Continual Spontaneous Urticaria 101 – HealthyWomen
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’ll be able to establish, like solar publicity. The welts often go away with time or remedy. However continual spontaneous urticaria, or CSU, are hives that happen abruptly, final for greater than six weeks and, not like acute urticaria, haven’t 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 folks get it extra usually than white folks. Decrease socioeconomic standing can even enhance 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, should you scratch them, they might change into 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 totally different areas
- Look purple or pores and skin coloration
- Flip white or disappear if you press on them
If you happen to’ve been scratching, you would possibly see scratch marks and blood as nicely.
CSU Causes
Not like acute hives, the reason for continual 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 struggle allergies. Nearly 1 in 10 folks with CSU have an autoimmune disease, like rheumatoid arthritis or Kind 1 diabetes.
When you’ve got CSU, you would possibly discover that some conditions could make it worse, like if you’re burdened or have an an infection, or if you’re chilly.
Diagnosing CSU
Your healthcare supplier (HCP) will decide when you’ve got acute urticaria or CSU. They’ll ask for an in depth medical historical past, in search of allergic reactions or something that would clarify the hives. A bodily examination is subsequent, trying on the hives and the place they’re.
Blood exams 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 would possibly refer you to an allergist, immunologist or dermatologist. The primary remedy will seemingly be antihistamines (allergy drugs). Nonetheless, 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, is perhaps the following choice, however many individuals don’t have success with omalizumab both. A 3rd choice is cyclosporine, which suppresses the immune system.
Researchers are additionally in search of various drugs for folks with CSU. In 2025, the Meals and Drug Administration authorized a biologic drugs known as dupilumab, which controls irritation by blocking the immune system, and there are different biologics which are nonetheless present process medical trials. These drugs may very well be added to different remedies or assist individuals who haven’t been capable of management their CSU with current remedies.
This instructional useful resource was created with help from Sanofi, a HealthyWomen Company Advisory Council member.
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