Urticaria and histamine

Urticaria and histamine

What is urticaria?

Urticaria is a raised, itchy rash that appears on the skin either in one specific place or it can spread across larger areas in response to an allergen or trigger. Also known as hives or welts, urticaria can range in size and last a matter of minutes or even hours.

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Types of urticaria

Spontaneous urticaria

This is where urticaria appears spontaneously, and it can be either:

  • acute (short-term) – hives form and fade within hours or days, for a maximum of six weeks
  • chronic (long-term) – hives form and persist for more than six weeks

Common allergens or triggers can include:

  • Food such as nuts or shellfish
  • Medications e.g. antibiotics
  • Insect bites or stings
  • Latex
  • Pet hair
  • Pollen

Physical forms of urticaria

  •  Heat urticaria – when the skin comes into contact with warmth or heat
  • Cold urticaria – when the skin comes into contact with the cold
  • Solar urticaria – in response to UV light or sunlight
  • Pressure urticaria – in response to pressure on the skin

Other forms

  • Cholinergic urticaria – in response to raised temperatures such as sweating or hot baths
  • Aquagenic urticaria – when the skin comes into contact with water
  • Contact urticaria – when the skin comes into contact with certain substances

Urticaria occurs when a trigger causes the mast cells to release histamine, and other chemical messengers, in the skin. This then causes the blood vessels to open up and leak, and this extra fluid leads to swelling (hives) and itching.

Common signs and symptoms of urticaria

These can include:

  • Red welts or hives, which range in size from a few millimetres to hand-palm size
  • Bumps on the skin that are red or skin-coloured wheals with clear edges
  • Itching
  • Rashes
  • Soft tissue swelling (oedema)


Urticaria is the presence of hives or welts on the skin in response to an allergen or trigger, which causes the mast cells to release histamine. There are different types of urticaria, and it can be an acute (short term) or chronic (long term) response. As histamine is intimately involved in the presence of urticaria, excess histamine in the body, such as with histamine intolerance can exacerbate symptoms.


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