Allergies Urticaria & Angioedema What Is Pressure Urticaria? Physical Urticaria, Pressure Hives, Dermatographism By Ashley Olivine, Ph.D., MPH Ashley Olivine, Ph.D., MPH 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. Learn about our editorial process Published on December 02, 2022 Medically reviewed by William Truswell, MD Medically reviewed by William Truswell, MD Facebook LinkedIn William Truswell, MD, is a board-certified facial plastic surgeon and otolaryngology (head and neck) surgeon. He is president of the American Board of Facial Plastic and Reconstructive Surgery and treats skin cancer patients as part of his practice. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Types Symptoms Causes Diagnosis Treatment Prevention Frequently Asked Questions Urticaria is the term for hives, a skin condition involving red, itchy bumps. Pressure urticaria is a type of hives caused by prolonged pressure on the skin over a long period, such as from carrying something heavy, an object resting on the body, or wearing tight clothing. About 2% to 5% of people experience pressure urticaria, either immediate or delayed. Learn more about pressure urticaria, the types, symptoms, causes, treatment options, and more. Monty Rakusen / Getting Images Types of Pressure Urticaria Pressure urticaria is a type of hives caused by a physical source, such as heat or something rubbing the skin. Pressure hives occur when a reaction of itchy bumps appears on the skin site where pressure was applied. There are two types of pressure urticaria: immediate and delayed. Immediate Immediate pressure urticaria is when hives appear on the skin within a few minutes of experiencing pressure, usually in about five to seven minutes. This condition is also called dermatographism. It can happen from rubbing or scratching in addition to pressure on the skin. Hives typically go away quickly, usually within a half-hour after they appear. Delayed Delayed pressure urticaria (DPU) is when hives appear on the skin a few hours after experiencing pressure, usually in about four to eight hours. The hives tend to go away within eight hours to two days. Medications generally used to treat hives, antihistamines, may not work if you have delayed pressure urticaria, but some research has shown that avoiding gluten can help. Pressure Urticaria Symptoms Symptoms of pressure urticaria are similar to those of other urticaria types. They include itchy bumps on the skin in the areas that experience prolonged pressure. People with pressure hives may also experience other symptoms, such as fatigue. Symptoms of Pressure Urticaria Aches in other areas of the body Bumps Fatigue Itching Pain in the area of the hives Redness Swelling Pressure Urticaria Causes The name pressure urticaria comes from its cause: prolonged pressure on the skin. This can come from wearing tight, constrictive clothing, carrying heavy items, or from body weight pressing down on a surface. People with pressure hives are more likely to get them on the palms of the hands, soles of the feet, shoulders, and back, as these areas are the most likely to endure pressure. Causes of Pressure Urticaria Body weight resting on a surface, such as laying or sitting for an extended period of timeCarrying heavy objects, such as a boxSomething heavy resting on the body, such as a heavy backpackWearing constrictive clothing, including belts, or arm or waistbands, or tight shoes Causes and Risk Factors of Urticaria (Hives) Diagnosis Like other types of hives, pressure urticaria can be diagnosed by a medical professional, such as a primary care practitioner or a dermatologist. Unlike other types of urticaria, there is a test for pressure urticaria. A healthcare provider can apply pressure to the skin and then look at the area immediately afterward and six hours later. Treatment Hives can be treated by avoiding things that cause them in the first place, such as pressure; providing comfort with ice or cold washcloths on the area; or taking medications, such as antihistamines or corticosteroids. However, delayed pressure hives do not respond well to antihistamines. Research has shown that avoiding gluten can also help people who experience pressure hives. Pressure Urticaria Treatments Avoiding excess pressure on the skinApplying cold washcloths or iceEating a gluten-free dietTaking medications (though antihistamines may not be effective in treating delayed pressure urticaria)Wearing loose clothing Prevention Since pressure hives are caused by extended pressure on the skin, they can sometimes be prevented. For example, by wearing special insoles in your shoes or wearing shoes that are not too tight, hives on your feet from tight shoes may be prevented. It can also be helpful to avoid edges when carrying objects or applying pressure to the body; instead, try to use positions that spread the weight over a larger surface area. Summary Pressure urticaria is a type of hives, or itchy bumps on the skin, caused by pressure. This may include pressure from wearing clothes or shoes that are too tight, carrying heavy items, or from body weight on a surface. Immediate pressure hives appear in about five to seven minutes, while delayed pressure hives can take four to eight hours. Unlike other types of hives, your healthcare provider can perform a test to determine whether you have pressure hives. Treatment options include using home remedies to relieve the discomfort, such as applying ice or cold compresses, taking medications, and eating a gluten-free diet. A Word From Verywell Pressure urticaria can be uncomfortable and interfere with daily activities. While this condition is unpleasant, it is not dangerous and is temporary. If you or someone you know is experiencing pressure hives, help is available. Reach out to your healthcare provider for support. Frequently Asked Questions How long does pressure urticaria last? Immediate pressure urticaria, or hives that appear within a few minutes of experiencing pressure, usually go away within 30 minutes. Delayed pressure urticaria, or hives that occur after a few hours of experiencing pressure, tend to last longer. They typically go away within 48 hours. How common is pressure urticaria? About 2% to 5% of people experience pressure urticaria, either immediate or delayed. Does delayed pressure urticaria go away? Yes, pressure urticaria does away. Pressure hives that appear immediately after pressure usually go away within 30 minutes, while delayed hives typically go away within 48 hours. However, people with this condition may experience symptoms on and off for years. 6 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. American College of Allergy, Asthma, and Immunology. Hives. American Osteopathic College of Dermatology. Urticaria. American Osteopathic College of Dermatology. Dermatographism. Global Allergy and Airways. Physical urticaria. American Academy of Allergy Asthma and Immunology. Current treatment options in delayed pressure urticaria. American Academy of Dermatology Association. Hives: diagnosis and treatment. 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. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit