Vanessa Lachey — actor, television host, and former Miss Teen USA — remembers her first experience with hives.
“I was eight years old, almost nine. I woke my dad up, and we didn’t know what was going on. He put me in an ice bath. I think back in the day, they thought, ‘Oh, this will help relieve her skin.’ But let me tell you, I was screaming,” Lachey tells Healthline.
As soon as Lachey was out of the ice and back in bed, the itching was back.
When most of us think of hives (also called urticaria), we think about occasional allergic reactions — itchy bumps that vanish shortly after popping up.
For some, they arrive after exposure to known triggers or as a reaction to an allergen.
But for others, like Lachey, hives can come without reason.
“The thing is, I don’t know when they’re gonna come,” Lachey says. “I’ve been allergy tested, and I have an intolerance to things that I try to avoid, but it can be anything from stress, to elements in the weather, to fabrics, to something in the air; anything.”
In addition to being unpredictable, Lachey’s hives also tend to linger.
“It can be a hive on my face, like a welt that lasts a few hours or a few days. Or it can be a rash on my body that lasts a week or two. I’ve had some before on my arms, and I’ll see traces of it for over a week,” she explains.
After dealing with hives for essentially her entire life, Lachey has finally found some relief through a new medication. She spoke with Healthline about tips for hives, how to navigate a flare-up, and her excitement over a new treatment that works with her daily life.
Healthline chatted with a couple of doctors about hives. While neither of them have treated Lachey for this condition, they say that her experience isn’t uncommon.
Anjuli Mehrotra, MD, an allergist/immunologist in the San Francisco Bay Area, explains that hives are usually divided into two categories: acute and chronic. “Acute hives are hives that are episodic and generally last for less than six weeks. If the hives last
Many cases of chronic hives, according to Mehrotra, don’t have known triggers and are considered to be a condition called chronic idiopathic urticaria (CIU).
“In this condition, none of the usual triggers are responsible for the hives (foods, drugs, environmental triggers, viruses, etc.). “It can be very frustrating to have hives without any obvious trigger,” Dr. Mehrotra says.
Laura Purdy MD, a board-certified family medicine physician says idiopathic is basically, “a fancy medical word for ‘we have ‘no idea what causes this.'”
CIU affects nearly 1.6 million people in the U.S. and is most commonly seen in
Mehrotra says both adults and children can experience chronic hives.
Although, as she notes, children tend to have less severe cases, responding better to antihistamines treatment. “Children also tend to have a shorter duration of chronic urticaria compared to adults,” she says.
This seems to be the case with Lachey’s children, who also experience hives but on a level less severe than Lachey.
“They’ll get hives around their neck, their face, and their little legs and arms,” Lachey says. “I have pictures of me holding my newborns and all of them would get it. So, it’s really interesting, we’re clearly connected,” she laughs.
Dr. Purdy says it’s possible that certain types of hives can be hereditary, or run in families. “Hives are a type of allergic reaction, so the predisposition to be sensitive to certain triggers can be common among family members,” she explains.
One
Hives can come in many shapes and sizes.
In addition to the potential of swelling or welting, hives are rashes that often lead to extreme itching, and Mehrotra says that can vary size. “They can be as small as a mosquito bite size, but can cluster and eventually coalesce into larger hives that can become quite large.”
Lachey experiences a range of hives. “I get tiny breakouts, I get big breakouts. They’re either are welts or they’re rash hives,” Lachey explains.
For some, the itchy feeling can be intense, causing serious pain and discomfort. “You literally feel it from the inside,” Lachey says. “You feel the pain and the tingling and the itchiness from the inside; there’s nothing that scratching does.”
Lachey recalls one painful breakout she experienced directly after giving birth to her first son. “That one was very severe; that one brought me to tears,” she says.
“I was so grateful to finally be home. My husband said, ‘You can’t even enjoy being home in your bed’ because I was up crying and itching.”
While hives can be unpredictable, there’s a long list of known triggers for hives, including some allergens.
Mehrotra says this can include:
- exposure to a food allergen
- certain types of environmental allergens (typically grass, pollen, or animal dander)
- drug allergies (antibiotics or certain anti-inflammatory medications called NSAIDs
- certain types of viruses
“A majority of the time, we cannot identify a particular cause for chronic hives, but we can see hives chronically due to some physical conditions (in association with cold, heat, pressure, exercise, sun, etc.) or occasionally associated with autoimmune diseases (thyroid disease, diabetes, celiac disease, rheumatoid arthritis, etc.), though this is more rare,” Mehrotra says.
Lachey knows some of her triggers, but because of her work, some are unavoidable. “I do travel, and I do work a lot. So, it (triggers) could be anything, anywhere, anytime. I honestly don’t know. Sometimes, yeah, it is stress. Sometimes it’s extreme weather changes; being a hot day going into a cold set.”
