Shots:
- Characterized by an itchy skin rash, urticaria, commonly known as hives, is often triggered by allergic reactions to food, medications, or contact with irritants.
- PharmaShots’ Disease of the Month report aims to educate a broad audience about health conditions affecting communities across the globe. This monthly feature provides a comprehensive overview of each disease, including its characteristics, types, symptoms, diagnostic approaches, available treatments, epidemiology, market size, ongoing clinical trials, active patient advocacy groups (PAGs), and inspiring patient stories.
- For a detailed landscape analysis and customized insights on urticaria, contact our team at connect@pharmashots.com.
Hives, or Urticaria is a skin condition marked by itchy welts that typically last more than six weeks and may recur over months or even years. While the exact cause often remains unknown, hives usually begin as itchy patches that swell and fade within 24 hours, although new ones may appear as others disappear. This condition can significantly disrupt sleep and daily life. Antihistamines are commonly prescribed to relieve symptoms. [1]
Urticaria is categorized based on how long the condition lasts: [2]
- Acute Urticaria: Lasts no longer than six weeks and usually resolves within a week. Fewer than 40% of cases become chronic.
- Chronic Urticaria: Persists beyond six weeks with frequent episodes (≥2/week), often lasting over a year. It may occur spontaneously or be triggered by specific stimuli.
Hives result from the release of immune chemicals like histamine into the bloodstream. While acute hives are often linked to identifiable triggers, the cause of chronic urticaria is frequently unknown.
Common triggers include: [1]
- Heat or cold
- Sunlight
- Vibration (e.g., jogging, lawn mowing)
- Pressure on the skin (e.g., tight clothing)
- Underlying medical conditions (e.g., thyroid disease, infections, allergies, cancer)
Acute Urticaria [3]
Symptoms may vary by individual and situation, but commonly include:
- Raised welts or bumps (reddish on lighter skin tones)
- Blanching (fading under pressure)
- Itchy skin
- Swelling under the skin (angioedema)
- Painful swelling of the lips, eyes, or throat
Chronic Urticaria [3]
Though similar in appearance to acute hives, chronic hives:
- Change in size and shape
- Appear, disappear, and reappear frequently, sometimes for months or years
- May be triggered by stress, heat, or exercise
Healthcare providers can often diagnose hives and angioedema based on skin examination. To identify specific triggers, the following tests may be used: [3]
- Skin Tests: Involve exposing the skin to potential allergens and observing for a reaction. Rarely used for chronic hives.
- Blood Tests: Detect allergen-specific antibodies. Elevated levels may indicate a link to hives and swelling.
Treatment Options [1]
First-line treatment typically includes over-the-counter antihistamines. If symptoms persist, physicians may prescribe:
- Montelukast (Singulair)
- Doxepin (Silenor, Zonalon)
- Ranitidine
- Omalizumab (Xolair)
If these fail to control symptoms, immunosuppressants such as cyclosporine, tacrolimus, hydroxychloroquine, or mycophenolate may be considered.
Self-Care Tips
Chronic urticaria can be long-lasting and disruptive. These tips may help manage symptoms: [1]
- Avoid Known Triggers: Common culprits include foods, medications, pollen, pet dander, latex, or insect stings. Stress and fatigue may also contribute.
- Use Over-the-Counter Antihistamines: Non-drowsy types (loratadine, cetirizine, famotidine, cimetidine, nizatidine) are effective for daytime use; diphenhydramine (Benadryl) may be used at night.
- Apply Cold: Use a cold washcloth or ice cube to relieve itching.
- Take a Cool Shower or Bath: Adding baking soda or oatmeal may provide extra relief.
- Use Anti-Itch Creams: Products with menthol offer a soothing effect.
- Wear Comfortable Clothing: Opt for soft cotton fabrics; avoid rough, tight, or woolen clothes.
- Protect Skin from the Sun: Apply sunscreen at least 30 minutes before going outside and seek shade when possible.
- Keep a Symptom Diary: Record timing, locations, foods, and activities associated with flare-ups.
- Prevalence: In 2019, approximately 65.14 million people were affected globally, corresponding to 841.88 cases per 100,000 population. [4]
- Demographics: Women are more frequently affected than men. Cases are more common in children (ages 1–4) and rise again in older adults. [5,6]
In 2024, the global urticaria treatment market was valued at $3.73B and is projected to reach $11.4B by 2032, growing at a CAGR of 15.0%. [7]
Dupixent (dupilumab) is indicated to treat chronic spontaneous urticaria [8]
Other approved therapies:
- Quzyttir (TerSera Therapeutics),
- Xolair (Genentech & Novartis), and
- Dupixent (Sanofi & Regeneron).
As of July 21, 2025, active and inactive Phase II and III clinical trials are concentrated in the US, followed by Spain, Australia, and Italy. [9]
Numerous patient advocacy groups are dedicated to supporting individuals with urticaria and other allergic conditions, aiming to improve patient care, raise awareness, and promote research.
- Vanessa Lachey
I was eight years old, almost nine. I woke my dad up, and we didn’t know what was going on. He put me in an ice bath. I think back in the day, they thought, ‘Oh, this will help relieve her skin.’ But let me tell you, I was screaming,” Lachey tells Healthline.
As soon as Lachey was out of the ice and back in bed, the itching was back.
When most of us think of hives (also called urticaria), we think about occasional allergic reactions — itchy bumps that vanish shortly after popping up.
For some, they arrive after exposure to known triggers or as a reaction to an allergen.
But for others, like Lachey, hives can come without reason.
“The thing is, I don’t know when they’re gonna come,” Lachey says. “I’ve been allergy tested, and I have an intolerance to things that I try to avoid, but it can be anything from stress, to elements in the weather, to fabrics, to something in the air; anything.”
In addition to being unpredictable, Lachey’s hives also tend to linger.
“It can be a hive on my face, like a welt that lasts a few hours or a few days. Or it can be a rash on my body that lasts a week or two. I’ve had some before on my arms, and I’ll see traces of it for over a week,” she explains.
After dealing with hives for essentially her entire life, Lachey has finally found some relief through a new medication. She spoke with Healthline about tips for hives, how to navigate a flare-up, and her excitement over a new treatment that works with her daily life.
Urticaria may be common, but its chronic form can severely impact quality of life. Advances in treatment and increased awareness are helping patients like Vanessa Lachey reclaim control. For an in-depth landscape analysis and tailored insights on urticaria, reach out to our team at connect@pharmashots.com
References
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