Chronic Spontaneous Urticaria: First Aid on the Go

Chronic spontaneous urticaria (CSU) is a condition involving hives and painful tissue swelling. Keeping useful items in a travel bag can help you manage the symptoms and find relief when you’re away from the comfort of your home.

“Urticaria” is the medical term for hives — raised, itchy bumps or welts that appear on your skin. They can vary in size, shape, color, and cause.

CSU involves nonallergic hives that appear suddenly, without an external trigger, and recur over a period of at least 6 weeks. Unlike other types of urticaria, CSU often features painful tissue swelling, known as angioedema, that typically develops around your eyes, mouth, hands, or feet.

CSU can appear anywhere on your body, with hive outbreaks lasting around 24 hours, though the condition is recurring. Because its underlying causes aren’t clear, there’s often no way to predict just when an urticaria episode will develop.

Keeping some useful items on hand when you leave home can help you find relief from symptoms no matter where you are.

What’s it called when chronic urticaria has an environmental cause?

When chronic hives have a known external or physical cause, such as insect bites, temperature, or touch, the condition is known as chronic inducible urticaria (CIndU) or physical urticaria.

Both CSU and CIndU are types of chronic urticaria, though the term “chronic urticaria” is often used synonymously with “CSU.”

What to pack in your CSU-friendly bag

You CSU-friendly bag is there to help you find relief in a variety of situations that could contribute to the development or worsening of CSU symptoms.

You can carry all your important items in one large bag and shift some to a smaller handbag to take with you while shopping, eating at restaurants, or attending social events.

Here are some items to consider adding:

Medical contact list

You might have your doctor’s number readily accessible in your phone contacts, but there may be times when someone else has to contact your doctor for you.

Having a physical list of important phone numbers in your CSU-friendly bag helps friends and family members quickly get in touch with your doctor if you’re unable to do it yourself.

While CSU isn’t life threatening, there may be times when having a loved one reach out to your doctor is easier than communicating through your discomfort.

Medications

It’s important to have medications with you if you aren’t going to be home to take your regular dose at the usual time. Staying consistent with your medication schedule helps prevent lapses in symptom management due to uneven dosing.

Having medications available may also help you during symptom flares. While most medications used to treat CSU are taken on a regular schedule (such as daily, weekly, or monthly), your doctor may provide alternative use instructions for when you experience a flare-up of hives.

Second-generation antihistamines are one of the primary medications used to treat CSU. They work by binding to histamine H1 receptors in your body, thus blocking your natural histamine and its effects, such as itching, swelling, and redness. Doctors occasionally increase antihistamine doses to help manage symptoms.

Common antihistamine medications that you might keep in your CSU-friendly bag include:

• cetirizine (Zyrtec)
• loratadine (Claritin)
• fexofenadine (Allegra)

Other medications you might have on hand are omalizumab (Xolair) and cyclosporine. If you’ve just recently received a CSU diagnosis, you might also have a short-term supply of corticosteroids.

If you’re unsure about using your medications at times when your symptoms worsen, contact your doctor first.

Moisturizer

Dry skin can compound itchiness from conditions such as CSU. By using a gentle, fragrance-free moisturizer formulated for sensitive skin, you can help keep your skin moisturized throughout the day, no matter where you are.

Cooling pack

Cold can help soothe itchiness and reduce swelling. While it might not be practical to carry an ice pack with you, you can try instant cold compresses that you can activate when you need them. These products work through chemical reactions triggered by folding, twisting, or breaking the package.

You can apply a cold compress to itchy areas for 10 to 20 minutes at a time.

OTC soothing creams or ointments

CSU is not an allergy. Even though many of its symptoms arise from histamine release, first-generation antihistamines (such as diphenhydramine) are often not as effective at relieving symptoms.

Over-the-counter (OTC) anti-itch creams and ointments usually feature first-generation antihistamines or corticosteroids, so they may not be as effective at managing symptoms if you’re having a hive flare from CSU. For example, topical corticosteroids are not considered a standard therapy for CSU.

Other OTC soothing creams and ointments, such as calamine lotion, may help. Calamine lotion is a soothing topical product made with zinc oxide and ferric oxide. It relieves itching and cools your skin through mechanisms that don’t involve histamine pathways.

Products made with the following ingredients can also help manage itch through alternative mechanisms:

• colloidal oatmeal
• zinc oxide
• aloe vera
• capsaicin
• pramoxine hydrochloride
• menthol

It may take some experimenting to learn which OTC product is the most effective at relieving your symptoms.

