Urticaria and histamine

What is urticaria?

Urticaria is a raised, itchy rash that appears on the skin either in one specific place or it can spread across larger areas in response to an allergen or trigger. Also known as hives or welts, urticaria can range in size and last a matter of minutes or even hours.

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Types of urticaria

Spontaneous urticaria
This is where urticaria appears spontaneously, and it can be either:

acute (short-term) – hives form and fade within hours or days, for a maximum of six weeks
chronic (long-term) – hives form and persist for more than six weeks

Common allergens or triggers can include:

Food such as nuts or shellfish
Medications e.g. antibiotics
Insect bites or stings
Latex
Pet hair
Pollen

Physical forms of urticaria

Heat urticaria – when the skin comes into contact with warmth or heat
Cold urticaria – when the skin comes into contact with the cold
Solar urticaria – in response to UV light or sunlight
Pressure urticaria – in response to pressure on the skin

Other forms

Cholinergic urticaria – in response to raised temperatures such as sweating or hot baths
Aquagenic urticaria – when the skin comes into contact with water
Contact urticaria – when the skin comes into contact with certain substances

Urticaria occurs when a trigger causes the mast cells to release histamine, and other chemical messengers, in the skin. This then causes the blood vessels to open up and leak, and this extra fluid leads to swelling (hives) and itching.

Common signs and symptoms of urticaria

These can include:

Red welts or hives, which range in size from a few millimetres to hand-palm size
Bumps on the skin that are red or skin-coloured wheals with clear edges
Itching
Rashes
Soft tissue swelling (oedema)

Final Thoughts

Urticaria is the presence of hives or welts on the skin in response to an allergen or trigger, which causes the mast cells to release histamine. There are different types of urticaria, and it can be an acute (short term) or chronic (long term) response. As histamine is intimately involved in the presence of urticaria, excess histamine in the body, such as with histamine intolerance can exacerbate symptoms.

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