Patients with chronic urticaria often arrive at my clinic in Koramangala after months of frustration, having seen several doctors and tried numerous medications without lasting relief. That frustration is something I take seriously from the first consultation.
What is chronic urticaria?
Chronic urticaria is defined as hives that recur on most days for six weeks or longer, often with no obvious trigger. This differs from acute urticaria, which appears suddenly from an identifiable cause and resolves within days. In chronic urticaria, the immune system continues releasing histamine in the skin even when no external allergen can be found on testing.
Why is the cause so hard to find?
In a significant proportion of cases, no specific trigger is ever identified, a pattern called chronic spontaneous urticaria. This reflects the body's own immune signalling rather than a single substance to avoid. A negative allergy test is not a dead end. It redirects management toward the right treatment rather than continued testing.
What makes it worse, and how is it assessed?
Pressure on the skin, heat, stress, infections, and certain medications including NSAIDs can aggravate symptoms once the condition is present. Assessment relies on a detailed history of timing and pattern, examination during a flare, and selective blood testing for urticaria, since broad allergy panels rarely identify a cause here.
What treatment actually helps?
Second-generation antihistamines, often at higher than standard doses under medical supervision, are first-line and provide meaningful relief for most patients. When this is not enough, additional treatments are introduced in a structured, step-wise manner based on response.
Consult Dr Gnanamurthy N
If you are dealing with recurrent hives or unexplained skin allergies, consult Dr Gnanamurthy N at Mother and Child Care Centre, Koramangala, Bengaluru. Not finding an obvious cause does not mean the condition cannot be managed well.
Phone: +91 63666 69168
Written by Dr Gnanamurthy N, MBBS, DCH, FIAP, AASC, FAAP, ICPP, Paediatrician and Allergy and Asthma Specialist, Mother and Child Care Centre, Koramangala, Bengaluru.
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