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Chronic urticaria: Standard management and patient education

David A Khan, MD
Section Editors
Sarbjit Saini, MD
Jeffrey Callen, MD, FACP, FAAD
Deputy Editor
Anna M Feldweg, MD


Chronic urticaria (CU) is defined by episodic urticaria (hives) for a duration of longer than six weeks [1]. The prevalence of this disorder is 1 to 2 percent of the general population in the United States and is believed to be similar around the world [2,3]. Associated angioedema occurs in at least 50 percent of patients with CU and usually affects the lips, cheeks, periorbital areas of the face, extremities, and genitals [4,5].

This topic will discuss the initial and most commonly used therapies for CU, as well as counseling of individuals with this disorder. Treatment of CU that is refractory to standard management and the diagnosis, pathogenesis, and prognosis of CU are presented separately. (See "Chronic urticaria: Treatment of refractory symptoms" and "Chronic urticaria: Clinical manifestations, diagnosis, pathogenesis, and natural history".)

Disorders involving isolated angioedema, urticarial vasculitis, and specific physical forms of CU (such as delayed-pressure urticaria, cholinergic urticaria, or cold urticaria) are discussed separately. (See "An overview of angioedema: Pathogenesis and causes" and "Urticarial vasculitis" and "Physical urticarias" and "Cold urticaria".)


In this review, the term chronic urticaria (CU) refers to patients with isolated chronic idiopathic urticaria (CIU), as well as those with both urticaria and angioedema. There are several closely related terms that are used in the CU literature.

Chronic idiopathic urticaria and chronic spontaneous urticaria — The terms "chronic urticaria," "chronic idiopathic urticaria," and "chronic spontaneous urticaria" are used interchangeably in this review. Chronic urticaria is the most general term and is used less in the literature over time because it is nonspecific and would often be used to describe patients with a mixture of idiopathic urticaria and physical urticaria (ie, hives triggered by physical stimuli, such as heat, cold, pressure applied to the skin, exercise, water, vibration, and sunlight). Physical urticaria, also called "inducible urticaria," is discussed separately. (See "Physical urticarias".)

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Literature review current through: Nov 2017. | This topic last updated: Apr 07, 2017.
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