What is chronic urticaria?
Chronic urticaria is a skin condition characterised by the appearance of red patches (papules or “welts”), accompanied by intense itching. To be considered chronic, these lesions must occur almost daily for more than six weeks.
The patches can vary in size, change location, and disappear within hours, reappearing elsewhere. In some patients, angioedema may also occur — swelling of the lips, eyelids, hands, or feet.
Is it an allergy?
In most cases, it is not caused by an allergy. It is an exaggerated reaction of the immune system in the skin, often without an identifiable cause (chronic spontaneous urticaria). In some cases, it may be triggered by physical stimuli (cold, heat, pressure, exercise) or worsened by infections, stress, or medications.
How is chronic urticaria treated?
Treatment should be guided by a specialist. The goals are to relieve symptoms and improve quality of life.
Avoiding aggravating factors: Not all patients have triggers, and these can vary from person to person. The most common include excessive heat, alcohol, anti-inflammatory drugs (such as ibuprofen), stress, skin pressure, or certain foods.
Non-sedating antihistamines: These are the first-line treatment. Higher doses may be used, under medical supervision, if standard doses do not control symptoms.
Advanced therapies: In resistant cases, the specialist may recommend hospital-administered medications, such as omalizumab.
Prognosis
Although chronic urticaria can be uncomfortable, it is not dangerous and does not leave permanent skin marks. Proper treatment should allow patients to live a normal daily life without limitations. In most cases, the condition tends to improve or resolve over time, though the course can be variable.
Article developed by Dr Pedro Morais Silva, Immunoallergist at HPA Health Group.
26, November 2025
