Chronic Hives and Skin Infections

Reviewed by: HU Medical Review Board

An important role for your skin is to protect you from infections. If your hives become very itchy, you may accidentally scratch and break the skin, especially if you scratch in your sleep. Any time your skin is broken, a germ can enter your body.1-3

This increases the risk of getting an infection, especially a bacterial infection. This is called a secondary infection. This is because your primary illness is chronic hives, and chronic hives lead to the infection.1-3

Most skin infections are mild and can be easily treated with antibiotics. However, they may be uncomfortable and can spread to your bloodstream if left untreated. This can become life-threatening.1-3

Which skin infections are most common?

Bacterial infections are the most common type in people with chronic hives. This is due to itching and scratching of hives.2,3

Most bacterial infections cannot spread from one person to another. Common strains of bacteria that cause an infection are Streptococcus or Staphylococcus. These bacteria can cause cellulitis. This is a common, potentially serious bacterial skin infection.2,3

Other types of skin infections may be caused by viruses, fungus, or parasites.1

What are symptoms of a secondary infection?

Symptoms of a skin infection vary and can range from mild or serious. Each type of bacterial skin infection looks slightly different. For example, cellulitis often occurs on lower legs and shows symptoms such as:4

  • Redness
  • Rash
  • Itching
  • Pain
  • Swelling
  • Tenderness
  • Warmth
  • Pus
  • Blisters

These are not all the possible symptoms of a skin infection. Talk to your doctor if you notice any symptoms that get worse or do not improve. Get emergency help if you have a fever or a swollen rash that is changing quickly. This can be a sign of a more severe infection.4

How can I prevent secondary infections?

The best way to prevent chronic hives from causing an infection is to avoid scratching.

Talk to your doctor about how to reduce the itchiness of your hives. They may be able to change your treatment to improve itchiness. For example, you may need to take a larger dose of antihistamines. Your doctor may also suggest other products, such as moisturizers or prescription topical creams.5,6

If you accidentally scratch yourself and break your skin, you can take steps to prevent a skin infection, including:4

  • Wash the wound immediately with soap and water, and then regularly after that
  • 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 an infection, such as swelling, fever, heat at the site, or more tenderness

Recurring episodes of cellulitis or other skin infections can cause serious complications. If you keep getting infections, your doctor may recommend you take preventive antibiotics.4

If left untreated, skin infections can spread to the bloodstream and become life-threatening. However, most cases of skin infections are easy to treat with different types of antibiotics.4

How are infections treated?

Treatment depends on the cause of the infection and the severity.

Bacterial infections are usually treated with topical antibiotics. These are applied directly to the skin. Oral antibiotics may also be needed. If the type of bacteria resists treatment, you may need antibiotics given through an IV.3,4

Other treatments that may help reduce the itchiness of an infection include:4

  • Using a cold compress
  • Taking over-the-counter antihistamines
  • Using topical creams and ointments

Talk to your doctor before trying any at-home remedies or over-the-counter drugs.

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