Complications From Chronic Hives

Hives are red, itchy bumps on your skin. Chronic hives are a condition where hives come and go for 6 weeks or more. In most cases, there is no known cause of chronic hives.1

While complications of chronic hives are rare, they do affect some people. Two possible complications include:2-5

  • Life-threatening swelling of the airways (anaphylaxis)
  • Infections caused by scratching itchy hives

Symptoms of chronic hives usually resolve on their own or with treatment. The condition usually lasts for a few years. Most people with chronic hives will not develop long-term complications. However, chronic hives can affect work, sleep, and social life. This can worsen your quality of life and lead to poor mental health.1

Anaphylaxis

A common symptom of chronic hives is angioedema. This is a painful type of swelling under the skin. It usually affects the lips, hands, feet, and genitals. But when it affects your throat or tongue, it can close off your airways. This condition is known as anaphylaxis.2

Anaphylaxis is usually triggered by a severe allergic reaction to a certain food. Get emergency help if you experience symptoms of anaphylaxis. These include:2

  • Dizziness or fainting
  • Nausea, vomiting, or diarrhea
  • Trouble breathing
  • Swelling of lips, eyelids, and tongue

People experiencing anaphylaxis need a shot of epinephrine right away. This is a hormone that will open your airways and reduce swelling. If you have had anaphylaxis before, your doctor should give you:3,4

  • An anaphylaxis action plan
  • An epinephrine auto-injector (such as EpiPen® or Auvi-Q®)
  • A plan for further evaluation
  • Printed information about anaphylaxis and its treatment

Even if you use epinephrine at home, you still need to go to an emergency room. Symptoms can return when the epinephrine wears off. You may need supplemental oxygen, intravenous fluids, and extra monitoring.4

Infections

Hives often feel itchy. When the itching sensation is intense, scratching too hard can injure the skin. Continued itching and scratching can increase the intensity of the itch. If you scratch too hard, you may break the skin. Any time your skin is broken, you have a higher risk of a skin infection.5

A skin infection happens when germs enter the skin. Bacteria are the most common germs to infect skin after a cut or scratch. A weakened immune system and other skin conditions increase the risk of a skin infection.6

If you scratch yourself and accidentally break your skin, you can take steps to prevent a skin infection. Here are some precautions to take if you have a skin wound:6

  • Wash your wound often with soap and water
  • Apply a protective cream, such as Vaseline or another over-the-counter ointment
  • Cover your wound with a bandage and change it often
  • Watch for signs of infection

Talk to your doctor if you have symptoms of a skin infection, such as:6

  • Pus or blisters
  • Red skin around the injury
  • Swelling
  • Tenderness or pain
  • Red spots

Your doctor may give you topical antibiotics to treat the infection. Get emergency help if you have a fever or swollen rash. These may be signs of a more severe infection.6

Quality of life

Symptoms of chronic hives can cause a large physical and emotional burden. One in 7 people with chronic hives experience emotional distress. This can have a huge impact on your quality of life. Some of the ways chronic hives affects quality of life include:1

  • Fear about the unknown nature of the condition
  • Anxiety about when hives will appear or worsen
  • Exhaustion from seeing many doctors and trying many treatments
  • Work, school, and sleep interruptions because of symptoms
  • Avoiding social situations because of stigma
  • Costs of healthcare and loss of work

These factors can worsen your mental health. This is why anxiety and depression are common complications of chronic hives. Talk to your doctor if you notice any signs of anxiety or depression, such as:7

  • Avoiding things you once enjoyed
  • Shakiness
  • Sleep disturbance
  • Lack of energy
  • Trouble concentrating or making decisions
  • Increased heart rate
  • Chest tightness
  • Racing thoughts
  • Recurring feelings of sadness
  • Frequent negative thoughts
  • Isolating yourself

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Written by: Matt Zajac │ Last reviewed: April 2022