Chronic urticaria, also known as chronic spontaneous urticaria or chronic idiopathic urticaria, is a condition where patients experience recurring hives for six weeks or longer. These hives can significantly impact quality of life, causing discomfort, itching, and visible skin changes. Understanding the causes, symptoms, and treatment options is essential for people with chronic urticaria to manage the condition effectively.
What Causes Chronic Urticaria?
Chronic urticaria is often linked to autoimmune diseases, thyroid disease, or systemic disease, but in many cases, the exact cause remains unknown, leading to the term chronic idiopathic urticaria. People with chronic urticaria may develop hives triggered by allergic reactions, physical stimuli such as pressure or cold (physical urticaria), or chronic autoimmune urticaria. Chronic inducible urticaria includes types like cold urticaria, cholinergic urticaria, and delayed pressure urticaria.
In rare instances, urticarial vasculitis or celiac disease may also be associated with chronic urticaria.
What Are the Signs and Symptoms of Chronic Hives?
The hallmark of chronic urticaria is the appearance of hives that persist for six weeks or longer. Symptoms include raised, red, itchy welts on the skin that can vary in size and shape. Patients with chronic spontaneous urticaria may also experience angioedema, causing swelling around the eyes, lips, or other areas.
Chronic hives may appear suddenly and disappear within hours, only to return elsewhere, affecting quality of life. Other signs and symptoms can include:
- Burning or stinging sensations on affected areas
- Persistent itching that worsens at night
- Frequent flare-ups without obvious triggers
How Is Chronic Spontaneous Urticaria Diagnosed?
Diagnosis of chronic urticaria involves a thorough medical history and physical examination. Allergy and clinical immunology tests may be performed to identify underlying autoimmune diseases or allergic reactions. Blood work can detect thyroid disease, celiac disease, or autoimmune urticaria.
Patients with chronic urticaria are also evaluated for physical urticaria triggers such as cold or pressure. Accurate diagnosis is crucial to differentiate chronic spontaneous urticaria from acute urticaria or other forms of urticarial vasculitis.
What Are the Treatment Options for Chronic Urticaria?
Treatment for chronic urticaria focuses on controlling symptoms and improving quality of life. The mainstay of treatment often involves antihistamines, which can reduce itching and swelling. In cases refractory to standard therapy, patients may benefit from omalizumab, a biologic therapy targeting autoimmune urticaria. Corticosteroids may be used short-term for severe chronic hives or angioedema.
Additional treatment options include:
- Avoiding known triggers of chronic hives
- Managing associated autoimmune diseases
- Monitoring for inducible urticaria triggers such as cold or pressure
Timely intervention and personalized treatment plans help people with chronic urticaria manage their condition effectively.
How Can Patients Manage Chronic Hives at Home?
Patients with chronic urticaria can adopt strategies to minimize flare-ups and improve daily comfort. Keeping a symptom diary helps identify potential triggers and patterns in chronic hives. Over-the-counter antihistamines can be used as directed to control mild flare-ups.
Patients should also:
- Avoid known allergens, extreme temperatures, and tight clothing that may exacerbate physical urticaria
- Maintain good skincare practices
- Practice stress management techniques
Regular follow-up with an allergy specialist ensures appropriate adjustments in treatment and management strategies. If you or a loved one is experiencing chronic hives or chronic urticaria, schedule an appointment with NY Allergy & Sinus Centers at 212-686-6321 to receive expert care and individualized treatment options.
