacteria, viruses, and parasites, and more. Interestingly, many people with CSU also have another autoimmune condition, suggesting a potential connection.
Autoimmune Connection
In cases of chronic hives, the immune response may be an autoimmune response. This means that the immune system mistakes a substance or type of physical stimuli as a threat. Some of the most common autoimmune conditions associated with chronic hives are systemic lupus erythematosus (SLE), pemphigus vulgaris, rheumatoid arthritis, Sjorgen's syndrome, celiac disease, type 1 diabetes mellitus, Hashimoto's thyroiditis, Graves' disease, vitiligo, polyglandular syndrome with autoimmune thyroid disease, pernicious anemia, or vitiligo, mixed connective tissue disease, and hypothyroidism.
Treatment
If doctors cannot quickly determine the cause of chronic hives, they may recommend wearing loose-fitting clothes, using products with no irritants or common allergens, applying cold compresses, using over-the-counter anti-itch creams, practicing relaxation or mindfulness techniques, and managing stress. If they do identify the cause, they may provide a person with more tailored treatment, such as antihistamine medications, omalizumab (Xolair), cyclosporin, or corticosteroids.
Associated Factors
People with CSU may have a higher rate of vitamin D deficiency and dysbiosis than others. An older 2012 study found that 9.8% of people with CSU also had hypothyroidism.
Prognosis
About 50% of people recover from chronic hives within 1 year, and between 80-90% of people will experience a reduction in symptoms within 5 years. However, chronic hives can reappear later on, and treatment can help manage them. Anyone who is concerned about recurring itchy skin and hives should speak with a doctor or dermatologist.
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