On the surface, chronic hives (also known as chronic idiopathic urticaria) may seem like nothing more than a mere annoyance.

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But the red, itchy skin welts, which can last more than six weeks, can take a toll on your self-esteem, body image and mental health. Chronic hives and stress can be a vicious cycle that worsens the skin disease.

So, what can you do? How can you take control of your life and not let chronic hives affect your mood?

Allergist Dylan Timberlake, MD, talks about the connection between chronic hives and your mental health and offers some self-care tips to help you navigate life with chronic hives.

There are two ways chronic hives can impact your mental health. First, chronic hives can affect your mental health and quality of life. Secondly, stress and anxiety can cause or trigger chronic hives.

Research shows that in people who are living with chronic hives, more than half have a moderate to severe impairment of their quality of life. They experience poor sleep, angioedema (skin swelling) and itchiness, relays Dr. Timberlake. A lot of people who have chronic hives are embarrassed to go to work or go out in public.

In fact, Dr. Timberlake says research shows that people who are living with chronic hives have a higher rate of depression and anxiety than the general population.

And when it comes to how stress affects chronic hives, Dr. Timberlake says its important to note that theres a subset of people with chronic hives who only get hives when theyre stressed or anxious. (Other potential triggers include exercise, body temperature, heat and cold.)

When we get stressed or anxious, our core body temperature increases, which for some people may be a trigger for their hives, explains Dr. Timberlake. So, you can have chronic hives that can then be worsened when you are stressed or anxious about something.

Living with chronic hives can be overwhelming, so self-care is vital to help you be the best version of yourself. Dr. Timberlake offers the following advice:

If you have chronic hives, theres a good chance it affects the quality of your sleep. Sure, you know you should get around seven to nine hours a night. But that can be tough. To help combat sleep issues, Dr. Timberlake stresses the importance of a bedtime routine that you follow every night.

I focus a lot on sleep because its so important it plays a role in depression, anxiety, daytime sleepiness and being attentive, he continues. Even a warm bath or a warm shower right before bedtime can really help with sleep.

Another big thing he discusses with his patients? Avoiding TVs and cellphones in your bedroom.

And if you take glucocorticoids, which are corticosteroids commonly used for hives, you may want to speak with your healthcare provider about alternative options.

Glucocorticoids can cause anxiety and poor sleep, and when youre already having those problems, glucocorticoids can definitely exacerbate them, he warns.

In some cases, exercise may trigger your chronic hives, as it raises your core body temperature. But exercise also releases endorphins, which can improve your overall mood.

If you know exercise is one of your triggers, it may be worth modifying how you work out and stay active. Instead of intense exercise like weightlifting or running that makes you sweaty, opt for low-impact exercises such as yoga or swimming.

Dr. Timberlake says that practicing meditation and mindfulness can be beneficial for people who have chronic hives.

Theres something called the mindfulness-based stress reduction (MBSR) program and the goal is accepting your body the way it is and living in the moment, he explains. This can be used for people with chronic illnesses to help decrease stress and anxiety and improve their self-confidence.

Lean on your loved ones family members and friends. They can be a great support system as you navigate living with chronic hives.

Theres plenty of data about the importance of the connections that we have with other people, stresses Dr. Timberlake. If youre going through a difficult time, if you dont want to go out in public and if youre not wanting to go to work, maintaining those social connections with loved ones is going to be really important for you.

Dont be afraid to open up to your loved ones and talk to them about your fears and worries. They can be a good sounding board to help you work through difficult situations and can make you feel less alone.

It can be helpful to talk to others who have chronic hives. You may have shared experiences and can offer advice, tips and guidance to one another.

A support group is a great idea because youre going to meet people at all different stages of living with chronic hives, says Dr. Timberlake.

If youre struggling with feeling comfortable going to work or out in public, it may be helpful to talk to a mental health therapist.

They can talk to you about social isolation and work with you on acceptance and decreasing your anxiety and depression, says Dr. Timberlake.

Dr. Timberlake talks to all of his chronic hives patients about their alcohol consumption, as alcohol can be a trigger.

Have you noticed that if youre drinking alcohol your hives flare up immediately afterward or are worse around the times when youre drinking? questions Dr. Timberlake. If you do notice a change, I would suggest abstaining from alcohol.

Whether its painting, reading a book or gardening, making time for hobbies you enjoy can have a positive impact on your mental health. Youll feel a sense of joy and accomplishment by spending time doing something you love.

It all comes back to having a strong social connection, notes Dr. Timberlake.

Your doctor may suggest that you keep a journal of your potential triggers and when you experience hives. You can use pen and paper or even a notes app on your cellphone whatever works best for you.

Journaling can be very beneficial for people from a self-care standpoint, encourages Dr. Timberlake. It gives you a space to document your symptoms, but also a place to track how youre feeling.

If you have chronic hives, focusing on your mental health is an important part of managing your condition. If you feel like no one understands what youre going through, dont hesitate to talk to your doctor who can help you in a variety of ways from suggesting treatment options to advising you on self-care solutions.

And as you go through it all, remember that youre not alone and you dont deserve to feel miserable.

Chronic hives can affect the quality of your life, says Dr. Timberlake. I recommend talking to your doctor about it so that we can work to get your symptoms under control. We have a lot of different medicines and nonmedical options that can improve your daily life.

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Chronic Hives and Mental Health: Self-Care Tips - Health Essentials