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Hives and Multiple Sclerosis: Causes and Management

Posted on April 13, 2022
Medically reviewed by
Amit M. Shelat, D.O.
Article written by
Sarah Winfrey

What Are Hives? | How People Experience Hives | MS & Hives | Causes | Management | Support

When you’re living with a condition like multiple sclerosis (MS) that can cause many symptoms, it’s easy to start wondering whether new physical symptoms are the result of MS. One of the common symptoms people wonder about is hives, technically called urticaria. Several MyMSTeam members have experienced these itchy, uncomfortable welts and have questioned whether MS is to blame.

Here is what you need to know about hives and MS, including what may cause them and how they can be managed. As with any new symptom, talk to your doctor or neurologist if you think you are experiencing hives. They can determine the cause and work with you to find a way of managing them that will help maintain your overall wellness and quality of life.

What Are Hives?

Hives are itchy, red bumps or lumps (welts) that may be uncomfortable or painful. They can occur when the immune system releases histamine and immunoglobulin E antibodies in response to a perceived threat. Both histamine (a signaling chemical) and immunoglobulin E (a type of protein) are involved in allergic responses.

Allergic responses are intended to protect the body from foreign invaders that may cause illness. However, these defenses are raised when they are not needed, causing reactions such as hives.

How Do People With MS Experience Hives?

Several MyMSTeam members deal with hives while living with MS. As one asked others, “Quick question: Have any of you noticed a change in your skin since your diagnosis? I wouldn’t say a rash — more like hives?”

A few members have experienced hives as a side effect of the medications they took for MS. “I had a [hard] time getting used to meds,” wrote one. “Some had bad side effects. I tried one medication and felt great on that until I had baseball-sized hives. Then, I tried another one and stopped that right away when hives started.” Another member shared that they “started with one drug but were only on it a couple months and broke out in huge hives. Then, I went on a second drug, which I started out in hives.”

Others have experienced hives as allergic reactions to over-the-counter medications, rather than as side effects from their MS treatments. “I can’t take ibuprofen or Aleve,” one shared. “They give me horrible hives that turn into welts and make my face swell so I look like an orangutan.”

The Connection Between MS and Hives

There is no known connection between MS and hives. Unlike the characteristic symptoms of MS, hives do not result from demyelination, or lesions on the myelin coating of the central nervous system (which includes the spinal cord and brain) nerve cells. This doesn’t mean that the condition will not cause hives, but it does mean that the connection is not common and that its mechanism is unknown.

MS is sometimes associated with itching — this is neurologic in origin and does not produce the red, itchy bumps associated with hives.

In addition, women are more likely to develop hives and are also more likely to have MS. Researchers do not yet know if this indicates a connection between the two conditions, or if it is a coincidence.

If you have MS and hives, ask your doctor or neurology team for medical advice. They may refer you to a dermatology expert who can help treat and manage hives and the associated discomfort.

What Can Cause Hives With MS?

There are several reasons why people with MS may develop hives.

Medication Side Effects

Several medications used to treat MS can cause hives as a side effect. Although this may not happen with everyone, talk to your doctor right away if you develop hives after starting a new MS treatment.

The majority of these medications are disease-modifying therapies — they all change the immune system to fight MS. Sometimes, these modifications can trigger the release of histamine, which can lead to hives.

Medications that may cause hives include (but are not limited to):

Allergic Reactions

Many people experience hives as an allergic reaction. This can be due to medication, as one of the above members reported. However, any allergic reaction can cause hives. People can develop hives as a response to foods, pollen, pet dander, and other allergens.

Sometimes, you will be able to determine what caused your hives. Other times, the cause may remain a mystery. In these cases, it’s important to treat the hives and then see if they return. If they don’t, it might have been due to a one-time exposure to an allergen. If they do return, work with your health care provider to figure out how to proceed.

Certain Illnesses

Some people break out in hives when they have certain illnesses, like the flu, COVID-19, or even a urinary tract infection. This may happen every time they get sick, or only occasionally.

Responses to the Environment

You can develop hives when you are too hot, too cold, too sweaty, or too stressed. Exposure to sunlight can also cause hives under certain circumstances. Some people wind up with hives when a belt, strap, or another item of clothing is pressing into and irritating their skin.

How To Manage Hives

The key to treating hives is to find out what is triggering them and avoid these triggers. This process may take trial and error. Your doctor or dermatologist can help you determine what particular substances or situations trigger your hives.

If you suspect your MS medication is causing hives, talk to your neurologist. Your doctor may be able to treat your hives effectively so you can continue with the medication. Additionally, hives may be a short-lived response that goes away as your body adjusts to a new drug. If the hives do not resolve, you and your doctor can discuss the risks and benefits of trying a different medication.

While you are waiting for your hives to go away, there are a few ways to treat them:

  • Antihistamines
  • Steroids
  • Immunosuppressants
  • Home remedies

Antihistamines

Your doctor may prescribe or recommend over-the-counter antihistamines. These medications reduce the histamines in your system, helping to alleviate the itching and discomfort associated with hives. Stronger antihistamines are also available with a prescription.

Steroids

Corticosteroids (also called steroids) can help reduce inflammation and itching. Your doctor may recommend a topical steroid cream that you can rub on your hives or give you a short course of oral steroids (such as prednisone).

Immunosuppressants

If you continue to have severe hives, your doctor may prescribe immunosuppressant drugs. Note that these may not be recommended for some people with MS — particularly those who are already taking medications that modify the immune system.

Home Remedies

You can soothe your hives at home by cooling the affected areas of your skin with a cool bath or shower or applying a cold compress. Wearing loose clothing and staying out of the sun may also help prevent the irritation that can cause or worsen hives.

Find Your Team

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 184,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you developed hives with MS? How did you manage them? Share your story in the comments below or by posting on MyMSTeam.

All updates must be accompanied by text or a picture.
Amit M. Shelat, D.O. is a fellow of the American Academy of Neurology and the American College of Physicians. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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