October 1, 2025, is World Urticaria Day.
Urticaria is the medical phrase for hives — itchy crimson welts that seem in your pores and skin. Acute urticaria occurs in response to an allergy or another supply you’ll be able to determine, like solar publicity. The welts normally go away with time or remedy. However persistent spontaneous urticaria, or CSU, are hives that happen out of the blue, final for greater than six weeks and, in contrast to acute urticaria, don’t have any identified trigger.
About 1% of individuals all over the world get CSU. Most get it after they’re of their 20s to 40s, though you will get it at any age — even childhood. Girls are twice as prone to get CSU than males, and Black and non-white individuals get it extra usually than white individuals. Decrease socioeconomic standing may also improve your possibilities for CSU.
Having hives could appear innocent, however the fixed, long-term itching from the welts can have a robust impression in your high quality of life. And, in the event you scratch them, they may turn out to be contaminated.
CSU Signs
CSU welts might seem like bug bites, however there are variations. The hives:
- Seem wherever on the physique, particularly alongside the waist, beneath the arm and within the groin
- Change shapes
- Disappear and reappear
- Transfer to completely different areas
- Look crimson or pores and skin coloration
- Flip white or disappear whenever you press on them
When you’ve been scratching, you may see scratch marks and blood as properly.
CSU Causes
In contrast to acute hives, the reason for persistent hives is unknown. Researchers consider that half the time, CSU is brought on by an autoimmune downside, and your physique is sending out histamine, which is a chemical your physique releases to combat allergic reactions. Virtually 1 in 10 individuals with CSU have an autoimmune illness, like rheumatoid arthritis or Kind 1 diabetes.
If in case you have CSU, you may discover that some conditions could make it worse, like whenever you’re careworn or have an an infection, or whenever you’re chilly.
Diagnosing CSU
Your healthcare supplier (HCP) will decide when you have acute urticaria or CSU. They’ll ask for an in depth medical historical past, searching for allergic reactions or something that would clarify the hives. A bodily examination is subsequent, wanting on the hives and the place they’re.
Blood assessments don’t diagnose CSU, however they will rule out different causes and even verify for autoimmune ailments in case your HCP suspects this could be the case.
Treating CSU
Your HCP may refer you to an allergist, immunologist or dermatologist. The primary remedy will seemingly be antihistamines (allergy medicines). Nevertheless, antihistamines aren’t efficient for most individuals with CSU. In the event that they don’t work, omalizumab, which can be used for bronchial asthma, could be the subsequent possibility, however many individuals don’t have success with omalizumab both. A 3rd possibility is cyclosporine, which suppresses the immune system.
Researchers are additionally searching for various medicines for individuals with CSU. In 2025, the Meals and Drug Administration authorised a biologic medication known as dupilumab, which controls irritation by blocking the immune system, and there are different biologics which can be nonetheless present process medical trials. These medicines could possibly be added to different therapies or assist individuals who haven’t been capable of management their CSU with present therapies.
This instructional useful resource was created with assist from Sanofi, a HealthyWomen Company Advisory Council member.
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