What Is Chronic Urticaria and How Do You Treat It?

Chronic urticaria is the medical term for long-term hives, or red, itchy welts on the skin, lasting six weeks or longer. This condition affects about 1% of people in the United States (U.S.).

Chronic idiopathic urticaria (CIU), also known as chronic spontaneous urticaria (CSU), is the medical term for long-term hives when the cause of hives is unknown.

Learn about chronic urticaria, its symptoms, causes, and how to prevent it.

A woman scratching at chronic urticaria on her back and shoulder.

chokja / Getty Images


Chronic urticaria symptoms consist of red, itchy welts on the skin, sometimes accompanied by swelling or pain. Symptoms are considered chronic even if they come and go, so long as they are present for at least six weeks.

Chronic Urticaria Symptoms

Potential Complications

Chronic urticaria can be uncomfortable, but this condition is generally not dangerous. It can, however, cause severe complications and, in some cases, may be a warning sign of a more serious medical condition, such as an autoimmune disease (a disease where the immune system attacks healthy cells).

Some potential complications of chronic urticaria include:

  • Anaphylaxis: A life-threatening allergic reaction that affects multiple body systems, often including severe symptoms such as difficulty breathing and closure of airways. Acute urticaria can present with anaphylaxis but rarely does so since it doesn't typically involve swelling below the vocal cords.
  • Mental health issues: Living with chronic diseases, including chronic urticaria, can increase mental health issues such as anxiety and depression.
  • Quality of life: Chronic urticaria can be extremely uncomfortable, so much so that it interferes with daily life.

If you or a loved one are struggling with mental health, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.


There are multiple causes of chronic urticaria, such as infection, stress, or autoimmune diseases.

In 95% of chronic hive cases, however, the cause is unknown. These cases are known as chronic idiopathic urticaria (CIU) or chronic spontaneous urticaria (CSU).

Chronic Urticaria Causes

  • Infection (this usually causes acute urticaria but can become chronic urticaria if immune dysregulation takes place)
  • Temperature (extreme heat or change in temperature)
  • Stress
  • Autoimmune diseases


A healthcare provider diagnoses chronic urticaria after having a detailed conversation, completing a skin exam, and ruling out other potential causes of the hives, including anaphylactic reactions. Hives lasting for six weeks or more are diagnosed as chronic or long-term urticaria, while hives present for less than six weeks are diagnosed as acute or short-term urticaria.


Hives are treated with medications to lessen the itch and relieve discomfort. There are also ways to prevent and improve symptoms at home, such as applying cold compresses to the affected skin. Stress management can help with treatment, as increased stress can worsen hives. Long-term hives can also cause more stress, leading to mental health challenges such as anxiety and depression.

Chronic Urticaria Treatments

  • Taking medications, such as antihistamines
  • Relieving stress
  • Prioritizing comfort (loose clothing, cooler temperature)
  • Keeping nails trimmed and short to prevent scratching and the ongoing itch/scratch cycle (itching that leads to aggravating the skin barrier, which then leads to welts, and then worsens the itch)
  • Moisturizing skin with unscented emollients (moisturizers) to help reduce the itch

When to See a Healthcare Provider

It is essential to seek care from a healthcare provider if hives are accompanied by breathing difficulty or other signs of anaphylaxis. This is to rule out a severe anaphylaxis reaction that can lead to death. It is also important to seek medical care if hives do not go away within a few days, cause extreme discomfort, interfere with daily life, or lead to mental health challenges, such as anxiety or depression.


There are ways to prevent chronic urticaria, including keeping your skin moisturized, avoiding extreme heat, and taking medications if necessary. When the hives are related to an autoimmune condition, it can help to seek treatment for the autoimmune disease to manage symptoms, including hives. In addition, since stress can increase the risk of chronic urticaria, regular relaxation and stress relief practices can also help prevent hives.


Chronic urticaria, or long-term hives, is a medical condition in which hives last six weeks or more. Symptoms include red, itchy welts on the skin. While this condition is uncomfortable, it is generally not dangerous. However, it can lead to complications such as mental health challenges and compromised quality of life.

This condition may be caused by temperature, stress, autoimmune disease, or may be unknown. Treatment options, such as medications to manage symptoms and behaviors and lifestyle changes to prevent outbreaks and provide relief, are available.

A Word From Verywell

Suspecting, being diagnosed with, and living with chronic urticaria or hives can be uncomfortable and interfere with daily life. Treatment options are available and can relieve symptoms until they go away. If you or someone you know is experiencing hives, help is available. Reach out to a healthcare professional, such as a primary healthcare provider, for support.

Frequently Asked Questions

  • Is chronic urticaria and idiopathic urticaria the same?

    Chronic urticaria is long-term hives lasting six weeks or more. Idiopathic urticaria or spontaneous urticaria is hives without a known cause. Chronic urticaria is often idiopathic or without a known cause, but that is not always the case.

  • Is there a cure for chronic hives?

    There is no known cure for hives. Medications for chronic hives treat the symptoms and lessen the reaction rather than cure the condition. Hives tend to go away after a few months, though they can last years before going away.

  • Are chronic hives an autoimmune disease?

    No, chronic hives or urticaria is not an autoimmune disease. However, there is a link between chronic spontaneous urticaria (CSU), or long-term hives without a known cause, and autoimmune disease. Some data suggests that nearly half of people with CSU have an autoimmune disease.

  • Is chronic urticaria contagious?

    No, chronic urticaria is not contagious. It can not be transmitted from person to person, like a cold or the flu.

  • How long does chronic urticaria last?

    Urticaria, or hives, must last at least six weeks to be considered chronic or long-term. It can last months or years before it goes away, and there is no way of knowing how long it will last. There are treatments, such as medications, to manage the symptoms and provide relief.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Ashley Olivine, Ph.D., MPH
Dr. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development.