An accurate diagnosis of your type of urticaria is very important for the treatment and management of the condition. There is a known trigger in some kinds of hives, but in other cases there is no known trigger. Although this can be incredibly frustrating, an accurate diagnosis is important because the different types of hives are treated differently.
Classification of the different types of urticaria
Chronic urticaria
Chronic urticaria is a severe disease that is characterized by the re-occurrence of persistent hives and/or sometimes painful deeper swelling of the skin for 6 weeks or more.1 There are two subtypes:
- Chronic spontaneous urticaria occurs randomly with no known trigger. It is not caused by an allergy but may be the result of autoimmunity, an intolerance, an underlying infection or another illness.2
- Chronic inducible urticaria has a known trigger, such as cold, sunlight, increased body heat, pressure or vibration.1 Although the trigger is known, it is very difficult to avoid the trigger entirely.
Both types of chronic urticaria are burdensome conditions that affect quality of life.3,4
Acute urticaria
Acute urticaria is defined as hives that last for less than 6 weeks. The causes can be known (such as allergies and infections) or unknown.1
All forms of urticaria involve the activation of mast cells by your immune system which release histamine and other chemicals into the area. This causes the nerve endings in the skin to become irritated and itch, and the blood vessels to swell and leak, causing redness and swelling.5
There are medication available that can relieve the symptoms of hives. Some of these work after the mast cells have been activated and others work by preventing the mast cells from being activated in the first place.
If hives and itch are interfering with your quality of life, there are effective treatment options. For some of these treatments you need to be in the care of an immunologist or dermatologist. Speak to your GP about a referral to an urticaria specialist.
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References
- Australasian Society of Clinical Immunology and Allergy. ASCIA HP Position Paper Chronic Spontaneous Urticaria Guidelines 2020. Available from https://allergy.org.au/images/stories/pospapers/ASCIA_HP_Position_Paper_CSU_2020.pdf Accessed July 2024.
- Asero R et al. F1000Research 2017; 6:1095.
- Maurer M et al. Allergy 2011; 66:317–330.
- Maurer M et al. Allergy 2017; 72: 2005-2016.
- Australasian Society of Clinical Immunology and Allergy. ASCIA PC Hives Urticaria 2024. Available from https://allergy.org.au/patients/skin-allergy/urticaria-hives Accessed July 2024.