What is urticaria?

Urticaria is a raised, itchy rash that appears on the skin either in one specific place or across larger areas in response to an allergen or other trigger. Also known as hives or welts, urticaria can range in size and last for 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 dilate and leak, and the extra fluid leads to swelling (hives) and itching.

5 common signs and symptoms of urticaria

These can include:

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

Conclusion

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 urticaria, excess histamine in the body, such as in histamine intolerance, can exacerbate symptoms.

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