extreme facial redness and hives

Sorry to hear what is going on with you esp having to speak in front of ppl.. I had my fourth xolair shot a week or so ago.. at first i was having joint pain but now it has eased up.. I was told i still need to take my antiistamines and I dont every day except for benedryl at night. But i have found out after about three days of not taking them I get hives again and for the last two days my face has turned bright red and hot but no hives there only on my legs so I guess I will listen even tho after this last xolair shot i thought they were gone, they werent.Every dr I have gone to told me they may never find a reason for my hives as most drs cant find reasons for them.. I try to stay gluten free as much as possible even tho i am not celiac i am sensitive to it and I have a hive flare almost right away or intense itching..It is just so hard to know the right thing to do what is working for one person may not work for you.. it seems to be all trial and error and xolair bandage.. Try not to become depressed but that is easier said than done as i became that way until i started the xolair shots and i am trying to be positive and hope this shot puts me in remission.. 

Could the facial redness be rosacea or something similar? I've never had hives that weep either, you should get that checked out. You probably want to go to a good consultant immunologist. Angiodema can affect your blood pressure which could explain the ringing in your ears and blurry vision. It might be happening in the afternoon because of tiredness and stress, or something you are eating. But it could also be the hydroxyzine wearing off maybe? I used to find me itching becoming noticeable in the evenings like that. Sometimes the hives are made worse by stress, and noticing the onset of the hives can then actually cause them to flare even more.

Alcohol can be bad news for things like that, and it's also worth trying a very strict elimination diet for a couple of months that eliminates common triggers (gluten, milk, alcohol, eggs, citrus fruits (inc. tomatoes), nuts, food additives, salicylates, sulphites (wine)). It can be food intolerance rather than allergy, so I wouldn't discount diet on the basis of allergy tests. For diets that work for autoimmunity, you could read Dr. Gundry's Diet Evolution or Plant Paradox. Also, there's a great book just published by eminent neuroscientists called Psychobiotics which covers similar material from a different angle. Both books will give you an inkling on how important diet it.

Prednisone will make you put on weight and hydroxyzine won't help either. Also, steroids can mess with your mood and sleep. From what you are writing, it sounds like this is starting to cause you a lot of anxiety. For anxiety, especially public speaking, a beta blocker like Propranolol could help (if you don't have Asthma). For itching, sleeping and anxiety, I found Gabapentin very helpful. Don't get into a situation where panic attacks start to become a problem. I'd get that addresses straight away. Finding a good therapist and doing some talking therapy can be very helpful as it's hard to underestimate how devastating urticaria is. People who haven't been through it don't understand. And the effect it has (and the drugs have) on mood and anxiety levels can make the urticaria so much worse. It can become a vicious cycle.

Apart from diet and mood, the other major factor here is sleep. You need to sort that out to get better. I'd suggest you try Gabapentin to help with your sleep. Two 300mg tablets of Gabapentin got me back to sleeping properly and left me able to function in the daytime, unlike hydroxyzine and other sedating anti-histamines which induce sedation not sleep. You need good quality and quantity of REM and NREM sleep for your body (and emotional stability) to recover. It might be worth reading the book 'Why We Sleep' by Matthew Walker.

If Gabapentin doesn't help you sleep, and you are really in a bind, Amytriptaline is very very powerful antihistamine, controls itching and will make you sleep like a stone. It can help with the daytime anxiety too if that is getting out of control. It will make you very groggy, interferes with your ability to function (driving and concentration) and is bad for appetite increases / weight gain. A good consultant also recently told me that low-dose naltraxone can help suppress the autoimmunity and itching.

Xolair can cause some reactions initially, but I wonder if you should stick with it. If not, you'd be best to get off the prednisone onto something like Dapsone or an immunosuppressant like Ciclosporine or Mycophenolate, to really get control of the hives without causing long-term health problems. For some people a course of Ciclosporine (or Xolair) can help people go into remission. Don't stay on steroids, they will ruin your health and mood.

