Are biologic injections effective for chronic itchy hives?

Question

Hi doctor,

I keep getting itchy red welts all over my body for no apparent reason. Sometimes they last for hours, other times days, and antihistamines barely help.

I was told it is chronic urticaria, but we cannot figure out the cause. I have tried changing my soaps, detergents, and even my diet, but nothing has worked. It is so uncomfortable, especially at night.

Could this be autoimmune or related to stress?
I read that biologic injections, such as Omalizumab, can help alleviate symptoms in people with chronic hives. Are those safe for long-term use?

I want to stop itching and wake up without these red marks every morning.

Please guide.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns.

I understand your concern, and I know that it can be challenging to deal with a rash that occurs spontaneously.

It is likely that you are experiencing urticaria, which presents as itchy bumps that can appear suddenly and may take some time to disappear. Since this problem is recurrent, it often does not respond well to antihistamines alone.

Typically, there are allergens that trigger this condition. While you have made significant changes to avoid potential allergens, it's important to know that urticaria can sometimes be caused by a viral infection that weakens the immune system or could be autoimmune in nature, both of which can be extremely difficult to treat.

You should continue to avoid known allergens and conditions that may trigger or exacerbate the rash, such as hot showers, stress, and disrupted schedules. Effective stress management techniques, including daily exercise, staying hydrated, maintaining a proper sleep routine, and eating healthily, are essential.

In addition, you may consider taking leukotriene inhibitors like Montelukast. Rather than moving directly to biologics, starting with low doses of steroids may be more beneficial.

During flare-ups, cold compresses or cold showers can provide relief. Always opt for clothing made from natural fibers instead of synthetic materials, and wear loose-fitting clothing. Using emollients and anti-itch lotions such as Calamine may also help soothe the skin.

I hope this answers your query. Feel free to reach out anytime.

Thank you.