Urticaria and Hormones

Urticaria despite being a common dermatological condition is largely unknown and can be triggered by not just external stimuli but the hormonal dysfunctions as well. The thyroid hormone has been implicated in the pathogenesis of urticaria, with a higher prevalence in patients with autoimmune thyroid disease. Estrogen and Progesterone have also been implicated to trigger urticaria through its effects on mast cells, which are responsible for the release of histamine, cytokines, and other mediators of inflammation. Estrogen has been shown to increase the expression of mast cell tryptase, a protease that activates the complement system and cleaves other mediators of inflammation. Off lately, insulin resistance and chronic inflammation associated with metabolic syndrome has also been linked to trigger mast cell activation and histamine release, leading to the development of urticaria. Although Antihistamines remain the first line management, replacement therapy for hypothyroidism, hormone therapy for estrogen and progesterone dysfunction and lifestyle modifications, including weight loss, healthy diet, and regular exercise for metabolic syndrome are the treatment options available.