Lastly, for the panic attacks and and anxiety and general mood, it might be a good idea to start meditation, yoga, tai chi or something similar. Any therapeutic exercise that has you concentrate on technique will help, swimming, running, golf even. Swimming and running are really good as you tend to concentrate on breathing. 

I hope you get better soon. I remember clearly the first couple of years of cold urticaria and how bad it was. It will get much better once you start figuring out your triggers and what helps you. It's very individual and takes time to work out your particular puzzle.

I get same thing but all over my body. I get xolair shots and take benedryl And pepcid. Sounds like you have mast cell activation syndrome. I have this and just been Dx with it. There are various bloodwork and 24 hour urine test they can do to diagnose this. They can also check your tryptase level. You have to see an immunologist who specializes in this. If you go on Facebook and join m as cell activation syndrome group. They can give you a list in In your area. I hope this helps

I get same thing but all over my body. I get xolair shots and take benedryl And pepcid. Sounds like you have mast cell activation syndrome. I have this and just been Dx with it. There are various bloodwork and 24 hour urine test they can do to diagnose this. They can also check your tryptase level. You have to see an immunologist who specializes in this. If you go on Facebook and join mast cell activation syndrome group. They can give you a list in In your area. I hope this helps

Hi Bill --- in regard to your doctors "thinking" it is ICU....please ask them to do the blood work that specifically identifies the condition.  It took me 4 doctors before finally my dermatologist ordered the specific blood work for diagnosing hives.  Hives totally affect your emotions and anxiety and panic attacks became a big problem for me as well...thus, I am on several anti-anxiety medications that help a lot and now I only take them when I need them.  For a while though, they were a part of my daily regimen.  I like Doxipan alot to help me sleep and since my hives tend to come at night, this helped minimize my morning break outs.  Not a big fan of Atarax, although it helps some people.  And, while I know a lot of people are against Xanax, nothing helps me as much as xanax to curb a panic attack.  The fear of breaking out can become a very debilitating factor with hives and I have lived that too.  I have now been hive free for 3 months and am taking the Xolair injections once a month.  They are affecting me for a couple of weeks with overall pain, joints, back, hands, tingling feet, etc. and my hair is falling out more than it should and I have gained almost 40 pounds during the past 8 months since my hives began.  The first two weeks after the injections, I hurt, the second two weeks are good.   I don't think that the Xolair is singularly the culprit though, I believe that the months on prednisone set me up for weight increase.  Although the weight gain is very disturbing to me, I am going to finish out my series of 6 months of injections before chancing the hives return.  My doctor has informed me that after 6 months of the injections, often the hives will stay away...sort of like going into remission.  So...having said all of that, I would encourage you to take the injections AND don't be ashamed to ask your doctor for some medication that will help you get through the anxiety and panic attacks.  And stay connected to this support group.  It has been SUCH A BIG help to me!  I wish you all the best!  It's a journey................  

Thanks to all of you for the prompt replies. So, I have already done everything you have suggested, 24 hour urine, multiple blood works, stool sample tests, etc.  And I am already taking 1-2 MG of Xanax a day when I feel the hives coming-thisis another concern because I now how addictive that can be.  I have seen 2 immunologists, an allergist , an internist and a director if residences at Emory.  Money is not an issue, its just about finding a fix.  They have all come to the same conclusion that they can't figure it out so shoot up with Xolair.  Not so sure I like that as an answer .  I spoke to a Holistic doctor today who happens to be a friend of the family and she suggested a bunch f probiotics and various vitamins-so I went and got them and am going to try that.  At this point I will try virtually anything.  I can't keep taking handfuls of antihistamines every day.  I am 6'5" and have weighed 220 since I was inc college and workout hard 4-5 days a week and yet my face looks like a balloon and I am gaining weight rapidly.  I plan to do the next 2 shots of Xolair and will keep you all posted.  Thanks again for the support, feedback and empathy.  It really is a lie altering affliction.

Bill, yes it is a life changing journey.....but, I believe that the Xolair injections will help you!  My first ones didn't really show much hope, but by my second injections, my hives were gone and have stayed gone!  We're here for you -- sending prayers for you right now!