On an April afternoon in Changsha, the weather still carried a bit of returning-south humidity. Ms. Li, 47, was preparing a lesson plan for an upcoming open class when she suddenly felt her arm skin itching unbearably as if bitten by countless ants. She rolled up her sleeve and saw large red rashes appearing, worse than before.

Over the past year, her body would periodically develop large hives for no apparent reason, intensely itchy, not only affecting her classroom performance but also causing restless, scratched nights. A friend suggested she see a doctor; Ms. Li originally thought it was just a “minor issue,” but the urticaria lasted for half a year and she couldn’t get rid of it.

The doctor prescribed amlawritin (a common second-generation antihistamine); it worked well at first—after about ten days of medication the rash seemed to calm. But one month later, as soon as she stopped the drug, the symptoms returned.

Seeking peace of mind, Ms. Li made the “little pill” a daily staple, taking one tablet every day. After six months, besides the skin problems, she was surprised to develop new issues: dry mouth, fatigue, decreased appetite, palpitations. She couldn’t help but wonder: Is it really safe to take antihistamines long-term? What will this regimen do to the body?

Is urticaria a "minor illness"? Recurrent episodes are the real danger

Many people, like Teacher Li, think urticaria is just a "minor illness" and that enduring it or taking a bit of medicine will get them through. But in fact, urticaria that recurs for more than 6 weeks is considered "chronic urticaria," and it involves complex immune, metabolic, and even psychological mechanisms.

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Medical data show that chronic urticaria has a higher incidence in middle-aged women, affecting about 2–5 people per 100. It is often associated with immune abnormalities, chronic infections, endocrine disorders, or persistent psychological stress, and most patients have no identifiable cause.

As a second-generation antihistamine, amlexanox (Note: original drug name "氨雷他定"—ensure correct drug identification) does improve the drowsiness, decreased attention, and other side effects of older drugs, and is regarded by many as a "safe standby medication."

But importantly, no antihistamine has been proven suitable for long-term (more than 6 months) daily use, especially for people who already have impaired hepatic metabolism, reduced renal function, or particular constitutions; the risks must be guarded against.

After six months of medication, what changes might occur?

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Medications are tools for controlling symptoms, but long-term dependence can bring entirely new health problems. Teacher Li’s case is not isolated. Studies show that long-term continuous use of antihistamines such as amenamezine has multiple potential health impacts:

Liver function abnormalities

10-30%

More than 99% of amenamezine is metabolized by the liver. In some people with long-term use, liver enzyme levels rise, with alanine aminotransferase (ALT) or aspartate aminotransferase (AST) exceeding the upper limit of normal by 10–30%. The risk increases further in the presence of chronic hepatitis or alcohol-related liver damage.

Electrolyte imbalance

Clinical studies indicate that antihistamines cause hyponatremia in approximately 4–7% of cases. This can lead to persistent dry mouth, fatigue, palpitations, seizures, and other combined symptoms; Mr. Li’s newly developed symptoms are related to this.

Tolerance and symptom rebound

With long-term use at the same dose, the body easily develops adaptation to the drug, and efficacy diminishes. Many patients find that the medication is effective initially, but after six months symptoms recur and worsen — a “the more you take, the more you need” phenomenon.

Delay in diagnosing the primary disease

Behind chronic urticaria may lurk thyroid disease, autoimmune dysregulation, chronic infection, or even tumors. Simply "suppressing" it with medication can delay more in-depth investigation and true early intervention.

Not all urticaria should be "pressed down" with drugs

In clinics, one often hears people joke: "Doctor, I have this allergic constitution, it's an old problem—can I carry some amlexanox/antihistamine on me?" In fact, indiscriminate medication like this is no better than treating the symptom without addressing the cause, and in the long run the harms outweigh the benefits.

Scientific guidelines recommend that the management of chronic urticaria should first seek triggering factors. Common triggers include diet (seafood, nuts, high-sugar foods), environmental factors (pollen, temperature changes), Helicobacter pylori infection, thyroid dysfunction, or emotional stress. Only after excluding these triggers should the decision be made whether long-term medication is needed as adjunctive therapy.

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In actual practice, patients should undergo regular allergen screening, thyroid function tests, immune evaluation, gastroscopy, etc., to determine the cause and avoid "blind medication." At the same time, if medication is taken daily for more than 4 weeks, liver and kidney function, electrolytes, and ECG must be regularly rechecked; if abnormalities are found, the treatment plan should be adjusted promptly.

Besides taking medication, how should urticaria be managed more scientifically?

Stable living habits are the most fundamental "maintenance medicine" for chronic urticaria. Authoritative consensus points out:

Regular sleep and wake cycles, and stress control

Regular sleep can reduce fluctuations in immune system function by about 20%, preventing widespread nocturnal wheals; moderate exercise can help relieve physical and mental stress.

Dietary adjustments, reduce irritants

Eat less spicy food, seafood, alcohol, and other high-allergen foods; a light diet is recommended. According to rough conversions from the China Food Composition Table, daily intake of fruits and vegetables should each be no less than 250–400 g, which helps with anti-inflammation and immune regulation.

Emotion management and psychological adjustment

Many studies show that the recurrence rate of urticaria is about 28% higher under anxiety and depression than normal. Seek professional psychological counseling when necessary.

Avoid drastic environmental changes

Rapid changes in temperature such as alternating hot and cold, intense sun exposure, or getting chilled are also important triggers for recurrent wheals; pay extra attention to these in daily life.