Jaipur, October 2026.

It starts with an itch. Then come the raised, red patches that seem to appear out of nowhere. You may assume it is something you ate, a new product you used or simply a temporary allergic reaction. But what if the hives keep coming back, week after week?

When itching and hives continue to recur for more than six weeks, it could be chronic spontaneous urticaria (CSU). CSU is a type of chronic urticaria where recurring itchy hives, deeper swelling called angioedema, or both occur without an identifiable external trigger. Unlike a one-time allergic reaction, there may not be one specific food, medicine or environmental factor that explains why the symptoms keep returning.

The condition can be more disruptive than it appears on the skin. The constant itching, sudden flare-ups and uncertainty around when symptoms may return can affect sleep, energy, concentration and everyday activities.

Dr. Surendra Kumar Thalor, Dermatologist, Jaipur, said, “Hives are commonly perceived as an allergic reaction that should resolve on its own. However, when itching and hives persist or recur for more than six weeks, chronic spontaneous urticaria may be a possible cause. Beyond the physical symptoms, the condition can disrupt sleep, affect energy levels and interfere with everyday routines. Seeking advice from a dermatologist or allergist can help identify the condition and guide appropriate treatment.”

Here are five signs that may indicate your recurring hives and itching could be CSU:

1. Your hives keep coming back

Hives are raised, itchy patches or welts that can appear on different parts of the body. Individual hives often disappear within hours, while new ones may appear elsewhere. If this pattern continues for more than six weeks, speak to a healthcare professional.

2.The itching affects your sleep and energy

Persistent itching can make it difficult to sleep comfortably and leave you tired during the day. A 2025 survey of people living with CSU, 62% reported sleep problems during flare-ups and 49% experienced fatigue.[1] This can also affect concentration and daily routines.

3. You notice swelling along with your hives

CSU can cause angioedema, a deeper swelling beneath the skin. It commonly affects the lips, eyelids, hands or feet and can occur with or without hives. Recurring, unexplained swelling should be discussed with a healthcare professional.

4. You cannot identify a clear trigger

When hives keep appearing, it is natural to look for a reason, such as a particular food, medicine or skincare product. However, CSU is characterised by recurring symptoms without an identifiable specific external trigger. Certain factors may worsen symptoms, but there may not be one clear cause behind each episode.

5. It starts affecting your everyday life

CSU can affect more than physical comfort. Visible hives or swelling may make some people uncomfortable in social situations, while repeated flare-ups can make everyday plans harder to manage. Over time, this can also affect emotional wellbeing.

For someone experiencing recurring hives, the six-week mark can be an important point to pause and look beyond the assumption of a temporary allergy. When symptoms keep returning, recognising the pattern can help put a name to what may be happening and highlight the impact CSU can have beyond the skin.