Hello John, I understand how uncomfortable and frustrating this must be for you. Based on your description it seems like you are experiencing chronic urticaria.
This can occur due to immune system over-reactivity or allergy.
You have to find out your triggers. Generally they are - stress, temperature changes, certain foods or (seafood, nuts, eggs, preservatives) or even unknown causes. As I said, you have to figure out after what your symptoms increase. What you can do now is -
Tab. Levocetirizne 5mg, at night daily × 15 days.
Keep a dairy of what you eat, activities or situations before hives appear.
Skin Care – Avoid hot showers, harsh soaps; apply gentle moisturizer.
Don’t keep taking steroids or antibiotics repeatedly, unless prescribed for a proven infection.
If you develop swelling of lips/tongue, difficulty breathing, dizziness → this may be angioedema/anaphylaxis (emergency) - consult a family physician or a dermatologist.
Since your hives have lasted >6 weeks, you should meet a Dermatologist or Allergist for proper evaluation (sometimes blood tests, thyroid tests, or allergy panel are needed).
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med
You have chronic hives that keep recurring, which is often immune-mediated or allergy-related rather than caused by infection, so short courses of steroids or antibiotics usually don’t provide lasting relief. Long-term management with non-sedating antihistamines, trigger identification, and sometimes additional immunomodulatory therapy is typically needed. Please consult a dermatologist or allergist for a proper diagnosis and a safe, effective long-term treatment plan.
Investigation:
CBC, ESR, CRP. LFT, RFT, Thyroid profile (TSH, Anti-TPO antibodies). ANA (autoimmune screening). Urine routine
This looks like chronic urticaria, not infection → antibiotics are unnecessary. Mainstay = regular non-sedating antihistamines (long-term, daily, not just when hives appear). Work-up should rule out autoimmune and thyroid causes.
1.Chronic hives (urticaria) often happen due to an overactive immune response. It may be triggered by allergies, infections, stress, food additives, temperature changes, or sometimes without a clear cause. Steroids and antibiotics usually help only temporarily and are not long-term solutions.
2.The dark marks you see are called post-inflammatory hyperpigmentation. They are not dangerous, but they take time to fade. Scratching makes the marks worse, so avoiding irritation is very important.
3.A doctor may recommend blood tests, thyroid profile, allergy testing, and sometimes stool or urine tests to rule out hidden infections or allergies that may trigger hives. Identifying the cause can change the treatment completely.
4.The mainstay for chronic hives is non-sedating antihistamines (like cetirizine, levocetirizine, or fexofenadine) taken daily under supervision, sometimes in higher doses. If standard antihistamines fail, doctors may add montelukast, omalizumab injections, or immunomodulators depending on severity. These are far safer long-term than repeating steroids.
5.Keep a diary of foods, medicines, and situations when hives worsen. Avoid alcohol, seafood, peanuts, artificial food coloring, or excess stress if you notice a link. Wear loose cotton clothing, avoid very hot showers, and keep skin moisturized. Apply soothing calamine or aloe vera lotion for itching.
6.Chronic hives can last for weeks or months but are not usually dangerous. With the right allergy work-up and consistent treatment, most people gain full control. The dark marks will gradually fade once the flare-ups stop.
Hi John, I see you have been facing hives for 8 weeks. I understand how distressing this must feel — having hives (urticaria) that last almost 2 months is considered chronic urticaria if they persist beyond 6 weeks. Most cases of chronic urticaria are not due to infection or allergy. Often, the immune system gets overactive and releases histamine in the skin. Many times, we never find the exact cause (called chronic spontaneous urticaria). Avoid Stress, infections, hot showers, scratching, certain foods (shellfish, nuts, eggs), medications (NSAIDs, antibiotics). Dark spots after healing are likely post-inflammatory hyperpigmentation, common in darker skin tones after inflammation. Your earlier medications won’t work because Prednisone (steroid): Helps short-term, but hives often come back after stopping. Long-term use is risky. Cephalexin (antibiotic): Hives are rarely due to bacterial infection, so this usually won’t help. You should take: Cetirizine 10 mg, or Loratadine 10 mg, or Fexofenadine 180 mg (once daily). May also include montelukast. The dose can be increased to 2-3 x. Avoid Heat, alcohol, stress and painkillers If you take any. If any of these appear Swelling of lips, tongue, throat (angioedema). Difficulty breathing or swallowing. Very widespread rash with fever or joint pain. Then visit a doctor urgently. Hope this might have helped you a little.
Hi John,
It seems to be Urticaria. But need investigation. Please do CBC THYROID PROFILE ESR/CRP IgE Lft/Rft Antibiotics and steroids will not help. You may need Anti histamines after analysing reports.
Meanwhile : Avoid fermented/ processed foods Apply Lactocalamine over hives.
I hope this clears your query Thank you.
Hello Your symptoms need detailed history, proper examination and appropriate management. Consult a DERMATOLOGIST for best opinion.
Don’t take any medicines without consultation.
Hi Dear John, Kindly donot panic Urticaria is a condition that occurs due to allergic response Some get after food intake or contact irritant or some insect bites Kindly look into the cause of it and when it occurs Can do Serum IgE levels and Absolute eosinophil count Can Do C1 Esterase enzyme levels Kindly take Lactocalamine lotions and apply over the skin TAKE CETIRIZINE 10mg 0-0-1 for 5 days Take care
It sounds like you’re dealing with chronic urticaria, a form of hives that persists for more than six weeks. These can be incredibly frustrating, especially when treatments aren’t providing relief. Hives can be triggered by various factors—like stress, certain foods, medications, temperature changes, or even pressure on the skin. Since medications like prednisone and cephalexin aren’t resolving your symptoms, it’s crucial to consider other possibilities and explore additional strategies. First, review any recent lifestyle changes, new foods, or stress factors that might be contributing. Sometimes keeping a diary of your daily activities, foods, and symptoms can help identify any patterns or triggers. Antihistamines are often the first line of treatment for chronic urticaria and these are generally safe for long-term use. Over-the-counter options include cetirizine or loratadine, but sometimes, increased doses may be required based on a healthcare provider’s direction. In some cases, adding an H2 blocker like ranitidine or a leukotriene antagonist like montelukast might be beneficial. If these common strategies still aren’t effective, other options include omalizumab injections or cyclosporine, but these require a specialist’s involvement. If you haven’t yet, seeing a dermatologist or allergist might provide more targeted insights and treatment. Given the persistence of your symptoms and the appearance of dark spots post-healing, it’s also important to rule out other underlying skin conditions or systemic causes with proper diagnostic tests. Please seek a thorough evaluation from a healthcare provider who can integrate these insights with your personal medical history and tailor recommendations appropriately.
