Itchy, discolored welts — commonly called hives or wheals — can be very uncomfortable, and people with chronic (ongoing) hives may constantly search for relief. Some anti-itch treatments, such as antihistamines, can take time to work, and you may not always have them on hand. If you feel like you can’t resist scratching any longer, could a cold compress help?

The American Academy of Dermatology suggests using a cold compress as one of several self-care options to relieve the itchiness of chronic hives. Although no strategy works for everyone, applying a cool compress is simple, quick, and usually has no side effects. If you’re looking for relief from chronic hives, a cold compress might be worth a try.

What Are Chronic Hives?

Chronic hives — also called chronic urticaria — are very itchy welts that last longer than six weeks. If you have chronic hives, you may have flare-ups as often as four to seven days a week. Both acute hives, which appear quickly and go away within a few days or weeks, and chronic hives develop because of an immune system reaction.

In chronic hives, certain immune cells called mast cells are triggered. These cells release chemicals like histamine, which lead to symptoms such as severe itch, changes in skin color, and angioedema (swelling). There are two main types of chronic hives.

Hives that happen for no clear reason are referred to as chronic spontaneous urticaria. This type is also called chronic idiopathic urticaria — “idiopathic” means the cause is unknown. Chronic inducible urticaria is triggered by something specific. Common triggers include:

• Hot or cold temperatures
• Pressure or friction on the skin
• Allergic reactions to foods like nuts or fish
• Medications, such as some nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics
• Preservatives or additives used in foods or skin care products
• Stress, exercise, and situations that raise adrenaline
• Sunlight or other sources of ultraviolet light, such as tanning beds
• Contact with certain chemicals, plants, or animals

Chronic hives can also be triggered by infections, autoimmune diseases, and other health conditions, including asthma and lymphoma. Studies suggest that between 7 percent and 30 percent of people with chronic urticaria have both types of hives — both with and without known causes.

Do Cold Compresses Help Chronic Hives?

Scratching may feel good at first but can actually make chronic hives worse, leading to more irritation and itchiness. If scratching breaks the skin, the risk of infection increases — especially if your fingernails aren’t clean.

The American Academy of Dermatology recommends some simple self-care practices to reduce the itch of chronic hives. One suggestion is to use a cool compress, which may provide quick, temporary relief. However, if cold temperatures are a known trigger for your hives, you shouldn’t use this strategy.

To make a cool compress, run a clean washcloth under cold water, wring out the excess, and place the damp cloth on your skin. You can also wrap some ice cubes in a washcloth to make an ice pack. Hold the cool compress or ice pack to the affected area for 10 to 20 minutes. You can do this several times daily.

Do Hot Compresses Help Chronic Hives?

Hot compresses aren’t recommended for chronic hives. Hot water tends to make skin irritation worse. The American Academy of Dermatology recommends taking warm (not hot) baths or showers to avoid irritating inflamed skin. Also, heat can trigger hives for some people, so it’s best to avoid using hot compresses.

Other Home Remedies for Chronic Hives

Several other at-home strategies may help you find relief, but be sure to avoid anything you know triggers your hives. Along with cool compresses, these are easy home remedies that may soothe your itch:

Anti-Itch Creams and Lotions

Anti-itch products that contain menthol, hydrocortisone, or pramoxine can relieve itchiness and soothe irritated skin. Many of these creams and lotions are available over the counter.

Calamine lotion may also help, but it can be drying, so you may also need to apply a moisturizer. Fragrance-free moisturizers can help hydrate your skin without causing more irritation.

Antihistamines

Antihistamines can help manage itchy skin by blocking the effects of histamine, a chemical that causes hives symptoms such as severe itch. Many antihistamines, such as loratadine and cetirizine, are available over the counter and are usually taken by mouth.

Some antihistamines, such as diphenhydramine, may cause drowsiness. If you need to stay alert, opt for an antihistamine that’s less likely to make you sleepy.

Loose-Fitting Clothes

Heat, pressure, and friction can trigger hives in some people. Tight clothing may rub or press on skin and make symptoms worse. Try wearing loose-fitting clothes to see if the change in wardrobe eases your symptoms.

Your clothes could also be making you too warm. To avoid overheating, choose items in breathable fabrics, like cotton clothing.

Cool Baths and Showers

A cool bath or shower may help relieve itchiness, especially if you have large areas of hives.

You can also add soothing ingredients such as oatmeal or baking soda for extra comfort. Colloidal oatmeal is a well-known remedy for skin irritation — try adding it to lukewarm water for a soothing soak.

Talk to Your Doctor

If home remedies don’t provide relief from your chronic hives symptoms, reach out to your primary care provider. They may adjust your treatment plan or refer you to a dermatologist (a doctor who specializes in skin conditions) or, if allergies are suspected, an allergist for testing.

Even if you and your doctor can’t pinpoint a trigger, it’s possible to treat chronic hives. Around 50 percent of people with chronic hives see their flare-ups stop within a year.

Join the Conversation

On MyChronicHivesTeam, people share their experiences with chronic hives, get advice, and find support from others who understand.

Have you tried a cold compress to manage chronic hives? Let others know in the comments below.