Ep. 163: Understanding Chronic Spontaneous Urticaria: Hives Demystified (Originally Ep. 75)
Part of the series: Allergy, Asthma & Immunology Innovations Podcast
This podcast was made in partnership with Allergy & Asthma Network. We thank Novartis for sponsoring this podcast.
Editor's note: We first published this episode on June 6, 2024. We are re-releasing it on June 25, 2026 with a new intro, as the perfect foundation before next week's episode on the new chronic urticaria guidelines.
Do you get hives and have no clue why? Then this episode is for you!
Join Kortney and Dr. Gupta as they unpack chronic spontaneous urticaria (CSU) in a six-part series. You may also have heard of this condition called chronic idiopathic urticaria or spontaneous urticaria.
In this first episode, Kortney and Dr. Gupta dive into the nitty-gritty of chronic spontaneous urticaria. They define the medical term "urticaria," commonly known as hives, and discuss how CSU differs from other forms of urticaria. They dive into the symptoms, including the itchy and transient nature of hives, and emphasize that CSU can vary in appearance depending on skin tone.
What may seem complicated in chronic spontaneous urticaria is that there are no triggers. Instead, Dr. G walks us through the factors that may be culprits to CSU flares, such as stress and certain medications, and she highlights the impact of autoimmune conditions on CSU prevalence.
What we cover in our episode about chronic spontaneous urticaria:
What hives really are. We define urticaria, the medical word for hives, and explain the two things that make a rash a hive: it itches, and it comes and goes.
CSU versus other types of hives. We break down how chronic spontaneous urticaria differs from chronic inducible urticaria (CINDU) and from a typical allergic reaction.
Histamine and the itch. Learn how histamine causes the swelling and itching, and why scratching feels so good even though it makes things worse.
What can make hives flare. CSU has no true trigger, but we cover the common culprits, like stress, that can set the mast cells off.
Who gets CSU and how long it lasts. We look at who is most affected, the link to autoimmune conditions, and whether CSU ever goes away.
More resources about spontaneous hives:
Chronic Urticaria Hub from Allergy & Asthma Network
Explore our full catalog of hives episodes
Diagnosis and the basics
Ep. 76 Diagnosing Chronic Spontaneous Urticaria
Ep. 128 Is Chronic Spontaneous Urticaria an Autoimmune Disease?
Ep. 90 Challenges in Diagnosis and Treatment of Chronic Urticaria in Skin of Color
Treatment
Ep. 78 Chronic Spontaneous Urticaria Treatments
Ep. 131 What Is a BTK Inhibitor?
Ep. 147 The REMIX Trial: Remibrutinib for Chronic Hives
Ep. 116 Why Fexofenadine Is Considered a Truly Non-Sedating Antihistamine
Living with chronic hives
Ep. 148 How Do You Know Your Chronic Hives Are Under Control?
Ep. 122 Mortality in adult patients with chronic spontaneous urticaria: A real-world cohort study
Ep. 80 Chronic Spontaneous Urticaria Myths and Misconceptions
Ep. 79 Living with Chronic Spontaneous Urticaria: A patient story
Ep. 91 A Patient's Experience with Chronic Urticaria and Skin of ColorEp. 107 Hives in the Latinx Community
What is chronic spontaneous urticaria?
Chronic Spontaneous Urticaria (CSU) is a type of urticaria (hives) where the hives appear and disappear spontaneously without a known trigger. CSU is characterized by itchy, raised rashes that should not last longer than 24 hours in one spot. It is considered chronic if it persists for at least six weeks. Additionally, 30-50% of CSU patients experience angioedema, which involves swelling in the skin without itching.
Medical terms used when talking about chronic spontaneous urticaria:
Urticaria = Hives/ Welts/ Wheals
Pruritus = Itch
Angioedema = Swelling
Chronic Spontaneous Urticaria Episode in a Nut Shell
Definition of Urticaria: Urticaria, or hives, are itchy, raised rashes that come and go.
Difference between CSU and Other Urticarias: CSU has no specific trigger and lasts at least six weeks.
Role of Histamine: Histamine release causes itching and swelling.
Factors Exacerbating CSU: Stress, medications, infections, and autoimmune mechanisms.
Impact on Different Populations: More common in females and those over 20, often linked with autoimmune disorders.
Management and Treatment: There is no cure, but symptoms are manageable; seeking medical advice is crucial.
We thank Novartis for sponsoring this podcast.
Timestamps
Understanding Chronic Spontaneous Urticaria: Hives Demystified
01:30 What is urticaria
03:47 Defining chronic spontaneous urticaria
04:32 Allergic reactions and hives
05:35 Chronic inducible urticaria
06:43 How hives look
08:32 What is happening in the body to cause hives
09:54 Itching, what you need to know
12:57 Angioedema
13:57 What can make you more sensitive to getting hives
17:27 Who is more likely to have CSU
18:15 Does CSU ever go away
20:06 When should you see a doctor