Loose clothing

Even though CSU isn’t caused by external triggers, certain environmental factors, such as tight clothing, can aggravate your symptoms. Tight clothes can create friction and heat and trap sweat against your skin.

If you start to feel itchy while you’re out, changing into loose clothing can allow air to circulate across your skin and reduce friction.

A personal fan

Heat is another potential irritant when you’re already experiencing CSU symptoms. When you’re starting to feel overheated, using a personal fan may help. A variety of styles are available, including fans that sit around your neck and ones that can fit in the palm of your hand.

Distraction items

It’s not always possible to gain immediate relief from CSU symptoms. If you’re in a situation where your symptoms aren’t improving, distraction may help until you can contact your doctor.

Distraction is a mental technique that involves shifting your focus away from something distressing, such as pain or itch, to help lessen its impact. Even though the sensations continue, distraction puts something else in the forefront of your mind.

Possible distraction items include headphones for music, a book, games, puzzles, and a crafting item like a knitting set.

When to see a doctor

Many people successfully manage CSU with medications. Although estimates vary across studies, one 2022 research review suggests that up to 47% of people may experience remission (a period of time without symptoms) within 12 months.

If your symptoms are worsening, are occurring more often even when you follow your current treatment plan, or do not improve with the help of rescue aids you keep in your CSU bag, it may be time to talk with your doctor.

⁣ What is ‌Chronic Spontaneous​ Urticaria?

Chronic Spontaneous Urticaria ⁣(CSU) is ⁢a condition⁤ characterized by the‌ spontaneous occurrence ⁢of hives and swelling on the skin, lasting​ for six weeks or longer. The exact​ cause‍ of CSU is often unknown, making it challenging to determine‌ specific triggers. It can lead to uncomfortable symptoms such as⁢ itching and redness.

What are the symptoms of CSU?

The primary symptoms of​ CSU include itchy ‌hives or‍ welts on the ⁤skin, and angioedema, which is swelling under the skin. These symptoms can occur anywhere on the body ‍and may vary in ‌size and shape. They often appear and resolve spontaneously, often recurring without any identifiable trigger.

How can I⁢ manage ⁢CSU⁢ symptoms on the go?

For immediate relief, you⁤ can‍ take over-the-counter ​antihistamines to ‌reduce itching and ‍swelling. Wearing loose-fitting clothing ⁣can help minimize irritation, and applying cool compresses can soothe the​ skin. Stay calm and avoid scratching to prevent worsening of the symptoms.

⁤What should I include⁢ in a first-aid kit for CSU?

A first-aid kit for CSU should include antihistamines, cool ⁤compresses or instant cold packs, calamine lotion, and any prescribed emergency medications. It’s also useful to⁢ have a⁤ list of known triggers as well as ⁣contact information ‍for ⁣healthcare providers.

Are there specific triggers I should avoid?

While‌ triggers can‌ vary‌ for each individual, common ones include stress, heat, certain foods, alcohol, and medications. It’s beneficial to keep a‌ diary​ to identify and ‌avoid potential triggers effectively.

⁤When should I seek ⁣medical attention?

Seek medical​ attention if you experience severe swelling, especially ⁣in areas like the face or throat, which could indicate⁣ an anaphylactic reaction. Additionally, if the symptoms do⁤ not ⁤respond to‌ over-the-counter ‍medications or if they are severely impacting your daily life, consult a healthcare ‍professional.

Can CSU affect my daily activities?

Yes, CSU can affect daily activities due to symptoms like⁣ itching and swelling. However,⁣ with proper management, most people can‍ effectively‌ control the condition‍ and maintain a regular lifestyle. It’s essential⁣ to follow an appropriate treatment plan ⁢and remain vigilant about potential triggers.

What are the long-term treatments for CSU?

Long-term treatments for CSU may include‍ prescription ⁢antihistamines, leukotriene receptor antagonists, or therapies like omalizumab. Your healthcare provider may ‍also suggest lifestyle changes or complementary therapies, such as stress management techniques, to help control symptoms.

Takeaway

CSU is a nonallergic condition involving recurrent hives and tissue swelling over a period of at least 6 weeks. Unlike other forms of urticaria, CSU doesn’t have an environmental or physical trigger.

Most people can successfully manage CSU with regular medication, but keeping a bag of CSU-friendly supplies on hand can help you manage your symptoms and find relief when you’re away from home.