chronic urticaria

Urticaria, also known as hives, weals, welts or nettle rash, is a raised, itchy rash that appears on the skin. The rash is usually very itchy and ranges in size from a few millimeters to the size of a hand.

Chronic urticaria (CU) is a perturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag for a serious internal disease.

Chronic urticaria may occur when the body’s immune system attacks its own tissues. This is known as an autoimmune reaction. About a third to half of all chronic cases of urticaria are reckoned to be autoimmune related. Chronic urticaria rash lasts for more than six weeks and returns often over months or years. It is advised to see your Dermatologist in Karachi if you have a severe rash or a rash that lasts for more than a few days. This  condition can be very uncomfortable and interfere with sleep and daily activities.


For most people with chronic urticaria, there’s no known cause. In rare scenarios, medication allergies or food allergies are the culprit. The most common allergic cause is something you consume regularly. About 1 in 5 people with chronic urticaria also have an autoimmune disease, such as:

  • Celiac disease
  • Dermatomyositis
  • Diabetes
  • Lupus
  • Polymyositis
  • Rheumatoid arthritis
  • Thyroid disease
  • Vitiligo

Other conditions that may cause chronic urticaria include:

  • Asthma
  • Infections like H. pylori bacterial infections and sinus infections
  • Liver disease
  • Lymphomas
  • Vasculitis


Urticaria rash can appear anywhere on your body and look different on each person. The rash can have different shapes and sizes. Common symptoms of chronic urticaria include:

  • Batches of rashes that can arise anywhere on the body
  • Rashes that might be red, purple or skin colored, depending on your skin color
  • Rashes that vary in size, change shape, and appear and fade repeatedly
  • Itchiness, which can be intense
  • Painful swelling (angioedema) around the eyes, cheeks or lips
  • Flare ups triggered by heat, exercise or stress
  • Symptoms that persist for more than six weeks and recur often and anytime, sometimes for months or years


If you’ve had a rash for several weeks without an apparent reason, see a Skin Specialist in Lahore at your earliest. In order to make a diagnosis, they’ll examine your rash and may ask you:

  • When and where the rashes begin?
  • How long did they last?
  • Did something trigger the rashes?
  • Do you have swelling?
  • What other symptoms do you have?
  • Have you started taking any new supplements or meds?

They’ll also ask about the foods you eat and if you have pets, to see if it’s an allergic reaction. They may check for other illnesses or conditions that could cause a rash. If they are unable to find the cause, you are likely to be diagnosed with chronic urticaria.


Usually OTC antihistamines are preferred treatment for chronic urticaria rashes. Non-sedative antihistamines with few side effects include:

  • cetirizine
  • loratadine
  • fexofenadine
  • desloratadine
  • levocetirizine

If the rash doesn’t clear up with OTC antihistamines, your dermatologist may try other courses of treatment, including:

  • H2 blockers: These drugs decrease the production of histamines that can cause rashes or overproduction of stomach acids.
  • Short-term oral corticosteroids: These are especially useful for reducing the swelling around eyes, lips, or throat that can accompany the rash.
  • Sedating antihistamine: This can include doxepin, which is available as an oral or topical medication.
  • Immune suppressants: These include cyclosporine, tacrolimus, mycophenolic acid, and methotrexate.
  • Monoclonal antibodies: Omalizumab is an expensive, new drug that has proved very effective against chronic idiopathic urticaria. It’s typically injected once every month.


Some complications associated with chronic urticaria include:


Angioedema is swelling in the deeper layers of skin. It’s often severe and is caused by a fluid build up. Angioedema can affect any part of the body, but eyes, lips, genitals, hands and feet are commonly affected.

Emotional impact

Living with any long-term condition can be difficult. Chronic urticaria can have a considerable negative impact on a person’s mood and quality of life. Living with itchy skin can be particularly upsetting. People with chronic urticaria may develop psychological or emotional problems like stress, anxiety and depression.


Urticaria can be one of the first symptoms of a severe allergic reaction known as anaphylaxis. Anaphylaxis should always be treated as a medical emergency. Symptoms of anaphylaxis include dizziness, troubled breathing and swelling of the tongue, lips, mouth or throat.


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