The exact cause is often difficult to determine. However, there are typical triggers:

Common triggers

• Infections
• Food intolerances
• Medications (e.g. painkillers)
• physical stimuli (pressure, cold, heat, sun)
• stress

Immunological mechanisms

In chronic urticaria, the immune system is often overactive, without a clear external trigger.

Typical signs:

• intensely itchy welts
• red or whitish swellings
• Flowing, migrating skin changes
• Swelling of lips or eyes
• Burning or sensation of heat

The welts can appear individually or over a large area.

Acute urticaria

• Duration: a few hours to a maximum of 6 weeks
• often triggered by infections or allergies
• It usually heals completely.

Chronic urticaria

• Duration: longer than 6 weeks
• daily or in bursts
• often without a clear cause
• very stressful, but easily treatable

INFOBOX:
Chronic urticaria is not dangerous and not contagious, but it should definitely be treated professionally.

Medical history

• Time course
• possible triggers
• Medication intake

Clinical examination

Assessment of wheals, swelling & progression.

Allergy tests (if needed)

To identify possible triggers.

Blood tests

To clarify inflammatory or immunological causes.

Provocation tests

In cases of suspected cold, heat, or pressure urticaria.

Treatment depends on the severity and cause:

1. Antihistamines (basic therapy)

• inhibit histamine effects
• relieves itching and hives
• Increased dosages can be used in chronic cases.

2. Cortisone (short-term)

Suitable for the rapid control of severe flare-ups, but not for long-term therapy.

3. Avoiding individual triggers

• Medications
• Cold/Heat
• Pressure
• Food intolerances

Omalizumab (anti-IgE therapy)

One of the most important advances in chronic urticaria:

• very high effectiveness
• rapid improvement of symptoms
• Suitable for antihistamine-resistant urticaria
• monthly injections

INFOBOX:
Most patients experience almost complete symptom control with omalizumab.

✔ Mild, fragrance-free skincare
✔ Stress reduction
✔ cooling compresses
✔ Avoid tight-fitting clothing
✔ Reduce alcohol and spicy foods
✔ Regular intake of prescribed medication

Is urticaria contagious?
No.

How long does a flare-up last?
Often minutes to hours; recurring in chronic forms.

Is cortisone necessary?
Only for short periods during severe flare-ups.

What if antihistamines don't work?
Then therapy with biologics is very promising.

Can stress trigger urticaria?
Yes, stress is a common trigger.

Urticaria is unpleasant and can significantly impact daily life, but it is now very treatable. Modern antihistamines, trigger point therapy, and innovative biologics can reliably soothe the condition, resulting in significantly less itching, less swelling, and improved quality of life.