Taking the Next Step in Treating Chronic Hives
Last updated: June 2022
Chronic hives are a tricky problem to solve. The treatment that works for you might not have any effect on me and vice versa. Sometimes I think about all the trigger management and drug combinations I could possibly try and it feels like a daunting battle against an evasive enemy.
The recommended treatment progression for chronic hives follows a stepwise approach. This means that the approach can increase or decrease based on how a person responds to treatment and side effects.1
Stuck on the H1 antihistamine step
I am well beyond taking the standard dose of an over-the-counter antihistamine. After trying different dosages and combinations of non-drowsy antihistamines, I’ve found 1 antihistamine that works best for me and I currently take 4 times the standard daily dose.
At my recent annual allergist appointment, my doctor walked into the exam, took one look at my arms, and said, “I see your hives are still recurring.” Indeed, despite the hefty daily dose of antihistamines, I have breakthrough hives regularly.
I am not at the point where breakthrough hives are disrupting my daily life, but I will admit, it would be nice to have them more controlled. When the doctor started talking about my options, I was all ears.
Adding new drugs to control my symptoms
I left the doctor’s office with 2 new prescriptions to add to my antihistamine regimen – an H2 blocker (Pepcid®) and a leukotriene receptor antagonist (Singulair®). I’m not thrilled to be taking so much medication daily, but I’m even less thrilled with losing the daily battle against my hives.
It has only been a few days on this new regimen, so I am practicing patience as I wait to see how my body responds.
What is the next step in my treatment progression?
If my current treatment plan does not work, the next step for me is likely Xolair®. It’s comforting to know there is a “next step” and that I haven’t exhausted all options yet. While it would be nice if hives had one, straightforward treatment option that just worked, how many health conditions are so lucky? Not many.
Trigger management is part of my treatment plan
Medication helps me, but I know it’s not the only thing that helps me manage my hives. While I am optimistic about the relief I may get from the little orange bottles in my medicine cabinet, I also wake up each day determined to help my own cause.
This means doing what I can to manage my triggers – for me, these include stress, tight clothing, and prolonged sitting. I won’t sugarcoat it, some days are hard. Managing stress takes effort and sometimes I fail. There are some days I wish that medication could solve my hives problem and there are other days I wish lifestyle changes alone could be my answer.
Accepting where I am
I know I have not reached the last step in chronic hives’ stepwise treatment progression; I am somewhere in the middle. Maybe I keep climbing. Maybe I stay right where I am. I have accepted that this might not be a linear journey.
Where are you in treatment progression? Do you feel like you have more “steps” ahead of you? I would love to hear about your treatment journey! Please share in the comments below!
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