[19F] Experiencing severe and persistent hives

Patient Description

A 19-year-old female has been experiencing severe hives daily for the past week, with symptoms worsening each day. The hives are raised, red, and extremely itchy, covering her entire stomach, upper chest, elbows, shoulders, ankles, thighs, knees, and neck. Benadryl provided only temporary relief and caused drowsiness. The patient has a medical history of POTS, diagnosed in August 2023, and Hashimoto's disease, diagnosed in 2022. She is currently taking Sprentec for birth control and has no known drug allergies or other medications. There have been no recent exposures to new substances, injuries, or other symptoms such as swelling, difficulty breathing, fever, joint pains, changes in urine color, wheezing, chest tightness, or throat closure.

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Arora's Assessment

What might be happening

Based on the information you've provided, it seems that you're experiencing a condition known as urticaria, also known as hives. This condition is characterized by the sudden appearance of raised, red, and itchy welts on the skin. The exact cause of urticaria can be difficult to identify, but it's often a reaction to an allergen, stress, or unknown triggers.

Given your medical history of Postural Orthostatic Tachycardia Syndrome (POTS) and Hashimoto's disease, it's possible that your immune system may be more reactive, which could potentially contribute to the development of urticaria. However, it's also important to note that many people with these conditions do not experience urticaria, and many people with urticaria do not have these conditions.

What you can do

While waiting for a medical consultation, you can try the following to help manage your symptoms:

  1. Avoid scratching the hives, as this can worsen the itchiness and potentially lead to skin damage.
  2. Apply a cool, damp cloth to the affected areas to help soothe the skin and reduce itching.
  3. Continue taking antihistamines as directed by your healthcare provider or pharmacist. These medications can help reduce the severity of your symptoms.
  4. Try to identify and avoid potential triggers for your hives. This could include certain foods, medications, or environmental factors.

What you should look out for

You should seek immediate medical attention if you experience any of the following symptoms:

  • Difficulty breathing or swallowing
  • Swelling of your lips, tongue, or throat
  • Feeling faint or dizzy
  • Hives that persist for more than a few days or worsen over time

Please remember that while I strive to provide accurate information, I am an AI and not a doctor. It's important to consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are common triggers for hives or urticaria?

Common triggers for hives include certain foods (like nuts, shellfish, and eggs), medications, insect stings, stress, and environmental factors such as pollen or pet dander. Sometimes, the exact trigger is unknown.


How can antihistamines help with hives, and are there alternatives to Benadryl?

Antihistamines help by blocking the action of histamine, a substance in the body that causes allergic symptoms. Alternatives to Benadryl, which can cause drowsiness, include non-drowsy antihistamines like loratadine (Claritin) or cetirizine (Zyrtec).


Can autoimmune conditions like Hashimoto's disease contribute to the development of hives?

Yes, autoimmune conditions like Hashimoto's disease can sometimes make the immune system more reactive, potentially contributing to the development of hives. However, not everyone with autoimmune conditions will experience hives.


What should I do if my hives do not improve or worsen over time?

If your hives do not improve or worsen, it's important to consult a healthcare provider. They may recommend further testing to identify triggers or prescribe stronger medications to manage the symptoms.


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