October 1, 2025, is World Urticaria Day.
Urticaria is the medical phrase for hives — itchy purple welts that seem in your pores and skin. Acute urticaria occurs in response to an allergy or another supply you may establish, like solar publicity. The welts normally go away with time or remedy. However persistent spontaneous urticaria, or CSU, are hives that happen all of the sudden, final for greater than six weeks and, not like acute urticaria, haven’t any recognized trigger.
About 1% of individuals around the globe get CSU. Most get it once they’re of their 20s to 40s, though you may get it at any age — even childhood. Ladies are twice as more likely to get CSU than males, and Black and non-white individuals get it extra typically than white individuals. Decrease socioeconomic standing may improve your possibilities for CSU.
Having hives could appear innocent, however the fixed, long-term itching from the welts can have a robust influence in your high quality of life. And, when you scratch them, they might change into contaminated.
CSU Signs
CSU welts might appear to be bug bites, however there are variations. The hives:
- Seem wherever on the physique, particularly alongside the waist, underneath the arm and within the groin
- Change shapes
- Disappear and reappear
- Transfer to totally different places
- Look purple or pores and skin coloration
- Flip white or disappear while you press on them
For those who’ve been scratching, you may see scratch marks and blood as properly.
CSU Causes
Not like acute hives, the reason for persistent hives is unknown. Researchers imagine that half the time, CSU is attributable to an autoimmune downside, and your physique is sending out histamine, which is a chemical your physique releases to combat allergies. Virtually 1 in 10 individuals with CSU have an autoimmune disease, like rheumatoid arthritis or Kind 1 diabetes.
When you’ve got CSU, you may discover that some conditions could make it worse, like while you’re confused or have an an infection, or while you’re chilly.
Diagnosing CSU
Your healthcare supplier (HCP) will decide you probably have acute urticaria or CSU. They’ll ask for an in depth medical historical past, in search of allergic reactions or something that might 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’ll rule out different causes and even test for autoimmune illnesses in case your HCP suspects this is perhaps the case.
Treating CSU
Your HCP may refer you to an allergist, immunologist or dermatologist. The primary remedy will possible be antihistamines (allergy drugs). Nevertheless, antihistamines aren’t efficient for most individuals with CSU. In the event that they don’t work, omalizumab, which can also be used for bronchial asthma, is perhaps 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 in search of different drugs for individuals with CSU. In 2025, the Meals and Drug Administration authorized a biologic medication known as dupilumab, which controls irritation by blocking the immune system, and there are different biologics which might be nonetheless present process scientific trials. These drugs could possibly be added to different therapies or assist individuals who haven’t been capable of management their CSU with current therapies.
This instructional useful resource was created with assist from Sanofi, a HealthyWomen Company Advisory Council member.
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