Living with chronic spontaneous urticaria (CSU) can mean having many uncomfortable days. Worse yet, it can seem that the itchy rashes and welts develop when you least expect them. Though it may not seem like it, CSU has various triggers that you need to know. Once you have that information, it can be easier for you to avoid them and have fewer flare-ups.
10 Surprising Triggers of CSU
1. Stressful Situations
Stress and anxiety have been known to cause different health issues. They can upset your stomach and make your heart race. For some people with CSU, stress can also trigger a flare-up. If you’re under constant stress, this can even lead to more severe symptoms that you can’t treat at home. While you can try stress management techniques such as meditation and breathing exercises to maintain a healthy mental state, it’s usually best to avoid stressful situations as much as possible.
Mental and emotional stress can trigger CIU for some people. It’s also possible that the constant itch and uncomfortable feelings associated with CIU hives can cause more stress, which may make symptoms last longer.
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2. Pet Dander
It might not surprise you that pet dander can trigger a CSU flare-up. However, you might not expect how easily you can come in contact with these irritants. You don’t need to have to be in contact with a pet or even have one to have a reaction. The flakes of skin can stick around on furniture, bedding, clothing, and anywhere the pet spends time. That means you can even have a reaction if you spend time with someone who has been in contact with pets.
With this trigger, you should stay away from pets while also letting people with pets know that you may have a reaction to them if they have had contact recently.
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3. Drinking Alcohol
Although more study needs to be done, some people with CSU experience an allergic reaction when they drink alcohol. In this case, it’s best not to drink alcohol at all.
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4. Wearing Tight Clothing
Tight clothing can put pressure on the skin and irritate it. To make things worse, tight clothing traps heat, which is also known to be a problem for sensitive skin. While you’re more likely to see rashes or welts where the most pressure is applied, it doesn’t mean you’ll only see the problem there.
5. Environmental Irritants
Depending on where you live or work, irritants in the environment can trigger the symptoms of CSU. Pollen from certain plants, cinnamon, and stinging nettle can trigger a flare-up. If you’re outside, excessive cold or heat can irritate your skin. Getting bitten by insects can also have the same effect.
7. Scratching Your Skin
As impossible as it may seem, you shouldn’t scratch your itchy skin. It may feel satisfying at the time, but doing so eventually makes things worse. Scratching irritates the area and reduces your skin’s itch threshold. That means itching can seem more intense than it is over time, which makes you more likely to scratch. You’ll get stuck in a vicious cycle where you’re constantly causing a flare-up.
8. Catching an Infection
Getting sick can also trigger your CSU symptoms. The infection may be viral, bacterial, parasitic, or fungal in nature, but even the common cold can set off a flare-up. Some conditions, like diabetes, lupus, thyroid disease, rheumatoid arthritis, and celiac disease, can also irritate.
9. Taking Certain Medications
Some painkillers, like nonsteroidal anti-inflammatory drugs (NSAIDs), can trigger your CSU symptoms. Antibiotics that contain penicillin can also cause a flare-up. Interestingly, it’s possible to take these medications initially and have no reaction. In this case, it’s essential to stay vigilant for the start of any symptoms.
10. Your Diet
Sometimes what you eat can set off flare-ups. For example, if you have a latex allergy, eating bananas, chestnuts, kiwis, or mangos can cause a reaction. Some people can also have an allergic reaction to the additives that are used in foods, spices, and supplements. Additionally, spicy foods have been known to trigger CSU symptoms.
11. Taking Hot Showers
A hot shower can feel good at times, but you’re drying out your skin and increasing the likelihood that you’ll have an allergic reaction. You’ll have better luck avoiding flare-ups if you shower with warm water instead.
RELATED: Living with CSU When Triggers Are Everywhere
How to Handle Flare-Ups
Unfortunately, even as you work to manage your triggers, you may never completely stop having flare-ups. If you develop the characteristic hives and welts, there are a few ways to ease your symptoms at home. The first thing you should know is that doctors recommend staying away from painkillers even if you’re having discomfort.
That’s because almost 30 percent of people with CSU have an allergic reaction to nonsteroidal anti-inflammatory drugs (NSAIDs). It’s estimated that it might happen because these drugs inhibit cyclooxygenase-1, an enzyme involved in the immune system’s inflammation response. Of course, if you’ve taken NSAIDs before with no issues, then it may be possible for you to take them again.
Instead of painkillers, consider using a cool compress on the affected area. You can easily make one by running a washcloth under cold water and squeezing out the excess liquid. Once you have the compress, place it on the itchy area for about 20 minutes. Most importantly, don’t scratch the area, as this only makes the problem worse.
As much as possible, consider wearing loose-fitting clothing so you don’t irritate the affected areas. Applying over-the-counter creams or ointments that soothe itchy skin can also help.
When to See a Doctor
Generally, it’s a good idea to talk to your doctor if you’ve been having unexplained hives, raised bumps, and itchy skin for more than six weeks. Even if you haven’t talked to your doctor and have been trying to manage the symptoms on your own, it isn’t too late to get the help you need. It’s unlikely that you’ll be able to completely keep your symptoms at bay without medical intervention.
When treating CSU, doctors are likely to start with antihistamines. These drugs stop your body from producing the histamines that cause the allergic reactions you usually experience. Some antihistamines have a non-drowsy formulation, but sometimes only the ones that make you drowsy work well enough. A few of the side effects of antihistamines are drowsiness, dry mouth, dizziness, and tinnitus, and higher doses may lead to euphoria, problems with coordination, and delirium.
While antihistamines are effective for most people dealing with CSU, others need further treatment. If antihistamines don’t work, your next bet may be a leukotriene receptor antagonist (LRA). These drugs work by interfering with the cell signaling that contributes to inflammation and other symptoms that are characteristic of CSU. With these drugs, you may experience headache, cough, indigestion, stomach pain, influenza infection, gastrointestinal upset, headaches, and upper respiratory infection.
Immunomodulatory therapy is another option your doctor may explore if antihistamines don’t work for you. This treatment uses immunosuppressants to keep your immune system from reacting to triggers. However, doctors use this sparingly because of the variety of potential side effects. The list can include nausea, headache, cough, joint pain or soreness, colds, respiratory infections, irregular heartbeat (arrhythmia), decline in kidney function, cold sores, eye redness, itching eyes, joint pain, shortness of breath, and wheezing.
You may also be prescribed corticosteroids for short-term use. Although these drugs are effective for reducing itching and swelling, they come with the risk of increased high blood sugar levels, trouble sleeping, increased appetite, and high blood pressure.
Finally, phototherapy can be used to supplement antihistamines. Although doctors still aren’t sure how exposing the affected areas to controlled light helps CSU, many people have gotten relief from their symptoms.
Though you may not know it, CSU has some unexpected triggers, and avoiding them can reduce your likelihood of having flare-ups. However, staying away from triggers usually isn’t enough to stop flare-ups altogether, so it’s best to talk to a doctor about persistent symptoms.
