People with chronic hives are at higher risk of also having other chronic conditions. Coexisting conditions are known as comorbidities. The term comorbidity is used to describe a condition or illness that occurs at the same time of another condition or illness. Comorbid illnesses can interact in ways that worsen both.
The most common comorbidities of chronic hives are allergic and autoimmune conditions. Other conditions may also be linked to chronic hives, but some studies conflict each other.
Comorbid conditions do not affect treatment or severity of chronic hives. However, these conditions can affect your quality of life and overall health. Diagnosing any other conditions you have along with chronic hives can help you get the best possible treatment.
Allergic diseases
Allergic reactions happen when exposure to an allergen triggers an immune reaction. Your immune system produces proteins called IgE antibodies. These proteins cause physical changes in your body that lead to allergy symptoms.1
This allergic reaction is a feature of atopic conditions. People with chronic hives have about a 5 times higher risk of having an atopic condition. Some atopic conditions linked to chronic hives include:2-4
- Atopic dermatitis (eczema)
- Asthma
- Rhinoconjunctivitis (itchy, watery eyes and sneezing or a stuffy nose without a cold or flu)
Some studies have also linked mastocytosis to chronic hives. This is a condition where you have too many white blood cells called mast cells. When they are triggered, mast cells release chemicals that cause symptoms of allergies. This can lead to anaphylaxis, which is also linked to chronic hives. Anaphylaxis is a severe, life-threatening allergic reaction.2
Autoimmune conditions
Autoimmune conditions happen when your immune system mistakenly attacks healthy cells. The immune system normally fights invaders like bacteria and viruses. When it mistakes your cells for foreign invaders, it releases proteins called auto-antibodies that attack healthy cells.1
There are dozens of autoimmune conditions. Some conditions affect only 1 organ. Others affect the whole body. Some autoimmune conditions linked chronic hives include:2,5,6
- Thyroid diseases, such as Graves’ disease and Hashimoto’s thyroiditis
- Systemic lupus erythematosus (SLE)
- Rheumatoid arthritis
- Celiac disease
- Vitiligo
- Psoriasis
- Sjögren syndrome
Thyroid diseases are the most common conditions linked to chronic hives. About 10 percent of people with chronic hives also have a thyroid condition.7
Osteoporosis and diabetes
Some studies have found a higher risk of osteoporosis (weak, brittle bones) and diabetes in people with chronic hives. People treated with steroids have a higher risk of both of these conditions. This is why doctors recommend against using steroids to treat chronic hives.3,8
Mental health conditions
Mental health conditions are strongly linked to chronic hives. Between 25 and 65 percent of people with chronic hives experience emotional distress. Depression seems to be the most common mental health condition among those with chronic hives.3,6,9
Other mental health conditions commonly found in people with chronic hives include:10
- Sleep-wake disorders
- Anxiety disorders
- Mood disorders
- Trauma and stress-related disorders
- Obsessive-compulsive disorders
- Substance-related and addictive disorders
The link between chronic hives and depression can be explained by a number of factors, including:2
- Loss of sleep
- Itchiness
- Social stigma
- Uncertainty in diagnosis
- Poor mental health
Cancer
The link between chronic hives and cancer is under debate. Some studies show that people with chronic hives have a slightly higher risk of cancer. The most common cancers in people with chronic hives include:2,11
- Stomach
- Thyroid
- Liver
- Prostate
However, other studies have not shown a higher risk of cancer. More research is needed to better understand if cancer and chronic hives are related. For now, doctors will only screen for cancer in people with chronic hives if they have signs or symptoms of cancer.1,12,13
Treating other conditions
Treatment will be different depending on the type of other condition a person with chronic hives develops. For example, diabetes treatments are different from treatments for anxiety and depression. Talk to your doctor about the best treatment choice for you.