Does Chronic Spontaneous Urticaria Ever Go Away?

Chronic spontaneous urticaria (CSU) isn’t just physically uncomfortable. The mysterious, come-and-go nature of the condition can also be incredibly stressful.

With chronic hives, “Symptoms may flare for weeks or months, then disappear, only to return again without warning,” says Inderpal Randhawa, MD, a board-certified allergist and immunologist and founder of the Food Allergy Institute in Long Beach, California.

So whether this is your first flare-up or your tenth, you’ve probably found yourself wondering whether you’re destined to deal with hives for the rest of your life. The short answer: While it’s not possible to say with certainty, the condition does tend to ease up over time. Keep reading to learn why CSU shows up in the first place and when it might disappear.

And even though “spontaneous” is in the name, there are certain well-known triggers for flares, including an allergic reaction, exposure to heat or cold, heavy vibration (for example, from jogging or using a lawn mower), infections, pressure on the skin (like a tight waistband), stress, and sunlight. “These aren’t the cause of hives but, rather, aggravating factors,” says Jessica Hui, MD, a pediatric allergist and immunologist at National Jewish Health in Denver.

When you’re exposed to one of these triggers, your body releases immune system chemicals, such as histamine, into the bloodstream. The reaction leads to the development of purple, red, or skin-colored welts (sometimes called wheals) that can vary in size and shape. The welts can appear, fade, and reappear throughout the body, making your skin itchy, swollen, and uncomfortable.

Unfortunately, there’s no clear-cut answer as to when chronic hives go away. “We don’t fully understand why some patients go into remission and others don’t,” says Dr. Randhawa, noting that “genetic predisposition, immune dysregulation, and autoimmunity may all play roles.”

Be prepared, though, for symptoms to return. “Relapses are common, especially after stopping treatment,” Randhawa says. “Patients with autoimmune markers or thyroid disease may be more prone to recurrence.”

While relapses can’t always be prevented, avoiding the triggers that made CSU flare in the past can help keep the condition at bay, says Dr. Hui. And be proactive if you start to notice symptoms such as itching, prickling, swelling, or tingling. “Keep an extra antihistamine with you, so you can treat the flare right when it happens,” she recommends.

• The symptoms of chronic spontaneous urticaria often linger for a year or more before they disappear.
• Chronic hive outbreaks can appear in cycles for two to five years, but a smaller number of people can experience them for 10 years or more.
• Over-the-counter and prescription treatments can help ease the itching and swelling from chronic hives in the meantime.