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15 Things to Record in Your Chronic Hives Symptom Journal

Use a journal to identify patterns in symptoms, identify potential triggers, and track your progress with treatment.

15 Things to Record in Your Chronic Hives Symptom Journal

Living with chronic hives can be frustrating and challenging. Known by the clinical name chronic urticaria, chronic hives recur and persist for a period of six weeks or longer (hives that resolve in less than six weeks’ time are categorized as acute urticaria). There are two major categories of chronic hives:

  • Chronic inducible urticaria (CIndU). With this type, hives occur in response to a physical trigger, such as cold temperatures or pressure against the skin. This type is also sometimes called chronic physical urticaria.
  • Chronic spontaneous urticaria (CSU). With this type, symptoms have no identifiable trigger, and occur for no apparent reason at all. This type is also called chronic idiopathic urticaria. The majority of cases of chronic hives are CSU.

People who are experiencing recurring or long-lasting hives are encouraged to keep a symptom journal. Keeping a symptom journal is useful for several reasons. It can help you identify patterns in your symptoms, discover or rule out potential triggers, track your progress with treatment, better communicate with your healthcare provider, and gain a better understanding of your overall health.

A symptom journal can follow any format—use a notebook and pen, keep a text file on your computer, or download an app that helps you track symptoms. The most important thing is that the format you choose works for you.

Here are 15 ideas for what to track in your symptom journal:

  • Symptoms. First and foremost, use your journal to keep track of your hive symptoms, noting appearance, changes, and severity.
  • Illness, infections, or allergies. These can trigger hives.
  • Food. A record of the foods you eat can be useful information for your healthcare provider. Depending on where you are in your diagnosis, you may be tested for food allergies or sensitivities, but do not make any major dietary changes without the guidance of a healthcare provider.
  • Places. Write down the places you go each day. Hives can result from exposure to environmental factors.
  • Weather. Temperature, humidity, sunlight, and pollen can all trigger hives.
  • Activities. Keep track of what you do, including exercise, going outdoors, and household chores.
  • Bug bites and stings. A bite or a sting can trigger hives.
  • Animals. Did you play with a pet? Pet dander can trigger hives for some people.
  • Clothing. Tight clothing may trigger inducible hives, and rough fabrics (like wool) may aggravate symptoms. Write down what you wear.
  • Habits. Be honest about things like smoking or using other nicotine products, alcohol use, and recreational drug use.
  • Stress. Make note of your stress level. Emotional and mental stress are a known trigger for hives. Persistent hives can also be frustrating and stressful. Your healthcare provider can advise you on strategies for managing stress.
  • Mood and anxiety. Anxiety and depression are more prevalent among people with chronic hives. Keep track of how and what you are feeling day to day. This is an important part of your health, and something that everyone should discuss with their healthcare provider.
  • Sleep. Hives can interfere with sleep. Keep track of the number of hours you sleep, difficulties falling asleep, how often you wake up in the night, and how rested you feel in the morning.
  • Medications. Keep a list of all the medications you take, including medications for other health conditions, over-the-counter medications, and supplements.
  • Chronic hive treatments. There are a number of different therapy options for chronic hives. Make note of the times you take your medications, any difficulties with adhering to your treatment plan (including the cost of medication), and any side effects you experience.

Medically reviewed in February 2020.

Sources:
UpToDate. "Patient education: Hives (urticaria) (Beyond the Basics)."
Merck Manual Consumer Version. “Hives.”
Melek Aslan Kayiran and Necmettin Akdeniz. "Diagnosis and treatment of urticaria in primary care." Northern Clinics of Istanbul, Feb. 2019. Vol. 6.
American Academy of Allergy, Asthma & Immunology. "Hives (Urticaria) and Angioedema Overview."
American College of Allergy, Asthma & Immunology. "Hives (Urticaria)."
Mayo Clinic. "Hives and Angioedema."
Medical News Today. "What is cholinergic urticaria and how is it treated?"
National Organization for Rare Disorders. "Urticaria, Cold."
familydoctor.org. "Hives (Urticaria)."
Kiran Vasant Godse. "Chronic Urticaria and Treatment Options." Indian Journal of Dermatology. Oct-Dec, 2009. Vol. 54, No. 4.
Susan Simpkin. "Cutaneous adverse effects of alcohol." DermNet NZ, 2011.
Sandeep Sachdeva, Vibhanshu Gupta, Syed Suhail Amin, Mohd Tahseen. "Chronic Urticaria." Indian Journal of Dermatology. Nov-Dec, 2011. Vol. 56, No. 6.
HealthLine. "Nicotine Allergy."
Gerasimos N. Konstantinou and George N. Konstantinou. "Psychiatric comorbidity in chronic urticaria patients: a systematic review and meta-analysis." Clinical and Translational Allergy, 2019. Vol. 9.
Guan-Yi He, MD, Tsen-Fang Tsai, MD, Cheng-Li Lin, MS, Hong-Mo Shih, MD, and Tai-Yi Hsu, MD. "Association between sleep disorders and subsequent chronic spontaneous urticaria development." Medicine (Baltimore), 2018. Vol. 97, No. 34.

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