Very sedating

thyroid problems, liver problems, skin diseases, sinusitis) or if there is an allergic cause (i.e. This can be accomplished by a good history and physical, a few blood and urine tests and sometimes a skin biopsy.Some patients with chronic hives and elevated anti-thyroid antibodies in the blood improve when given thyroid supplement even if the thyroid function is normal.

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This is the use of hydroxychloroquine, a drug originally used for malaria.

In a clinical trial 83% improved or cleared completely when used for three months or more.

Fortunately, most patients will become less affected by sedation after they have taken the drug regularly for a while.

If that doesn't work, some doctors may try a short course of cortisone (steroids) to clear the hives completely.

Neither the patient nor the doctor can determine the cause of the hives.

Patients will often say, "It has got to be something causing these hives." The truth is hard to accept for some patients.

Then the patient can maintain the effect with the much safer antihistamines, since steroids have significant side effects if used long term.

A drug used for psoriasis and kidney transplants, cyclosporin, is almost always effective in clearing even the most severe cases of chronic hives at low doses.

Common reasons for lack of effectiveness of antihistamines are 1) the particular antihistamine used is not strong enough 2) the antihistamine is not used in a high enough dose 3) the antihistamines are not continued for a long enough period.

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