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What causes recurrent hives?

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Posted on Mon, 28 Jul 2014
Question: I am looking for Skin/Allergy specialist . I see, ENT specialist listed, when I try to submit the question.
Is there Skin specialist in Allergy available?...

My nephew gets hives very often, rather everyday. He need to take Allegra 120 in the noon. If he take Allegra 120, hives does not appear on that day.
Lately another Doctor prescribed to take Lorfast every morning for 3 months. What is your opinion? What is preferred?
How can we avoid this allergic Hives?
What is proven medication?
And forgot to quote, the allergy test showed allergy for "Rye".
doctor
Answered by Dr. Hardik Pitroda (2 hours later)
Brief Answer:
avoid allergen, antihistaminics

Detailed Answer:
Hello,

Thank you for posting on HCM.

The condition you have referred to is called Urticaria or hives. Its an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues.

If I were your treating dermatologist, I would insist upon complete history and clinical examination. I would also order laboratory work-up like complete blood count (CBC), ESR, thyroid function test, random blood sugar level and urine and stool examination.You may have to go for specific tests like patch test, food prick test, IgE antibody levels etc for better understanding of the cause of allergy.

As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering food (rye etc) from diet.

I would also advise you various anti-histaminics for long duration( atleast 3 months). In my patients, I prefer to start with oral loratidine (lorfast) tablet in morning and levocetrizine at night time. If still there are eruptions, I would suggest updosing of levocetrizine i.e if 5mg levocetrizine doesnot relieve hives, take two tablets (10mg), if still no control take three tablets (15mg) and so on upto to total 20 mg at a single time.

Apart from anti-histaminics, oral corticosteroids can be used in different regimens.
For non- responding cases there are many other drugs like dapsone, cyclosporine, montelukast, omalizumab etc are of proven benefit and can be used in certain selected cases.

Hope this will help you in resolving your query.

Let me know if there is any more assistance required from my side.

Thank you
Dr Hardik Pitroda

Above answer was peer-reviewed by : Dr. Prasad
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Dr. Hardik Pitroda

Dermatologist

Practicing since :2010

Answered : 1489 Questions

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What causes recurrent hives?

Brief Answer: avoid allergen, antihistaminics Detailed Answer: Hello, Thank you for posting on HCM. The condition you have referred to is called Urticaria or hives. Its an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. If I were your treating dermatologist, I would insist upon complete history and clinical examination. I would also order laboratory work-up like complete blood count (CBC), ESR, thyroid function test, random blood sugar level and urine and stool examination.You may have to go for specific tests like patch test, food prick test, IgE antibody levels etc for better understanding of the cause of allergy. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering food (rye etc) from diet. I would also advise you various anti-histaminics for long duration( atleast 3 months). In my patients, I prefer to start with oral loratidine (lorfast) tablet in morning and levocetrizine at night time. If still there are eruptions, I would suggest updosing of levocetrizine i.e if 5mg levocetrizine doesnot relieve hives, take two tablets (10mg), if still no control take three tablets (15mg) and so on upto to total 20 mg at a single time. Apart from anti-histaminics, oral corticosteroids can be used in different regimens. For non- responding cases there are many other drugs like dapsone, cyclosporine, montelukast, omalizumab etc are of proven benefit and can be used in certain selected cases. Hope this will help you in resolving your query. Let me know if there is any more assistance required from my side. Thank you Dr Hardik Pitroda