{
  "id": 16253526,
  "title": "When hives keep coming back for no obvious reason",
  "url": "https://urgent.news/2026/10/24/when-hives-keep-coming-back-for-no-obvious-reason",
  "topic": "world",
  "section": "World",
  "published": "2026-10-24T00:30:00.000Z",
  "source": {
    "name": "Free Malaysia Today",
    "slug": "free-malaysia-today-freemalays",
    "url": "https://www.freemalaysiatoday.com/category/leisure/2026/10/24/when-hives-keep-coming-back-for-no-obvious-reason"
  },
  "original_language": "en",
  "account": "Chronic spontaneous urticaria (CSU) is a condition characterized by recurring itchy, raised hives for more than six weeks without an obvious external trigger. The rash can appear suddenly, last for hours, and then reappear elsewhere on the body, making it difficult to predict. Dermatologist Dr Peter Ch’ng often hears patients say, \"The rash disappeared while I was waiting to see you, but I know it will come back again.\" This pattern is familiar to people living with CSU.\n\nThe condition can significantly impact a person's life, affecting sleep, concentration, work, and emotional wellbeing. Typical urticaria lesions are smooth and transient, disappearing within a day without leaving marks. However, rashes that persist, scale, become painful, or leave bruise-like changes may indicate another condition and require further assessment.\n\nWhile stress may worsen urticaria in some individuals, there is no direct link between haze and CSU. Some patients mistake the rash for eczema, psoriasis, or an allergic reaction. Getting the diagnosis right is crucial because similar-looking conditions may require different management.\n\nA Malaysian study found that over 80% of patients with CSU reported moderate-to-severe itching and hives, which can significantly impact work, social life, and daily activities. Clear photographs during flare-ups are useful for documenting the rash's behavior. Typical urticaria lesions are smooth and transient, but rashes that persist, scale, become painful, or leave bruise-like changes may indicate another condition.\n\nNot every episode of hives is CSU; the six-week duration or recurrence threshold helps distinguish chronic disease from a short-lived episode. Some patients use steroid cream to manage flare-ups, but this approach often makes little sense as individual lesions vanish quickly and reappear elsewhere. Repeated steroid injections as a long-term solution should be approached with caution due to potential health risks.\n\nInternational guidelines recommend second-generation H1 antihistamines as first-line treatment. If symptoms remain uncontrolled, treatment can be escalated under medical supervision. Dr Ch’ng emphasizes that the goal is clear, symptom-free skin rather than merely partial improvement.",
  "summary": "Chronic spontaneous urticaria can appear, disappear and move around the body, often making the condition difficult to capture during a medical visit.",
  "key_points": [
    "Chronic spontaneous urticaria (CSU) lasts over six weeks without external trigger",
    "Dermatologist Dr Peter Ch’ng hears patients’ recurring rash pattern",
    "Over 80% Malaysian CSU patients report moderate-to-severe itching and hives"
  ],
  "editors_take": "Distinguishing chronic spontaneous urticaria from temporary rashes is essential for patients to avoid ineffective steroid treatments and access the correct long-term management for their recurring symptoms.",
  "illustration": null,
  "coverage": {
    "outlets": 1,
    "also_reported_by": []
  },
  "ai_generated": true,
  "disclaimer": "Summaries, key points and the editor’s take are written by software from other outlets’ reporting and may contain errors — always check the linked original."
}