Physical exam and medical history
Your doctor will do a physical exam and ask you a number of questions to try to understand what might be causing your symptoms. He or she may also ask you to keep a diary to keep track of:
- Your activities
- Any medications, herbal remedies or supplements you take
- What you eat and drink
- Where hives appear and how long it takes a welt to fade
It isn't always possible to determine the underlying cause of chronic hives. If the first-choice therapies haven't worked for you, your doctor may order one or more tests, including:
June 13, 2014
- Blood tests
- Allergy tests, though only if your medical history and food diary haven't helped identify the cause of your hives
- Tests to rule out underlying conditions
- Hives. American Academy of Dermatology. http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/hives. Accessed Jan. 29, 2014.
- Hives (urticaria). American College of Allergy, Asthma and Immunology. http://www.acaai.org/allergist/allergies/Types/skin-allergies/hives/Pages/default.aspx. Accessed Jan. 29, 2014.
- Khan DA. Chronic urticaria: Standard management and patient education. http://www.uptodate.com/home. Accessed Jan. 29, 2014.
- Goldsmith LA, et al., eds. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=740. Accessed Jan. 29, 2014.
- Khan DA. Chronic urticaria: Treatment of refractory symptoms. http://www.uptodate.com/home. Accessed Feb. 3, 2014.
- Bolognia JL, et al. Dermatology. 3rd ed. Philadelphia, Pa.: Elsevier; 2012. http://www.clinicalkey.com. Accessed Jan. 29, 2014.
- Uysal P, et al. An algorithm for treating chronic urticaria with omalizumab: Dose interval should be individualized. Journal of Allergy and Clinical Immunology. In press. Accessed Jan. 30, 2014.
- Saini SS. Chronic spontaneous urticaria: Etiology and pathogenesis. Immunology and Allergy Clinics of North America. 2014;34:33.
- Kaplan A, et al. Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy. Journal of Allergy and Clinical Immunology. 2013;132:101.
- Darlenski R, et al. Chronic urticaria as a systemic disease. Clinics in Dermatology. In press. Accessed Jan. 30, 2014.
- Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed Jan. 30, 2014.
- Casale TB. Omalizumab for chronic urticaria. Journal of Allergy and Clinical Immunology: In Practice. 2014;2:118.
- Khan DA. Alternative agents in refractory chronic urticaria: Evidence and considerations on their selection and use. Journal of Allergy and Clinical Immunology: In Practice. 2013;1:433.
- Metz M, et al. Omalizumab is an effective and rapidly acting therapy in difficult-to-treat chronic urticaria: A retrospective clinical analysis. Journal of Dermatological Science. 2014;73:57.
- Pizzorno JE, et al. Textbook of Natural Medicine. 4th ed. St. Louis, Mo.: Churchill Livingstone Elsevier; 2013. http://www.clinicalkey.com. Accessed Jan. 31. 2014.
- Sussman G, et al. Real-life experiences with omalizumab for the treatment of chronic urticaria. Annals of Allergy, Asthma and Immunology. In press. Accessed Jan. 31, 2014.
- Neuropsychiatric events with certain asthma drugs. FDA Patient Safety News: Show #89, August 2009. U.S. Food and Drug Administration. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/printer.cfm?id=1050. Accessed Feb. 6, 2014.