My skin swells in patches over my neck, shoulders, back, head, and some regions of my legs and arms. What should I do?

Q. What to do for patchy swelling over my neck, shoulders, back, head, and some regions of my legs and arms?

Answered by
Dr. Dhepe Snehal Madhav
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Sep 01, 2022 and last reviewed on: Sep 20, 2023

Hi doctor,

What are these? Are these hives? I am breaking out almost daily; my skin swells in patches over my neck, shoulders, back, head, and some regions of my legs and arms. At first, it started probably about three months ago in tiny patchy areas near the top of the shoulders in the back of the head but more recently, it is growing in size and has spread all over the body. Zyrtec would help at first, but now it seems like the body is becoming immune to Zyrtec, and the patches of swelling on the skin are increasing. My mom suffered from the same condition, and it went undiagnosed. Zyrtec was taken for swelling on the skin, and no other medication was taken. I recently went in and got a complete physical check-up with my primary care physician. The laboratory results were normal.



Welcome to

I understand your concern. It is chronic urticaria (a frequently occurring skin disease). In urticaria, the localized wheel is surrounded by an area of itchy redness. Cutaneous hives may last for 30 minutes to 24 hours. The cause could be physical, autoimmune, vasculitis, constant pressure or vibration, cholinergic like emotional, exercise, cold, aquagenic, drugs, foods such as shellfish or eggs, nuts, berries, etc. Inhalants such as grass pollens or animal dander, house dust, insect bite, infections such as bacterial or viral, any illness. Identify and remove the trigger factor like food, infection, or drugs. Eliminate risk or trigger factor which aggravates urticaria. Follow this treatment plan as mentioned below. Tablet Loratadine 10 mg once daily after breakfast for ten days. Tablet Teczine M (Levocetirizine and Montelukast) once at night after food for seven days. Use Calamine (Pramoxine) lotion three to four times daily for ten days. Tablet Roxid (Roxithromycin) 150 mg once a day after food for five days. Ensure proper hygiene with the avoidance of irritants.

Hi doctor,

Thank you for the reply. Can you give me a prescription for these medications?



Welcome back to

I understand your concern. You can get this over the counter. If there is abdominal pain, take tablet Zentel (Albendazole) 400 mg STAT (immediately, only once). The mainstay of treatment is antihistaminics. Combining Calamine lotion with Desonide cream or lotion reduces swelling or redness. Tablet Wysolone (Prednisolone) 5 mg before breakfast for three days. Sometimes infections like URTI (upper respiratory tract infection) or GIT (gastrointestinal tract infection) may cause it. However, the exact chronic cause remains unknown. The autoimmune system, chronic infection, and thyroid play their role. Avoidance of precipitating or provoking causes is curative in the case of urticaria. Teczin M (Levocetirizine and Montelukast, mast cell stabilizer ) are helpful in recalcitrant cases. Follow up with blood test CBC (complete blood count), ESR (erythrocyte sedimentation rate), absolute eosinophil count, urine analysis, stool examination for ova or cyst, blood chemistry profile, ANA (antinuclear antibody test), hepatitis B, and C antigen and antibody test, thyroid profile. Dermocalm lotion or Calamine lotion is another option to soothe lesions. Azac soap for bathing for two months. Follow the treatment mentioned above.

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