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Itching for answers?

A closer look at CSU

Itch is reported by 42% of people to be the worst symptom of chronic spontaneous urticaria (CSU), causing discomfort during the day and disrupted sleep at night.1 In fact, 92% of people report sleep interference because of itching, which in turn can affect the ability to perform day-to-day activities due to being less rested.1

This lack of sleep can reduce performance at work, and in instances when a partner’s sleep is also disturbed, can affect personal relationships as well.2

With an impact on so many aspects of your daily life, it is not surprising that people with CSU are often left with questions about the triggers and causes of this constant itching.

Why do we itch?

You may be surprised to hear that one of the culprits causing your itch – histamine – is a chemical that usually acts as part of our body’s defence against infection. Let’s take a closer look at some of the players involved, how hives are formed, and what actually causes your itch.

The players

White blood cells

  • Making up part of the immune system, these cells help keep us healthy by defending our body against infections. Most people know them as a component of the blood, but they are actually found in greatest number within the tissues of the body.3 There are many different types of white blood cells, including mast cells that can be found in our lungs, blood, bone marrow, intestines and skin.4

Histamine

  • The symptoms of CSU are caused by an abnormal activation of the immune system, and as part of this activation, the mast cells in the skin release a chemical called histamine.5,6
  • It is not entirely known what causes mast cell activation and histamine release in CSU, but it may be due to the body not recognising what would normally be a natural protein in our blood. As a result, white blood cells are activated to fight these unrecognised proteins, causing histamine release.7-9

The hives

  • The relaxation of blood vessels caused by the chemicals released from mast cells also means plasma from the blood can leak from blood vessels into the skin, making it swell up and form a hive.7
  • Hives are red because the relaxed blood vessels mean blood is closer to the surface of the skin.7

...and the ITCH

  • 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.7

Taking action

If you are suffering from itch, it may seem at times that the itch influences all aspects of your life, and is beyond your control. However, because we know the cause of the itch, there are options that have been developed to tackle histamine and reduce the symptoms you are experiencing. To find out more about these options, speak to your doctor. You can also reach out to other people with CSU and join them to share experiences, advice and support through the CSU Facebook Community.

They say that knowledge is power, so we hope this article brings you one step closer to regaining control of your condition.

References

  1. O’Donnell BF et al. Br J Dermatol 1997; 136:197-201.
  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. Encyclopedia Britannica. White Blood cells. Available at http://www.britannica.com/EBchecked/topic/337728/white-blood-cell. Accessed December 2014.
  4. Fodinger M et al. Blood. 1994; 84(9):2954-59.
  5. Hennino A et al. Clin Rev Allergy Immunol 2006; 30(1):3-11.
  6. 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.
  7. Zuberbier T et al. Allergy 2014; 69(7):868-87.
  8. Kaplan AP. Allergy Asthma Immunol Res. 2012; 4(6):326-31.
  9. Gomez G et al. J Immunol. 2007; 179(2):1353-61.
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