Urticaria, a rash also known as hives, are red blotchy and itchy lumps that can appear anywhere on the body in various shape and size. It may also cause a burning or stinging sensation. Angioedema (swelling of the eyes and lips), can sometimes occur with it. Hives and swelling usually disappear within minutes or hours and can come and go for days or weeks. Read more about causes.
Depending on the duration of symptoms, urticaria is classified as acute (less than 6 weeks) or chronic (more than 6 weeks). It is further classified into inducible (known triggers) or spontaneous (trigger not identified). Triggers may include cold pressure, sunlight, heat, water or sweat.
What is
Chronic Spontaneous Urticaria
Chronic spontaneous urticaria results from an overactive immune system that triggers mast cells to release histamine without an external trigger. It occurs spontaneously as the mast cells become increasing sensitive with a low threshold for releasing histamine. Sleep, stress and hormones can affect mast cell activation.
Treatment
Aim of the treatment is to be symptom free ie. no more hives, itch or swelling.
Treatments available include:
- Antihistamines: first line of treatment. They block the histamines released by mast cells. Sometimes higher doses or several antihistamines are used together.
- Corticosteroids: oral or injection. They can temporarily reduce swelling providing short term relief.
- Biologics (Xolair injections): for individuals already receiving antihistamines but still symptomatic. It works by blocking the antibody IgE that activates mast cells.
Our dermatologist will assess your urticaria and guide you to the most appropriate treatment
Pathophysiology
Urticaria results from the activation of immune cells called mast cells, which release histamine and other chemicals. Histamine dilates blood vessels causing fluid to leak into the skin resulting in local swelling and hives.
