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Making sense of the symptoms: Why am I so Itchy?

Making sense of the symptoms is the first in a new series identifying and discussing some of the most common symptoms of chronic spontaneous urticaria (CSU) and other types of skin disease.

Ah yes, a new year with a whole new list of resolutions that you will definitely stick to. Well, at least try to, right?

2016 Resolutions:

  1. Go to the gym at least twice a week: Totally do-able
  2. Stay away from the candy bucket at work: Maybe reachable (they have chocolate this year!)
  3. Stop scratching when a CSU breakout occurs: Simply impossible

While we can’t help you with the first two resolutions from above, we CAN be there for you when it comes to a CSU outbreak. So, let’s talk about it. That feeling. That annoyance. That awful, terrible, can-ruin-a-perfectly-good-day itch when you are living with a skin condition. An uncontrollable need to scratch during a breakout. It often can feel like a million cats clawing underneath your skin.

So here you are this January having an outbreak. It’s not that you have to scratch, it’s that you NEED to scratch, or at least it feels that way. To top it off, if you are living with cold urticaria, the cool temperatures and low humidity often contribute to even drier skin, exacerbating the issue this time of year.1 Happy winter to you, too.

And of course, it feels good to give in. Scratching is a temporary yet blissful feeling of relief to a problem that you face over and over again. It’s like giving into an old habit that never goes away. It keeps you up at night, you lose sleep, you’re cranky and your boss/boyfriend/girlfriend/pet goldfish all take notice.2


The bad news: Scratching your skin will not cure you of your symptoms. The good news: There are other ways to help manage your itchiness.

Why is this happening to me?

Now we’re about to get a little scientific on you, so put on your lab coat and plastic goggles! (Okay, you don’t really have to). The reason for your itching may not be as simple as you would think. After much research, scientists have pinpointed that itchy, dry skin is frequently caused by histamine, a chemical that acts as part of your body’s defense against infection.3 So why would a chemical that is supposed to protect the body cause so much irritation? Here’s why:

  • First, the symptoms are caused by an abnormal activation of the immune system, and as part of this activation, a type of white blood cells, called mast cells in the skin release histamine.4,5
  • It is not entirely known what causes mast cell activation and histamine release in chronic spontaneous urticaria, but it may be due to the body not recognizing what would normally be a natural protein in our blood. As a result, mast cells are activated to fight these unrecognized proteins, causing histamine release.6,7,8
  • Histamine, one of the chemicals released from your mast cells activates nerves in the skin which are normally used to detect changes in its immediate environment, such as heat or touch, and this causes your skin to itch.6

Long story short, scientists have at least identified the chemicals that cause itching (histamines) but they haven’t quite figured out the connection between having CSU and exposure to these chemicals. Changes in environment like temperature or clothing can also increase the irritating symptom.9

Ways to prevent it

Now that you know what causes that itch, it’s time to take action. The first place you should start is one you would expect: Your doctor’s office. Be sure to thoroughly explain your symptoms to your doctor so you can set the right path to reducing the itch that you are feeling. If you need a little help in keeping track of your urticaria symptoms, we’ve got you covered with our Urticaria Tracker App.

Although this is not scientifically proven, changing your diet around could lead to improvement in your symptoms. Try a low-histamine diet, which means excluding things like smoked fish, mature cheese and tomatoes10 and see if you notice a difference. You should still check first with your doctor about this and work out a specific diet that could work for you.

To combat the itch that may come with cold weather, keep your skin warm and moisturized (easier said than done this time of year, we know). Try wearing natural textures that let your skin can breathe and are comfortable.

Also, consider hopping on to the CSU Facebook community to share your experiences, advice and support with others who are also living with chronic spontaneous urticaria.

We hope this helped relieve some of the itch you’ve been begging to scratch. Keep an eye out for more Making Sense of the Symptoms series on our site as we’ll be going over other symptoms you may have and the best ways to combat them.

  1. Zuberbier, T., et al. "EAACI/GA2LEN/EDF guideline: definition, classification and diagnosis of urticaria." Allergy 61.3 (2006): 316-320. Accessed on November 15, 2015: http://onlinelibrary.wiley.com/store/10.1111/j.1398-9995.2005.00964.x/asset/j.1398-9995.2005.00964.x.pdf?v=1&t=ih2hmbzx&s=0c1da070aef69be82d2501ae31d6755769a8a4511
  2. Wheals of Despair. Chronic spontaneous urticaria: breaking free from the cycle of despair. Allergy UK & Novartis 2014; Available at http://content.zone-secure.net/whealsofdespair/ . Accessed: October, 2014.
  3. http://www.skintolivein.com/urticaria/urticaria-and-you/itching-for-answers/
  4. Hennino A et al. Clin Rev Allergy Immunol 2006; 30(1):3-11. Taken from: http://www.skintolivein.com/urticaria/urticaria-and-you/itching-for-answers/
  5. Saini S. abc News. Why do I itch when I get hives? Available at: http://abcnews.go.com/Health/AllergiesOther/story?id=4521888. Accessed December 2014. Taken from: http://www.skintolivein.com/urticaria/urticaria-and-you/itching-for-answers/
  6. Zuberbier T et al. Allergy 2014; 69(7):868-87. Taken from: http://www.skintolivein.com/urticaria/urticaria-and-you/itching-for-answers/
  7. Kaplan AP. Allergy Asthma Immunol Res. 2012; 4(6):326-31. Taken from: http://www.skintolivein.com/urticaria/urticaria-and-you/itching-for-answers/
  8. Gomez G et al. J Immunol. 2007; 179(2):1353-61. Taken from: http://www.skintolivein.com/urticaria/urticaria-and-you/itching-for-answers/
  9. Psoriasis. Schön MP, Boehncke WH. N Engl J Med. 2005 May 5;352(18):1899-912. Accessed on November 16, 2015: http://www.ncbi.nlm.nih.gov/pubmed/?term=15872205 http://www.nejm.org/doi/full/10.1056/NEJMra041320
  10. Website “urticarial day” – Diet. Last accessed: 13.10.15 http://urticariaday.org/urticaria/diet/

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