Also referred to as chronic hives, chronic urticaria is diagnosed when a case of hives lasts more than six weeks or recurs frequently. Hives are patches of itchy red or white bumps or welts that appear on the skin. Although the exact cause of chronic urticaria often remains unknown, it is occasionally caused by an allergic reaction to foods or food additives. In this case, a chronic urticaria diet can help relieve the severity or frequency of the condition.
If you haven’t been able to pinpoint the exact cause of your chronic urticaria, you might need to begin an elimination diet 1. To begin an elimination diet, remove all potential food allergens from your diet 1. Then, reintroduce foods -- one at a time -- about every five days. Throughout the process, keep a food journal to log the types and amounts of foods you eat, along with any symptoms you experience. Since you are introducing foods one at a time, you should be able to identify any that trigger your chronic urticaria symptoms. Your physician can help you determine which foods you should eliminate. Typical food groups eliminated from the diet include:
- dairy products
- citrus fruits
- foods made with corn
- foods that contain gluten
- processed foods
- If you haven’t been able to pinpoint the exact cause of your chronic urticaria, you might need to begin an elimination diet 1.
- Throughout the process, keep a food journal to log the types and amounts of foods you eat, along with any symptoms you experience.
Gluten-Free Diet for Ulcerative Colitis
Certain foods contain histamine, a protein heavily involved in allergic reactions. When histamine is released in the body, it causes blood vessels to become more permeable. As a result, fluids rush into the area and cause swelling. Histamine also triggers smooth muscle to contract, which can be quite dangerous when it affects the muscles surrounding the airways. Since histamine plays such a significant role in allergic reactions, your physician might recommend avoiding histamine-containing foods to lessen the severity of your chronic urticaria.
- Certain foods contain histamine, a protein heavily involved in allergic reactions.
- Histamine also triggers smooth muscle to contract, which can be quite dangerous when it affects the muscles surrounding the airways.
People with chronic urticaria are often quite sensitive to salicylates, a substance present in aspirin and certain foods, according to the International Chronic Urticaria Society 23. If your doctor recommends a salicylate-restricted diet, avoid most plant-based foods. This includes nearly all fruits except apples, pears and mangoes that are peeled and cored. Although most vegetables are quite low in salicylates, peeling and cooking them before consumption can be beneficial if you have chronic urticaria. Additional foods to avoid include almonds, peanuts, water chestnuts, artificial colors and artificial flavorings.
- People with chronic urticaria are often quite sensitive to salicylates, a substance present in aspirin and certain foods, according to the International Chronic Urticaria Society 2.
- If your doctor recommends a salicylate-restricted diet, avoid most plant-based foods.
Food Sensitivities and Ringing in Ears
Even if your condition does not require you to follow a specific urticaria diet, avoid any foods that trigger a urticaria episode or worsen your symptoms. These food triggers can vary from one person to the next – and an elimination diet can help you to initially determine which foods you need to avoid 1.
Gluten-Free Diet for Ulcerative Colitis
Food Sensitivities and Ringing in Ears
Foods That Trigger Ocular Migraines
Food for Gout Sufferers
Jock Itch & Diet
Unexplainable Stomach Pains After Every Meal
Difference Between Hives & Shingles
Foods to Avoid for Pemphigus
Elimination Diet for Salicylates
- Every Diet: Elimination Diets
- International Chronic Urticaria Society: Histamine-Restricted Diet
- International Chronic Urticaria Society: Low Salicylate Diet
- Asthma and Allergy Foundation of America: Chronic Urticaria (Hives)
- Justiz Vaillant AA, Zito PM. Immediate Hypersensitivity Reactions. [Updated 2019 Jun 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513315/
- Deacock SJ. An approach to the patient with urticaria. Clin Exp Immunol. 2008;153(2):151–161. doi:10.1111/j.1365-2249.2008.03693.x
- Kanani A, Betschel SD, Warrington R. Urticaria and angioedema. Allergy Asthma Clin Immunol. 2018;14(Suppl 2):59. Published 2018 Sep 12. doi:10.1186/s13223-018-0288-z
- Katelaris CH, Peake JE. 5. Allergy and the skin: eczema and chronic urticaria. Med J Aust. 2006;185(9):517-22.
