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  • Q&A with Australian Health Practitioners

    What causes chronic urticaria and how long can it last?

    A bout of urticaria has become persistent and requires daily anti-histamines to control itching and rash symptoms.
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    I am Accredited Practising Dietitian with a passion for helping people who suffer from food intolerance. I have 25 years of experience in this area ... View Profile

    Chronic urticaria can occur for a number of reasons.  The majority of cases are caused by our own immune system reacting to some stimulus.  It can also be an inherited problem and stress is a common trigger but sometimes the cause is never identified. Sometimes sensitivity to food chemicals can cause chronic urticaria.

    Urticaria can last just for a few days or it can continue for many years.  If the urticaria continues for more than six weeks it is called chronic urticaria and should be investigated for possible causes.  

    The first stop should be your GP and then an immunologist who will determine whether you have auto-immune urticaria, which is when the body's immune system causes symptoms without external or outside cause.  If your urticaria is auto-immune, there are medications which will help to control the symptoms and calm the immune system.  

    If your urticaria is not due to auto-immunity, it may be worth investigating sensitivity to food chemicals.   Urticaria that is caused by food chemicals is often associated with some stress on the body, such as an emotional upset, illness, medications or operations.  The stress lessens the ability of the body to deal with certain chemicals which can cause many symptoms, including urticaria.  It is not known how these chemicals cause urticaria so there are no blood tests which will determine this type of sensitivity.  However, If the urticaria is caused by food chemicals it will improve when the chemicals are eliminated from the diet.  

    An elimination diet designed specifically for urticaria has been developed and used successfully for the past 35 years in patients with chronic urticaria.  A dietitian who has expertise in the use of this low chemical diet is the best person to help you investigate food chemical sensitive urticaria.




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    Prof Rodney Sinclair

    Dermatologist (Skin Specialist)

    Professor Sinclair is Professor of Dermatology at the University of Melbourne and Head of Dermatology at the Epworth Hospital. He has written 7 textbooks of ... View Profile

    Chronic urticaria is urticaria (hives) that persits for more than 6 weeks. Most cases that resolve spontaneously will do so within 2-4 weeks and are called acute urticaria.  Cases that persist beyong 6 weeks tend not to resolve spontaneously and many patients still require treatment 10-20 years later. This then becomes chronic urticaria

    Furthermore, while it is usual to find a cause for acute urticaria, it is unusual to find a cause for chronic urticaria.  Endless investigations looking for a cause are only occasionaly useful.  Antihistamines are your best bet. 

    If you still get hives despite taking antihistamines consider enrolling in a clinical trial.  There are a number of clinical trials investigating new treatments for this incredibly frustrating condition. 

    http://www.racgp.org.au/afp/2014/september/evaluation,-diagnosis-and-management-of-chronic-urticaria/

    http://www.sinclairdermatology.com.au/clinical-trials/

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