How to manage recurring itchy hives at 25?

Hi,

Welcome to icliniq.com.

I understand your concern.

Based on your symptoms, this appears to be chronic urticaria (a condition where itchy, raised hives recur frequently and last for more than six weeks). In most cases, these bumps come and go within a few hours and recur unpredictably.

Possible triggers may include:

• Stress.

• Heat.

• Exercise.

• Certain medications.

However, in many patients, no definite cause is found. This is called chronic spontaneous urticaria (hives that occur without an identifiable trigger).

Recommended tests:

• CBC (Complete Blood Count test) – checks for blood abnormalities or infections

• ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein) – measure inflammation in the body

• Thyroid profile – checks for thyroid-related causes

• Kidney and liver function tests – to rule out organ-related problems

(Allergy tests are not always reliable in this condition and may give false positive results.)

Treatment Plan

Step 1 (First-line, for 1 month):

• Cetirizine 10 mg tablet (an antihistamine that reduces allergic itching and hives) – take once daily at night for 4 weeks.

• If hives persist, increase to 10 mg twice daily (morning and night) after 1 week.

Step 2 (If symptoms are not controlled in 4 weeks):

• Cetirizine 20 mg twice daily (maximum dose, under medical supervision) – continue for another 4 weeks.

• Add Montelukast 10 mg tablet once daily at night (a leukotriene receptor blocker that helps reduce allergic inflammation) – for 1 month.

Step 3 (If resistant after 2–3 months):

• Consider Omalizumab injection 300 mg subcutaneous (an antibody treatment given under the skin that blocks the allergy pathway) – once every 4 weeks as long-term therapy. This decision should be made by a dermatologist or allergist.

 I hope this helps.

Kindly revert if there are any queries.

Thank you.