- Goh CL, Tan KT. Chronic autoimmune urticaria: where we stand?. Indian J Dermatol. 2009;54(3):269–274. doi:10.4103/0019-5154.55640
- Greaves MW, Sabroe RA. ABC of allergies. Allergy and the skin. I--Urticaria. BMJ. 1998;316(7138):1147–1150. doi:10.1136/bmj.316.7138.1147
- Ograczyk-Piotrowska A, Gerlicz-Kowalczuk Z, Pietrzak A, Zalewska-Janowska AM. Stress, itch and quality of life in chronic urticaria females. Postepy Dermatol Alergol. 2018;35(2):156–160. doi:10.5114/ada.2018.75237
- Justiz Vaillant AA, Zito PM. Immediate Hypersensitivity Reactions. [Updated 2019 Jun 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Schoepke N, Doumoulakis G, Maurer M. Diagnosis of urticaria. Indian J Dermatol. 2013;58(3):211–218. doi:10.4103/0019-5154.110831
- Hollis K, Proctor C, McBride D, et al. Comparison of Urticaria Activity Score Over 7 Days (UAS7) Values Obtained from Once-Daily and Twice-Daily Versions: Results from the ASSURE-CSU Study. Am J Clin Dermatol. 2018;19(2):267–274. doi:10.1007/s40257-017-0331-8
- Gleich GJ, Yunginger JW. The radioallergosorbent test: a method to measure IgE antibodies, IgG blocking antibodies, and the potency of allergy extracts. Bull N Y Acad Med. 1981;57(7):559–567.
- Komarow HD, Arceo S, Young M, Nelson C, Metcalfe DD. Dissociation between history and challenge in patients with physical urticaria. J Allergy Clin Immunol Pract. 2014;2(6):786–790. doi:10.1016/j.jaip.2014.07.008
- Ying S, Kikuchi Y, Meng Q, Kay AB, Kaplan AP. TH1/TH2 cytokines and inflammatory cells in skin biopsy specimens from patients with chronic idiopathic urticaria: comparison with the allergen-induced late-phase cutaneous reaction. J Allergy Clin Immunol. 2002;109(4):694-700.
- Lee EE, Maibach HI. Treatment of urticaria. An evidence-based evaluation of antihistamines. Am J Clin Dermatol. 2001;2(1):27-32.
- Fedorowicz Z, Van zuuren EJ, Hu N. Histamine H2-receptor antagonists for urticaria. Cochrane Database Syst Rev. 2012;(3):CD008596.
- Godse K, Bagadia A, Patil S, Nadkarni N, Gautam M. "Busting" urticaria with a "burst" of steroids. Indian J Dermatol. 2014;59(6):618–619. doi:10.4103/0019-5154.143546
- de Silva NL, Damayanthi H, Rajapakse AC, Rodrigo C, Rajapakse S. Leukotriene receptor antagonists for chronic urticaria: a systematic review. Allergy Asthma Clin Immunol. 2014;10(1):24. Published 2014 May 7. doi:10.1186/1710-1492-10-24
- Özkaya E, Babuna kobaner G, Yılmaz Z, Kutlay A. Doxepin in difficult-to-treat chronic urticaria: A retrospective, cross-sectional study from Turkey. Dermatol Ther. 2019;32(4):e12993.
- Naaman S, Sussman G. Chronic idiopathic urticaria: treatment with omalizumab. Skin Therapy Lett. 2014;19(6):1-4.
- Benelli E, Longo G, Barbi E, Berti I. Anaphylaxis in atypical cold urticaria: case report and review of literature. Ital J Pediatr. 2018;44(1):135. Published 2018 Nov 13. doi:10.1186/s13052-018-0578-6
- Ferrer, M.; Bastra, J.; Gimenez-Arnau, A. et al. Management of urticaria: not too complicated, not to simple. Clin Experimental Allergy. 2014; 45(4):731-43. DOI: 10.1111/cea.12465.
- Schaefer, P. Acute and Chronic Urticaria: Evaluation and Treatment. Am Fam Physician. 2017; 95(11):717-724.
Krista Sheehan is a registered nurse and professional writer. She works in a neonatal intensive care unit (NICU) and her previous nursing experience includes geriatrics, pulmonary disorders and home health care. Her professional writing works focus mainly on the subjects of physical health, fitness, nutrition and positive lifestyle changes.