Working in front of the camera with hives proves to be tricky.
“We’ve changed clothes a few times, where I get sleeves for the arms, but there’s one episode of ‘NCIS’ where you see this welt on my left eye. It looks like I was hit in the eye or it looks like a bee sting. But it was a welt that did not go away for the time we were filming that episode — and that I think was a stress hive.”
Hives have popped up in the glam chair too, Lachey says. “The makeup artist will say, ‘You have a hive right here’ and I’m like, ‘Okay, it’ll go away.’”
While the crew tries to figure out if it’s a certain makeup brush or product, Lachey explains it could be anything. “I’m like, don’t freak out, it’s me. It’s not you. It’s me and it’ll go away.”
Because everyone is a little different, it’s important to consult your doctor on the best method of treatment. In addition to oral or topical medication, figuring out potential triggers can be helpful as well.
Medication
Your doctor can determine the best course of treatment for your hives. They may suggest prescription options, like omalizumab (Xolair), corticosteroids, or immunosuppressants.
It’s also possible to find relief from over-the-count treatments like antihistamines.
Lachey recalls her frustration trying to find a treatment that works for her. “All of the medications, they make you drowsy,” she explains. After her first child was born, she didn’t feel comfortable using drowsy medications. “I was already sleep-deprived — I was a new mom. I was also breastfeeding, so I was like, ‘I can’t do this.’”
Lachey didn’t want to opt for topical treatments either. “I didn’t want them all over my body while I’m holding my newborn. So, I just kind of surrendered and said this is something I just have to live with.”
After learning about a new non-drowsy, FDA-approved antihistamine by Allegra formulated to treat hives specifically, Lachey knew she was interested in testing it out and is now the spokesperson for the new over-the-counter medication.
“It’s specifically formulated to relieve the itching due to hives and reduce the hives themselves. It’s the only over-the-counter one that you can take orally that is 24-hour relief and is non-drowsy,” she said.
“Those factors are, for me, game-changers.”
Lachey brings it with her everywhere. “I had it with me when we were shooting ‘Love is Blind’ seasons four and five. And I’m now gonna bring it to work for ‘NCIS: Hawaii.’ It’s gonna be something that’s in the makeup trailer no matter what — I’m excited about it,” she says.
Keeping comfortable
Mehrotra has a short list of things you can do that may offer some relief and possibly help with prevention.
- stay in cool climates (turn on the AC during hot summer months)
- take cold showers or baths
- wear loose, cotton clothing
- moisturize the skin well with a hypoallergenic moisturizing cream at least twice daily
Simple and consistent products
People who experience hives many benefit from a consistent skin care routine. “Try to find a routine that works for you and then stick to that,” Lachey suggests.
“Unfortunately, people with hives can’t be too experimental with lotions or products, even sunscreens. You have to be very specific about what your skin is irritated with, so when you find a good rhythm and groove, and you have relief, stick to that.”
“I recommend fragrance-free products and keeping the products to a minimum,” Mehrotra adds.
Mehrotra also suggests choosing products with simple and hypoallergenic ingredients. Keep in mind that there’s no regulation on the term “hypoallergenic,” so you’ll have to check labels carefully when shopping, looking for ingredients that may be possible irritants or triggers for you.
Patch tests are a great way to test the waters with a new-to-you product — just apply a little of the product to a small area of your skin. Keep an eye out for any reactions over the next day or so. Depending on your skin tone, this could be redness, itching, or another sort of irritation.
Lachey says she focuses on keeping her skin clear and clean, sticking only to certain products. This way, when hives come, she knows it wasn’t thanks to a triggering product.
“I know it’s not as simple as that,” she says. “But you can’t be that girl who’s like ‘Oh, can I borrow a sunscreen?’ If you have hives, you have to find what works for you.”
Purdy says an allergist/immunologist is the best specialist to see, and sometimes a dermatologist can also add additional input. “There is blood work that can be done and other types of testing that can search for the cause,” Purdy says.
If you are having trouble managing hives or if you are having worsening symptoms, Mehrotra agrees it would be very helpful to see a doctor.
“It’s quite rare for hives to be a sign of a serious illness, but if you have hives lasting longer than six weeks, it would be good to get checked out by a physician,” she says.
Some hives are unpredictable, painful, and inconvenient, to say the least. But, there are ways to manage your discomfort.
It’s a good idea to visit your doctor, especially if your hives interfere with your daily life, and last for six weeks or longer. Your doctor may suggest prescription oral or topical medications or an OTC option like Allegra Hives.
Remember to be mindful of any triggers you may have and keep a consistent, simple skin care routine that works for you.