Autoimmune hives (urticaria) are a type of rash caused by an overactive immune system that attacks healthy skin. It may be associated with an autoimmune condition, such as autoimmune thyroid disease.
Hives are itchy red, skin-colored, or pale welts that can erupt without warning. They’re rarely dangerous but can be uncomfortable, especially if they recur often.
It can be challenging to figure out what triggers these itchy occurrences, although allergens can sometimes be a cause. When the reason for hives remains unknown, they’re said to be idiopathic.
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Autoimmune hives erupt when the body’s immune system
Autoimmune hives may be a stand-alone symptom with no obvious underlying cause. They may also occur in conjunction with diagnosable autoimmune conditions, and it’s possible to have more than one autoimmune condition at the same time.
For example, autoimmune thyroid diseases, such as Graves’ disease and Hashimoto’s thyroiditis, can occasionally present concurrently with hives.
Other conditions that may be present in those with autoimmune hives include:
- type 1 diabetes
- rheumatoid arthritis
- vitiligo
- lupus
- Sjögren’s
- celiac disease
The root cause of hives can be challenging to diagnose. Your doctor may want to rule out allergens as a first cause. To do this, you may be asked to provide an extensive history of substances you have eaten or come into contact with. You may undergo allergy testing, such as scratch tests.
A health professional will also want to know of other symptoms you have to determine if you might have any other autoimmune conditions.
Specific tests for autoimmune hives include:
- Basophil histamine release assay: A blood test that measures the release of histamine from basophils, a type of white blood cell, after exposure to stimuli.
- Autologous serum skin test: This test detects circulating autoantibodies released in response to histamine production. Blood is taken and left to clot outside the body for 30 minutes. Centrifugal force is then used to extract serum from blood. The serum is reinjected back into the body to see if hives form.
How long do autoimmune hives last?
Most hives should go away in a few hours to a few days. Hives that last for 6 weeks or longer are considered chronic. Some people may have hives for years.
Treatment for hives can vary
Once hives have erupted, oral antihistamines such as diphenhydramine (Benadryl) can quickly alleviate them. However, since diphenhydramine causes drowsiness and other side effects, it is not recommended for prophylactic use.
Non-drowsy antihistamines that block the release of histamine can prevent hives. They include:
- loratadine (Claritin, other brands)
- fexofenadine (Allegra, other brands)
- cetirizine (Zyrtec, other brands)
- desloratadine (Clarinex, other brands)
- levocetirizine (Xyzal)
Chronic hives that don’t respond to over-the-counter antihistamines may be treated with prescription medications such as:
- omalizumab, an IgG monoclonal antibody
- cyclosporine
Before exploring alternative therapy options, it’s important to note that more research is necessary to determine whether these treatments are effective.
Anecdotal evidence indicates that some people find symptom relief from autoimmune conditions using the autoimmune protocol diet. But, since autoimmune hives are not specifically caused by what you eat, dieting may not be an effective strategy for treating them. One exception to this is celiac disease, which is exacerbated by ingesting gluten. Elimination diets, on the other hand, may be helpful for finding the cause of hives due to allergens in foods.
Acupuncture is an age-old practice that may benefit treating hives of all kinds, including autoimmune hives. Despite widespread use, there is not a large body of scientific evidence published in English that supports this practice. Even so, anecdotal
Other alternative strategies include:
- reducing stress and fatigue
- applying calamine lotion directly to hives
- tepid showering
- keeping skin cool
- not wearing tight-fitting clothing
Learn more: 15 ways to get rid of hives and Home remedies for hives.
If you have hives that seem to erupt from food, product, or medication, eliminate the substance immediately. Hives caused by allergies can sometimes be associated with a serious allergic reaction, such as anaphylactic shock.
If you have chronic hives that last for 6 weeks or more, see a medical professional. In some instances, hives may be a clue that you have an undiagnosed, treatable condition.
Anaphylaxis
Anaphylaxis is a severe reaction to a trigger, such as an allergy, and is potentially life threatening.
Symptoms can develop quickly and include:
- feeling faint or lightheaded
- difficulty breathing or wheezing
- rapid heartbeat
- confusion
- anxiety
- clammy skin
- collapsing or losing consciousness
- hives
- swelling
- stomach pain, nausea, or vomiting
If you or someone nearby develops these symptoms, you should:
- Check to see whether they have an epinephrine pen. If they do, read and follow the instructions to dispense the medication.
- Dial 911 (or a local emergency number).
- Lay them down. If they have vomited, lay them on their side.
- Stay with them until emergency services arrive.
It is possible for someone to need more than one injection with an epinephrine pen. If symptoms do not begin to clear after 5 minutes, give a second injection if one is available.
There are other causes for hives besides an autoimmune condition. These include:
- allergy to things like pollen or pet dander
- viral or bacterial infection
- insect bites
- medications
- exposure to plants
Learn more: What to know if you’re breaking out in hives for no apparent reason.
Hives are also not the only skin symptom that
- blisters
- plaques
- patches
- eczema
Learn more: Everything you need to know about rashes (with pictures)
Autoimmune hives are caused by an overactive immune system that attacks healthy skin. They may be associated with an autoimmune condition, such as autoimmune thyroid disease.
Even though autoimmune hives are not caused by allergies, they often respond well to treatments for allergic skin reactions, such as oral antihistamines. Autoimmune hives may also respond well to alternative treatments such as acupuncture.
