Everything You Need to Know About Treating and Managing Hives

Hives aren’t only a common condition — roughly 20 percent of people will deal with them at some point in life — they’re also downright annoying, even uncomfortable to the point where sleeping, working, going to school, and socializing may be compromised. (1）幸运的是，有许多可用的治疗选择，包括您可以在家中自己做的一些治疗选择。

蜂箱可以作为单个病变或簇中出现。尽管它们似乎令人震惊，但大多数蜂箱在24小时内消失了。（（2) There’s not much you can do to make them go away more quickly during that time. But there are steps you can take to relieve the itching and perhaps prevent another hive from coming. (3)

请使用OTC抗组胺药

A 24-hour over-the-counter antihistamine likeClaritin,Zyrtec, ordiphenhydramine（（the generic form of Benadryl), can help relieve itching and discomfort, saysSarina Elmariah, MD, PhD, a board-certified dermatologist at Massachusetts General Hospital in Boston.

抗组胺药are designed to reduce or blockhistamine, a chemical in your body that’s responsible for hives’ welt-like bumps and itching. If you break out in hives again after the medicine wears off, take it for three to five days and then stop to see if you get more hives. If so, you should see your doctor, Dr. Elmariah says — and you can continue taking the antihistamine until you do so or your doctor tells you otherwise.

“Taking medication at this point is more about preventing another [hives outbreak] versus treating the existing one,” saysAdam Friedman, MD，华盛顿特区乔治华盛顿大学医学与健康科学学院皮肤病学教授。

But don't reach foraspirinand非甾体类抗炎药他说，因为它们可能会使您的蜂箱恶化。

Skip the Topical Creams

And don’t be tempted to try topical therapies, either. “Hydrocortisonemay help a little;Neosporin, as anantibiotic, will do nothing other than kill the normal bacteria on the skin; and topical Benadryl has been known to causecontact dermatitis（（anallergic reaction看起来像eczema),” Dr. Friedman explains.

Do NOT Scratch

管理蜂箱的最重要步骤之一是抵制挠痒痒的冲动。弗里德曼说，这样做可能会打破蜂巢，这可能会使您有感染的危险。以冷压或一袋冷冻豌豆的形式进行冰疗法是抑制瘙痒的最佳方法。

保湿

滋润皮肤可能会产生冷却效果 - 甚至首先冷却冰箱中的保湿霜，甚至会产生冷却效果。Anthony M. Rossi, MD, an assistant attending dermatologist at Memorial Sloan Kettering Cancer Center in New York City. (You may want to skip this remedy, though, if you get coldurticaria, or hives that result from exposure to cold. In this case, skip cold therapy.)

如果您有任何呼吸问题，则应立即寻求医疗护理。蜂箱通常与称为严重的过敏反应有关anaphylaxisand a condition called angioedema, where tissue in your face, lips, tongue, throat and even genitals can swell. (Other signs of angioedema include joint swelling, deep tissue pain, andwheezing)。两种情况下保证之旅the emergency room. (1,3)

另外，如果你有abdominal painElmariah说，或与荨麻疹相关的发烧，寻求立即医疗保健。

If you have only one outbreak of hives and you don’t have breathing difficulties, you probably don’t need medical attention. Yet if you continue to get multiple bouts of hives that continue after a couple of weeks, you may want to call a doctor, Elmariah suggests. “Most often, the hives will resolve during this time or you’ll figure out what’s causing them.”

但是持续数周的蜂箱保证去皮肤科医生。如果它们持续六个星期或更长时间，它们被认为是慢性蜂箱，这往往是由与短期或急性蜂箱相同的触发因素引起的。Rossi博士解释说：“由于皮肤科医生擅长与蜂箱合作，因此它们是获得适当治疗的最佳选择。”

医生如何诊断蜂箱

Expect to undergo a thorough physical exam. The dermatologist will also likely ask you to review your hives experience in detail, including when the hives started, if you suspect anything in particular triggered your hives, what medications you’ve tried, and what type of response you’ve gotten. Come prepared with this information.

医生还将验证颠簸（或颠簸）是蜂箱，经常在皮肤上盘旋，看看第二天是否消失了（如果是的话，那是一个蜂巢，Elmariah说）。

一旦他们确认是蜂箱，他们将努力确定扳机。罗西说：“弄清楚原因可能是其中最令人沮丧的部分，尤其是在测试没有帮助的情况下。”

You may require additional testing. If an allergy is suspected, you may need to undergoallergy testing。如果您被诊断出患有严重的过敏，医生可能会开处方epinephrine如果您意外暴露于过敏原，则自动注射器（例如Epipen）。（1）

而且，由于慢性蜂巢可以发出自身免疫性疾病的信号，因此您可能需要抽血，医生可以在许多自身免疫性疾病中寻找一种常见的抗体。在极少数情况下，当荨麻疹在24小时内不消失时，您的医生可能会做皮肤biopsyto see if there’s inflammation of the blood vessels, Rossi adds.

Treatments Doctors Use for Hives

Doctors usually prescribe antihistamines as a first course of treatment for hives. Acute cases can generally be treated with over-the-counter antihistamines like Benadryl,claritin（洛拉塔丁）,Allegra (fexofenadine),andZyrtec (cetirizine)。

If your hives are persisting (or you’ve already tried OTC antihistamines without success), your doctor may move to another class of antihistamines called H2 antihistamines, includingTagamet (cimetidine),pepcid（Famotidine）, andZantac (ranitidine)（（all require a prescription); up the dose of antihistamines (some as high as four times); or combine several antihistamines, Friedman says.

In some cases, your doctor may prescribe an oral steroid, such asprednisone,如果你的蜂巢仍然没有回应。口服steroids are stronger, but can cause more significant side effects than antihistamines. (3)

If you’re still not seeing results, your doctor may recommend even stronger medications, like an injectable prescription medication calledomalizumab (Zolair)。There’s also evidence that some off-label drugs like环孢菌素（restasis）, light therapies like narrowband UVB phototherapy, and维生素D补充可以帮助。一些研究，包括2014年4月发行的一项研究过敏，哮喘和免疫学的年鉴, have shown that 4,000 international units of vitamin D a day is effective, Friedman says. (4)

重要的是要注意，您不应该尝试在没有医生的指导下自行服用大剂量的维生素D或其他标签的药物。弗里德曼说，没有一个治疗对所有人都有用。对于某些人来说，这种疗法可能不安全。

The best prevention strategy is perhaps the most obvious: Avoid your triggers.

For example, if pressure on your skin gives you hives, skip the tight clothing and opt for looser-fitting clothes. If the sun is your trigger, avoid too much direct sun when you can and always wear sunscreen, which is a wise idea even if you’ve never gotten a hive in your life, Elmariah says.

她补充说，如果皮肤病学（否则称为刮擦皮肤）使您爆发，避免羊毛，刺激性化学药品和香精，刺激性肥皂，以及使用润肤剂来滋润皮肤，肯定会有所帮助。

Getting hives every time you锻炼? Consider taking a long-acting antihistamine like Claritin before your workout and exercising in an air-conditioned facility. “You’ll still sweat and you could get hives, but by surrounding yourself with cooler temperatures, you’ll reduce the symptoms,” Elmariah says.