Chronic urticaria is a condition where red itchy rash with swelling persists on and off for more than six weeks or months, or even years on your body. The cause of the rash is often not clear.  Some people also develop swelling of the lips, tongue or other areas of the body from time to time. It is more common in women. Rash usually lasts less than 24 hours, old lesions go and new ones come over 24 hours, generally worsened by scratching. The ongoing itch may cause distress and difficulty in sleeping. Most common areas are around the mouth, around the eyes, tongue, genitalia and hands and feet but can come on any part of the body.

The cause of the rash is the release of chemicals (such as histamine) from cells in the skin,  autoimmune disease (which means that our own immune system causes damage to some of our body’s own cells),  heat, cold, emotion, exercise, or strong sunlight, a germ (bacteria) called Helicobacter pylori, an allergy to a food, medicine or parasite.

To avoid rash, avoid tight clothes, alcohol, hot baths, strong sunlight, undue emotion, and keep your body cool.

Treatment for this is Antihistamine tablets; creams such as menthol are useful to cool the skin and help to relieve itching. Calamine lotion is also useful; steroids reduce inflammation and may ease urticaria. If all of these treatments fail, then only two choices remain with the patient. One is the immunosuppressant therapy, which is very expensive and needs to be taken lifelong.

The other option is the gold standard treatment for chronic urticaria – autologous serum therapy. The doctor injects the patient’s own serum (present in the blood) back in to the body. One injection per week for at least 8 weeks is required for freedom from chronic urticaria.

Dr. Rajshri Ritesh Gachkal
Dermatologist and cosmetologist
Bahrain Specialist Hospital