Chronic Hives and Quality of Life

Reviewed by: HU Medical Review Board

Chronic hives often greatly impact quality of life because the symptoms affect so many areas of life. Difficulties dealing with the physical symptoms often impact mental health issues too. That is why mood disorders like anxiety and depression are common in people with chronic hives.1,2

Some of the ways chronic hives affects your well-being include:2

  • Anxiety about when episodes will occur
  • Fear about the unknown causes of chronic hives
  • Avoiding social situations because of stigma
  • Extremely itchy or painful skin causing a “poison ivy sensation”
  • Difficulty sleeping
  • Missing work because of symptoms and doctor appointments
  • Delays in diagnosis and finding effective treatments, leading to frustration
  • Finding ways to pay for necessary healthcare

In short, chronic hives impact your mental, physical, and economic health, along with your education, social life, and relationships.1

Why is it important to measure quality of life?

Measuring your quality of life helps your healthcare team understand how hives affect your daily life and target treatments to bring relief.

Because of this, experts suggest that your doctor measures your quality of life at your first visit and then at each follow-up visit. This helps doctors track your disease activity and make decisions about your treatment.1

How do doctors measure quality of life?

Doctors have developed many ways to measure your quality of life. These are usually questions that ask about general life and disease-specific topics, such as:3

  • Participation in social relationships, activities, and sexual life
  • Effect on sleeping, eating, and working
  • Feelings of helplessness, embarrassment, and nervousness
  • Severity of symptoms
  • Alcohol and drug use
  • Anxiety about healthcare and treatments

People with chronic hives have a higher risk of poor quality of life than the general population. In fact, research shows the burden of chronic hives is similar to coronary artery disease. People with chronic hives also have worse quality of life scores in certain areas than people with allergies or diabetes.4

Your doctor may also use questionnaires that are more specific to skin conditions. These surveys allow doctors to see how chronic hives affect all aspects of your life. Some of the more common skin questionnaires include:4,5

  • Chronic urticaria quality of life questionnaire (CU-Q2oL)
  • Angioedema quality of life questionnaire (AE-QoL)
  • Chronic urticaria patient perspective (CUPP)
  • Dermatology Life Quality Index (DLQI)
  • SKINDEX-29

How can I improve my quality of life?

Quality of life is complicated to treat. This is because there are so many reasons why chronic hives affect quality of life.

The best way to reduce the burden of chronic hives is to treat your symptoms. Taking charge of your health can help you feel more control over your symptoms. Reducing the intensity of your symptoms can also improve your mental outlook and physical health. For example, studies have shown that antihistamines and omalizumab (Xolair®) improve sleep, and better sleep improves mood.6

You can also improve your well-being with lifestyle changes and various coping methods. Some ways to take care of your physical and mental health include:7

  • Learning as much as you can about your condition
  • Maintaining a healthy diet and exercise routine
  • Writing in a journal to express your emotions
  • Finding support groups for people with similar experiences
  • Advocating for others with chronic hives
  • Joining in social activities and spending time with family and friends
  • Practicing yoga, meditation, or mindfulness
  • Talking to a therapist or counselor
  • Avoiding alcohol and drugs

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