Chronic idiopathic urticaria (CIU), also known as chronic spontaneous urticaria (CSU), is the medical term for long-term hives when the cause of hives is unknown.
Learn about chronic urticaria, its symptoms, causes, and how to prevent it.
Symptoms
Chronic urticaria symptoms consist of red, itchy welts on the skin, sometimes accompanied by swelling or pain. Symptoms are considered chronic even if they come and go, so long as they are present for at least six weeks.
Potential Complications
Chronic urticaria can be uncomfortable, but this condition is generally not dangerous. It can, however, cause severe complications and, in some cases, may be a warning sign of a more serious medical condition, such as an autoimmune disease (a disease where the immune system attacks healthy cells).
Some potential complications of chronic urticaria include:
Anaphylaxis: A life-threatening allergic reaction that affects multiple body systems, often including severe symptoms such as difficulty breathing and closure of airways. Acute urticaria can present with anaphylaxis but rarely does so since it doesn’t typically involve swelling below the vocal cords. Mental health issues: Living with chronic diseases, including chronic urticaria, can increase mental health issues such as anxiety and depression. Quality of life: Chronic urticaria can be extremely uncomfortable, so much so that it interferes with daily life.
Causes
There are multiple causes of chronic urticaria, such as infection, stress, or autoimmune diseases.
For more mental health resources, see our National Helpline Database.
In 95% of chronic hive cases, however, the cause is unknown. These cases are known as chronic idiopathic urticaria (CIU) or chronic spontaneous urticaria (CSU).
Diagnosis
A healthcare provider diagnoses chronic urticaria after having a detailed conversation, completing a skin exam, and ruling out other potential causes of the hives, including anaphylactic reactions. Hives lasting for six weeks or more are diagnosed as chronic or long-term urticaria, while hives present for less than six weeks are diagnosed as acute or short-term urticaria.
Treatment
Hives are treated with medications to lessen the itch and relieve discomfort. There are also ways to prevent and improve symptoms at home, such as applying cold compresses to the affected skin. Stress management can help with treatment, as increased stress can worsen hives. Long-term hives can also cause more stress, leading to mental health challenges such as anxiety and depression.
When to See a Healthcare Provider
It is essential to seek care from a healthcare provider if hives are accompanied by breathing difficulty or other signs of anaphylaxis. This is to rule out a severe anaphylaxis reaction that can lead to death. It is also important to seek medical care if hives do not go away within a few days, cause extreme discomfort, interfere with daily life, or lead to mental health challenges, such as anxiety or depression.
Prevention
There are ways to prevent chronic urticaria, including keeping your skin moisturized, avoiding extreme heat, and taking medications if necessary. When the hives are related to an autoimmune condition, it can help to seek treatment for the autoimmune disease to manage symptoms, including hives. In addition, since stress can increase the risk of chronic urticaria, regular relaxation and stress relief practices can also help prevent hives.
Summary
Chronic urticaria, or long-term hives, is a medical condition in which hives last six weeks or more. Symptoms include red, itchy welts on the skin. While this condition is uncomfortable, it is generally not dangerous. However, it can lead to complications such as mental health challenges and compromised quality of life.
This condition may be caused by temperature, stress, autoimmune disease, or may be unknown. Treatment options, such as medications to manage symptoms and behaviors and lifestyle changes to prevent outbreaks and provide relief, are available.
A Word From Verywell
Suspecting, being diagnosed with, and living with chronic urticaria or hives can be uncomfortable and interfere with daily life. Treatment options are available and can relieve symptoms until they go away. If you or someone you know is experiencing hives, help is available. Reach out to a healthcare professional, such as a primary healthcare provider, for support.
