What Is the Best Thing to Take for Hives

First-Generation Antihistamines

Diphenhydramine: It quickly relieves itching and can reduce the swelling associated with hives. However, it commonly induces drowsiness, which may interfere with daily activities. For example, a person taking diphenhydramine might feel sleepy during work or school hours. It can also cause dry mouth, blurred vision, and urinary retention. Despite these side effects, it is still useful, especially when taken at night to help with sleep while also providing relief from hives symptoms.

Chlorpheniramine: Similar to diphenhydramine in its ability to alleviate itching and swelling, it has a somewhat milder sedative effect. It is available in different forms, such as tablets and syrups, making it convenient for various patients. Some people may tolerate it better than diphenhydramine in terms of drowsiness, but it can still cause some degree of sedation.

Second-Generation Antihistamines

Loratadine: This antihistamine offers a long-acting effect, typically providing relief for 24 hours. It has a minimal sedative effect, allowing patients to carry out their normal routines without feeling overly drowsy. It is easily accessible over the counter and is generally well-tolerated. For instance, a patient with mild to moderate hives can take loratadine in the morning and go about their day without significant impairment.

Cetirizine: It has a relatively rapid onset of action and provides relief for up to a day. It is less likely to cause drowsiness compared to first-generation antihistamines, although some patients may still experience a slight degree of sedation. It is available both by prescription and over the counter and can be beneficial for patients with associated nasal symptoms, as it can also relieve nasal congestion and sneezing.

Oral Corticosteroids

Prednisone: Often prescribed for short-term use to quickly control severe hives outbreaks. It works by suppressing the body’s immune response, thereby reducing inflammation and itching. However, long-term use is associated with significant side effects. For example, it can lead to weight gain, particularly in the abdominal area, due to changes in metabolism. It may also cause osteoporosis, increasing the risk of fractures, as well as suppressing the adrenal glands’ normal function. Therefore, it is usually reserved for acute, severe flare-ups and is carefully monitored by healthcare providers.

Topical Corticosteroids

Hydrocortisone Cream: When applied directly to the affected skin areas, it can provide local relief from itching and inflammation. It is less likely to cause systemic side effects compared to oral corticosteroids. However, it should be used with caution, especially on sensitive skin or if used for an extended period. Prolonged use can lead to skin thinning, which may make the skin more fragile and prone to damage. It can also cause local discoloration or other skin changes in some cases.

Cold Compress: Applying a cold compress to the hives can constrict blood vessels, reducing inflammation and providing immediate relief from itching. For example, wrapping a few ice cubes in a clean towel and gently placing it on the affected area for 10-15 minutes at a time can help soothe the skin. This can be repeated several times a day as needed.

Oatmeal Bath: Colloidal oatmeal has anti-inflammatory and soothing properties. Adding a cup of finely ground oatmeal to a warm bath and soaking in it for 15-20 minutes can help relieve itching and calm irritated skin. The oatmeal forms a protective layer on the skin, reducing the contact of irritants and providing a soothing effect.

Aloe Vera Gel: Applying pure aloe vera gel to the hives can help reduce redness, swelling, and itching. The gel contains compounds that have anti-inflammatory and moisturizing effects. It is important to use pure aloe vera gel without added fragrances or preservatives to avoid potential irritation.

Avoiding Triggers: Identifying and avoiding the substances or situations that trigger hives is crucial. This may involve keeping a food diary to identify potential food allergens, avoiding exposure to known environmental allergens like pollen or pet dander, and being cautious with new medications or personal care products. For example, if a person notices that hives occur after eating a particular food, eliminating that food from the diet can help prevent future outbreaks.

Stress Reduction: Stress can be a significant trigger or exacerbating factor for hives. Engaging in stress-reducing activities such as meditation, yoga, or deep breathing exercises can help manage hives. For instance, a person who experiences hives flare-ups during periods of high stress may find that practicing meditation for 15-20 minutes a day helps reduce the frequency and severity of the hives.

Regular Exercise: Moderate exercise can boost the immune system and improve overall health, which may have a positive impact on hives. However, it is important to avoid overexertion, as excessive exercise or sudden changes in exercise intensity can sometimes trigger hives. For example, starting a new, intense exercise routine might lead to hives in some individuals, so it is advisable to gradually increase the intensity and duration of exercise.

Immunomodulators

Cyclosporine: It modulates the immune system by suppressing T-cell activation. It has been shown to be effective in reducing the frequency and severity of hives in some patients with chronic urticaria. However, it requires close monitoring of blood levels, as it can have potential side effects such as kidney toxicity and an increased risk of infections. Regular blood tests are necessary to ensure the drug is working effectively and to detect any early signs of adverse effects.

Methotrexate: This drug interferes with the immune system’s cell proliferation. It may be used in selected patients with chronic hives, but it also requires careful monitoring of liver function and other potential adverse effects. Patients taking methotrexate need to have regular blood tests to check liver enzyme levels and other parameters to ensure the drug is safe for them.

Biologics

Omalizumab: It is a monoclonal antibody that targets IgE, reducing the allergic response. Clinical trials have demonstrated its effectiveness in improving symptoms and quality of life in patients with severe, refractory chronic hives. However, it is expensive and may not be widely available or covered by insurance. The high cost and limited availability can pose challenges for patients who might benefit from this treatment.