Myths and Misconceptions About Chronic Hives

Reviewed by: HU Medical Review Board

While hives are a very common skin condition, there is not much known about chronic hives. This is due to a few factors:

  • The cause of chronic hives is often unknown
  • Hives can be a symptom of many other conditions
  • Hives tend to come and go without obvious triggers
  • Different medicines work for some people and not others

Because of this, there are many myths and misconceptions about the condition. Knowing what is true and what is not will help you better understand chronic hives and the treatment options available.

Myth: Chronic hives are contagious

Hives are not contagious. They cannot spread from person to person. Most cases of chronic hives do not have a known cause. Many of the known causes are not contagious.1,2

Sometimes, hives are caused by an infection, such as strep throat. In these cases, the infection can spread to other people. But the hives themselves are not contagious.1

Myth: Chronic hives are an allergic reaction

Exposure to allergens is a common cause of acute hives. This means the hives last fewer than 6 weeks. For example, people with peanut allergies may break out with hives after eating peanuts. However, allergies are not the main cause of hives that last longer than 6 weeks (chronic hives).1,3

There are many non-allergic causes of chronic hives. For example, chronic hives may be a sign of an autoimmune condition. Hives may also happen after certain physical triggers. In many cases, there is no specific cause of chronic hives. Hives can develop suddenly without any particular trigger or cause.1,3

Myth: Chronic hives have no treatment

There is no cure for chronic hives. However, there are many treatments that relieve symptoms. The goal of treatment is to control symptoms without causing any side effects. Doctors start by prescribing non-drowsy antihistamines. Higher doses may be needed to treat symptoms.4,5

If antihistamines do not control symptoms, your doctor will suggest other drugs. They may try omalizumab (Xolair®), which is effective for most people who do not respond to antihistamines. If needed, your doctor may suggest steroids. However, these are only used for a short time to control severe flares.4,5

Myth: Chronic hives do not affect quality of life

Chronic hives have a large impact on quality of life. One in 7 people with chronic hives experience emotional distress. Anxiety is especially common because of the uncertain nature of the condition. Some of the ways it affects quality of life include:6,7

  • Uncertainty about what is causing or triggering symptoms
  • Fears during diagnosis delays
  • Unpredictability of symptoms coming and going
  • Avoiding social situations
  • Sleep problems because of pain and itchiness
  • Stress because of doctor’s appointments and healthcare costs

Myth: People with chronic hives must avoid many foods

People with chronic hives do not usually have to avoid many foods. Doctors may suggest avoiding certain foods that release more histamine. But strictly avoiding certain foods does not seem to have an effect on symptoms of chronic hives.8

Most cases of chronic hives do not have a known cause. They are not related to allergies or food sensitivities. However, many people with chronic hives do say that certain foods worsen symptoms. If you want to try eliminating foods, talk to your doctor before changing your diet.8

Myth: People with chronic hives must take medicines for life

Chronic hives usually only last a few years. The average duration of chronic hives is 2 to 5 years. Between 30 to 50 percent of people have no symptoms after 1 year. Only about 14 percent of people still have symptoms after 5 years.4

This means you may not need to take medicines to treat your symptoms for more than a few years. It can be frustrating to think you need to take medicine for chronic hives for the rest of your life. However, current medicines are safe and have few side effects. And many people quickly recover and will no longer need to take medicine for chronic hives.1

Myth: Chronic hives do not cause any complications

While complications of chronic hives are rare, they can happen. These include:1,9

  • Swelling of area beneath the skin (angioedema), which usually occurs on the face, neck, or extremities
  • Anaphylaxis, a life-threatening allergic reaction that needs emergency care
  • Infections caused by scratching too hard and creating breaks in the skin that are an entry for bacteria

However, whether or not you have complications, chronic hives have a huge impact on your well-being. Talk to your doctor about how to relieve symptoms and improve your quality of life.

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