Hives That Won’t Go Away: What Are Your Treatment Options?

If you’ve been dealing with persistent hives (urticaria) that won’t go away, you’re not alone. While most hives disappear within hours or days, chronic hives can last for weeks, months, or even years. The good news? There are multiple treatment options that can help control symptoms and improve your quality of life.

First-Line Treatments: Over-the-Counter Options

Most mild hives respond well to simple treatments, including:

• Non-drowsy antihistamines – Cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra)
• Traditional antihistamines (for nighttime relief) – Diphenhydramine (Benadryl), hydroxyzine
• Cool compresses – Helps reduce itching and inflammation
• Avoiding triggers – If a specific food, medication, or environmental factor is causing flares

When First-Line Treatments Don’t Work: Next Steps

If hives persist despite OTC medications, your doctor may recommend:

1. Higher doses of antihistamines – Some people need double or quadruple the standard dose.
2. H2 blockers – Medications like famotidine (Pepcid) can help by blocking a different type of histamine receptor.
3. Short-term corticosteroids – Prednisone may be used for severe flares, but it’s not a long-term solution.
4. Leukotriene inhibitors – Montelukast (Singulair) is sometimes added for additional relief.

Advanced Treatment: Biologics for Chronic Hives

For chronic idiopathic urticaria (CIU) or autoimmune hives, biologic medications can help when other treatments fail:

• Omalizumab (Xolair) – A biologic injection that blocks IgE, reducing hives in many patients.
• Cyclosporine – An immunosuppressant used in severe, treatment-resistant cases.
• Methotrexate or other immunomodulators – Used for autoimmune-related hives.

When to See a Specialist

You should see an allergist or immunologist if: ✔️ Hives last more than six weeks.
✔️ Standard antihistamines aren’t working.
✔️ You have angioedema (swelling of lips, face, or throat).
✔️ Hives are interfering with sleep or daily activities.
✔️ There are signs of autoimmune disease (e.g., joint pain, fatigue, thyroid issues).

FAQ: Persistent Hives and Treatment

Q: Can chronic hives go away on their own?
A: Yes, but it may take months or even years. Treatment can help manage symptoms while you wait for them to resolve.

Q: Will allergy testing help find the cause?
A: Allergy testing is useful for acute hives, but chronic hives are usually not allergy-related.

Q: Are chronic hives dangerous?
A: Most are not life-threatening, but if you experience throat swelling or difficulty breathing, seek emergency care.

A Personal Story

My patient, Ben, had daily hives for over a year. Standard antihistamines weren’t enough, but after starting omalizumab injections, his symptoms finally came under control. He went from constant itching to nearly hive-free within weeks!

If hives are disrupting your life, don’t suffer in silence—effective treatments are available. Talk to a specialist to find the right approach for long-term relief!

What are you waiting for?  If you or your child need help controlling allergies or if you think you need testing or treatment or that you might be a good candidate for allergy shots, Dr. Wendt and her team staff at Relieve Allergy, Asthma & Hives would love to help. Call for testing or treatment today!

Call 480-500-1902 or request an appointment at https://relieveallergyaz.com/contact now!  Begin your allergy testing journey with Dr. Wendt at Relieve Allergy in Scottsdale, Arizona—It’s time to take care of yourself!

Learn more about Dr. Wendt and Relieve Allergy Asthma & Hives at www.relieveallergyaz.com or connect with us: https://www.facebook.com/RelieveAllergy/, https://www.linkedin.com/in/julie-wendt/, https://x.com/RelieveAllergy, https://www.instagram.com/relieve_allergy/ or https://www.youtube.com/@JulieWendt-qx7jm.

Did you know? Dr. Wendt wrote the book on allergies.  Buy it NOW!

Relieve Allergy Asthma & Hives is located near Kierland Commons, 21803 N. Scottsdale Road Ste. 200, and has convenient evening and morning hours to accommodate your schedule. Dr. Wendt is also available for telemedicine appointments as appropriate. Most insurance plans are accepted.

DISCLAIMER: This blog is not meant to substitute for medical care by an Allergist-Immunologist nor is it intended to provide medical advice or imply a Physician-Patient relationship with its readers or their family. It is intended to provide guidance, direction, and moral support from someone experienced in testing and treating allergies. This is also not meant to be a “do-it-yourself” manual or a “how to” overcome your allergies. Some of the issues mentioned, whether allergic or look-a-like, can be dangerous or if left unchecked, deadly. Please develop a relationship with a Physician you trust to help you with diagnosis, advice, questions, and treatment regarding your and your family’s medical conditions.