Chronic urticaria is a real nuisance: the rash comes and goes, it’s unpredictable; the itchiness and discomfort around the body has a great impact on work, school and sleep. Many patients ask “when will this chronic urticaria get better?”. Many patients ask, “When will this chronic hives get better? Some patients go to several hospitals to find a way to “break the root” of the problem.
Frankly speaking, the causes of chronic urticaria, the triggers of aggravation and the length of the disease vary greatly from patient to patient, so it is not easy to find the “root”.
I. Possible causes and triggers of chronic urticaria
1, physical factors: chronic urticaria in more than half of the patients may be triggered by a variety of physical factors, such as higher temperatures (hot baths) or pressure on the skin surface (belt tightening parts or scratching the skin) is a relatively common physical triggers, other common physical triggers are sunlight, sports, cold wind and cold water, etc.. If urticaria is mainly induced by various physical factors, it is also called physical urticaria or induceable urticaria.
2, Infection: Infection lesions in the body can cause chronic urticaria to worsen, for example, when suffering from viral infections (common cold) or bacterial infections (tonsillitis or sinusitis), the urticaria rash is often more severe.
3, drugs: 20%-50% of patients with chronic urticaria will experience increased urticaria symptoms after taking antipyretic and analgesic drugs (such as aspirin and other painkillers and antipyretics), usually within a minimum of 15 minutes and a maximum of 24 hours after taking the drug. Some sedative-hypnotic drugs may also cause chronic urticaria symptoms to worsen.
Alcohol consumption: Alcohol consumption may trigger urticaria or aggravate chronic urticaria symptoms, mainly because of the presence of substances in wine or beverages containing wine that can directly cause the release of histamine (histamine is the most important inflammatory substance that causes urticaria and can cause skin eruptions, edema and itching symptoms).
5. Diet: Although food allergies (associated with IgE antibodies) are rarely a cause of chronic urticaria, many patients still find that their urticarial rash worsens after consuming certain foods, especially if multiple foods or spicy foods are consumed at once that seem to induce hives. This condition may be related to the presence of pseudoallergens in food, a class of naturally occurring aromatic substances that are present in varying amounts in many fruits, vegetables, and seafood. Some artificial colors and preservatives in processed foods are also pseudo-allergens, which may cause hives symptoms to worsen.
6, stress: many patients will find that hives symptoms worsen when the body is overworked or mental stress increases.
7, sleep: often stay up late or lack of sleep can also cause hives symptoms aggravated.
8, female physiological period: some female patients will experience increased symptoms during menstruation.
9, insect bites: Sometimes insect bites or parasitic infections can cause hives symptoms to worsen.
10.Other accompanying diseases: Chronic urticaria may be related to some autoimmune diseases and thyroid diseases.
Urticaria symptoms appear because “water is full and overflowing”
Some people may ask: of all the above reasons, which one is the reason why I have chronic urticaria? In fact, for a particular patient with chronic urticaria, it is the result of a combination of causes or triggers, all of which stimulate a cell (mast cell) in the skin, causing it to activate and release the inflammatory substance histamine, which results in itching, redness of the skin, and the manifestation of wind clumps (edema).
If we use the analogy of a pool of water and the alert water level, the various causes and triggers that may cause the onset of chronic urticaria are the water in the pool, and the mast cells in the skin are responsible for managing the alert water level, which is usually lower than normal in patients with chronic urticaria. symptoms of urticaria.
If one aspect of the triggers is controlled, such as relaxing and reducing stress, changing the work schedule and not staying up late, or treating chronic infections in the body, etc., the water level will return to below the alert level and the symptoms of hives will disappear.
It is a good idea for patients to keep a daily diary of their lives.
Usually at the initial visit, the doctor will ask about the hives flare-ups, diet, medications taken or underlying illnesses, etc. Sometimes some tests will be done, but unfortunately even with questionnaires or some ancillary laboratory tests, it is most of the time difficult for the doctor to identify the cause or triggers of the flare-ups in most patients.
Design a form to keep a detailed daily record of hives episodes, along with a detailed record of various foods consumed daily, medications, changes in living and working environment, other physical symptoms of discomfort, changes in mood and stress, other possible triggers, etc. By keeping a diary for a long time, it is possible to find triggers for hives attacks or exacerbations by comparing the fluctuations in symptoms and various changes in life.
Finally, I would like to remind you that in reality, about half of the patients with chronic urticaria are unable to find the cause or trigger, but even so, it is important to face the reality, standardize the treatment, not to get too hung up and learn to live in harmony with chronic urticaria.