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Causes
By Mayo Clinic staffChronic hives are an inflammation of the skin triggered when certain cells (mast cells) release histamine and other chemicals into your bloodstream, causing small blood vessels to leak. The exact cause of chronic hives isn't well understood — and triggers can be difficult to pinpoint. Chronic hives are thought to be caused by an immune system (autoimmune) disorder and may be linked to another health problem, such as thyroid disease or lupus.
Rarely, a reaction to medication, food, food additives, insects, parasites or infection is identified as an underlying cause of chronic hives. But in most cases, the cause of chronic hives is never identified even after testing and monitoring symptoms. Heat, cold, pressure, sunlight or other environmental stimuli may worsen chronic hives. Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others), also can worsen chronic hives.
- Kaplan AP. Urticaria and angioedema. In: Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2958607. Accessed May 2, 2009.
- Urticaria. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec10/ch109/ch109e.html. Accessed May 2, 2009.
- Austen KF. Allergies, anaphylaxis, and systemic mastocytosis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2858746. Accessed May 2, 2009.
- Bingham CO. Etiology and diagnosis of urticaria. http://www.uptodate.com/home/index.html. Accessed May 4, 2009.
- Urticaria. American College of Allergy, Asthma and Immunology. http://www.acaai.org/public/advice/urtic.htm. Accessed May 2, 2009.
- Fromer L. Treatment options for the relief of chronic idiopathic urticaria symptoms. Southern Medical Journal. 2008;101:186.
- Xyzal (prescribing information). Bridgewater, N.J.: Sanofi-Aventis. 2008. http://www.xyzal.com/pdf/pi.pdf. Accessed May 4, 2009.
- Sicherer SH. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2008. Journal of Allergy and Clinical Immunology. 2009;123:319.
- Khan DA. Chronic urticaria: Diagnosis and management. Allergy and Asthma Proceedings. 2008;29:439.
