Chronic Urticaria: Will Those Suffering Grow Out of It?

Will sufferers of chronic urticaria grow out of it? In most cases, yes. However, this will depend very much on whether the cause can be identified and avoided. Even the chronic idiopathic varieties tend to bum themselves out eventually. In some poor unfortunates it goes on and on for years.

Are there any complications? Most urticarias are more of a nuisance than a threat, there is no doubt that chronic urticaria can be demoralising. It can also seriously disrupt sleep, and it can sometimes become an obsession. Indeed, some patients become more obese with the cause of the itch than with the itch itself! These may invest a great deal of time and money trying to get to the root of their problem, only to become increasingly frustrated by their lack of success.

In some patients, the urticaria can progress to seriously affect other systems in the body besides the skin. The symptoms which ensue are due to the direct effects of histamine release from mast cells in other parts of the body. Affected patients may complain of joint pain and abdominal pain. They may also feel feverish. Continued and more widespread histamine release may lead to fatal or near-fatal anaphylaxis. This is true not only of allergic urticaria, but of the other (physical) urticarias. To make the point, Pamela nearly died from cold-induced urticaria.

Rarely, an angioedema (swelling) may occur in the throat or voice box. Space is limited in these areas, so even moderate swellings may obstruct the airway. This happened to Imelda on her fifteenth birthday. There was great fun at the party, and junk food aplenty. Suddenly, Imelda couldn't breathe. There was absolutely no movement of air in or out of her chest. She stood slightly forward with her mouth agape and tongue protruding. Her friends looked on in horror as she turned an ominous shade of purple. One of them, who thought she was choking, came forward to slap her on the back. As her hand came down on the chest wall there was an immediate silent 'cough' of expelled air, but this was not followed by an intake of air! Imelda, of course, was terrified. She ran out of the house in desperation and fell to the ground. She had a complete airway obstruction from swelling. Fortunately, the swelling subsided of its own accord, almost as rapidly as it had developed, and Imelda was able to breathe again. She had a close call. A little detective work led us to the culprit: she was reacting to sulphites, preservatives used in some soft drinks.

Malcom W. Grieves, "Urticaria and Angiodema." Amazon