Hives: Acute vs. Chronic, Dermatologist Explains Differences

Acute and chronic urticaria are fundamentally different conditions, not merely different stages of the same disease, according to a leading dermatologist. Dr. Yu You of Xizhi Cathay General Hospital explained that recent research published in JAMA Dermatology clarifies that these two forms of hives are separate illnesses.

“

Acute urticaria and chronic urticaria are two separate and independent diseases!

Acute urticaria often presents as a rapid allergic reaction triggered by external factors such as specific foods, medications, or infections. These outbreaks are usually short-lived and tend to resolve spontaneously. In contrast, chronic urticaria is defined by its persistence, recurring for more than six weeks. Dr. Yu emphasized that chronic cases are not simply unresolved acute episodes but stem from an immune system malfunction, leaning more towards an autoimmune disorder.

“

Acute urticaria is like an 'acute allergic reaction' of the skin, usually triggered by external allergens (like specific foods, drugs) or infections. It comes quickly and goes quickly, and most will heal on their own.

A common misconception is that aggressive treatment, such as high-dose systemic steroids during an acute phase, can prevent the condition from becoming chronic. However, Dr. Yu cited the research to debunk this myth, stating that such treatments in the acute stage do not reduce the risk of developing chronic urticaria. For patients experiencing acute hives, he advises against excessive anxiety, focusing instead on managing the itching and discomfort under medical guidance.

“

Chronic urticaria recurs for more than six weeks. It's not because your acute phase 'wasn't treated well,' but because your immune system 'crashed,' with the mechanism leaning more towards an 'autoimmune disease.'