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Last Updated on November 21, 2023

What is Papular Urticaria?

Papular Urticaria is a papulovesicular response to insect and arachnid attacks; this condition is more frequent in youngsters than adults. However, it appears in the summer or fall.

Understanding Papular Urticaria

Due to this Urticaria kind, the bumps on the skin are small, raised, and itchy. However, the bumps are typically pink, red, or brown and elevated above the skin surface, unlike the more familiar hives, which are generally red and flat. Nonetheless, they are often found in clusters and are extremely itchy, causing discomfort and distress.

Is Urticaria an AutoImmune Disease?

Urticaria, commonly known as hives, is generally not considered an autoimmune disease. It is primarily an allergic reaction that involves the release of histamine and other chemicals from mast cells in the skin. Numerous institutions are conducting and actively seeking volunteers to participate in urticaria clinical trials, today.

The Different Types of Urticaria

Types Of UrticariaUrticaria doesn’t conform to a uniform pattern but manifests in various forms. However, it’s imperative to grasp the diverse types of urticaria to ensure accurate diagnosis and effective management. Here, we’ll explore some of the prevalent variations.

  • Acute Urticaria

The most frequently occurring variant of hives is acute urticaria, which typically incites an allergen or a specific trigger. Furthermore, it typically endures for several hours to several days and often subsides without requiring medical intervention. However, common catalysts encompass food allergies, insect stings, medications, and infections.

  • Chronic Urticaria

On the flip side, chronic urticaria is defined by the persistence of hives for six weeks or longer without a discernible cause. Moreover, this form of urticaria poses a more significant challenge in terms of management and often requires extensive treatment. Nonetheless, the enduring nature of chronic urticaria can affect an individual’s quality of life.

  • Physical Urticaria

Physical urticaria refers to hives triggered by physical stimuli such as pressure, cold, heat, sunlight, or sweating. However, the hives develop in response to these specific triggers and can range from mild to severe. Moreover, managing physical urticaria involves avoiding the triggering factors and using appropriate protective measures.

  • Cholinergic Urticaria

Cholinergic urticaria is a specific type of physical urticaria occurring due to sweating or increased body temperature. It can lead to small, itchy hives, typically during or after exercise, hot showers, or emotional stress.

  • Dermatographism

Dermatographism, or “skin writing,” is a type of physical urticaria where hives appear when the skin is scratched or rubbed. It’s characterized by the ability to “write” or draw on the skin as raised welts develop along pressure lines.

  • Cold Urticaria

As the name suggests, cold urticaria occurs due to exposure to cold temperatures. Swelling and hives develop upon contact with extraordinary objects or air. However, this condition can be particularly problematic during winter or when swimming in cold water.

Where does Urticaria Commonly Occur?

Now, let us discuss the places where Urticaria commonly occurs. Its preferred places to make an appearance are the arms, legs, and torso. The thing to remember is that appearances don’t always tell the whole story. Urticaria can be a stubborn condition that likes to cause other worrisome symptoms too, particularly in the throat area. When stress enters the picture, it’s like adding to the trouble. Indeed, and the warmth? Urticaria also has a preference in that area. The next time you see these unwanted patches on your skin, just remember to reach out to your nearest doctor.

What Causes Urticaria?

The primary cause of papular urticaria is a hypersensitivity or allergic reaction to insect bites. However, when certain insects bite an individual with this condition, the immune system overreacts to the proteins or other components in the insect’s saliva. Moreover, this exaggerated immune response triggers the formation of papules and the characteristic itching.

Some of the common culprits responsible for causing urticaria include

  • Fleas

Flea bites are a notorious trigger for papular urticaria. Moreover, flea saliva can result in severe itching and abscesses, especially in areas like the lower legs and ankles where the skin is thinner.

  • Mosquitoes

Many people experience mosquito bites, and although most people only suffer mild pain, those with urticaria may react more severely. The saliva of mosquitoes can trigger bump formation.

  • Bedbugs

The comeback of bedbugs in different regions of the world in recent years has led to their increased notoriety. Bedbug bites can result in characteristic raised bumps and intense itching for individuals with papular urticaria.

  • Mites

A common cause of this condition is mites, such as those seen on chiggers and scabies mites. These tiny arachnids have the potential to induce an allergic skin reaction that results in abscesses.

  • Sandflies

In areas where sandflies are common, they may cause this condition. Their bites can cause a rash of itchy pimples, frequently accompanying swelling and redness.

Symptoms of Papular Urticaria

The appearance of bumps on the skin characterizes this urticaria type. These bumps can range in size from a pinhead to a small pea and are typically firm to the touch. The color of the bumps may vary from pink to red, and in some cases, they can appear brown. The following are common symptoms occurring with papular urticaria.

  • Itching

The hallmark symptom of papular urticaria is itching, which can be both intense and persistent. This itching often leads to scratching, potentially resulting in secondary skin issues such as abrasions or infection.

  • Clusters of Papules

Papular urticaria typically presents as clusters of papules on the skin, often in the areas where the insect bites are present. These clusters can be randomly distributed and vary in density.

  • Redness and Swelling

In addition to the papules, the affected skin area may exhibit redness and swelling, further contributing to the discomfort.

  • Occasional Pain

While itching is the primary symptom, some individuals may experience pain or tenderness at the site of the papules, especially if the area becomes irritated from scratching.

  • Recurrence

One of the defining features of this condition is its tendency to recur. This means that, without appropriate management and preventive measures, new clusters of papules can appear over time, often in response to fresh insect bites.

Diagnosis of Papular Urticaria

Diagnosing this type of urticaria typically involves a clinical evaluation by a healthcare professional. The diagnosis is primarily based on the characteristic appearance of the papules and the individual’s medical history, especially a history of exposure to insect bites. The healthcare provider may sometimes recommend additional tests or procedures to rule out other skin conditions or infections.

Management and Treatment

Managing and treating this condition involves a combination of preventive measures, symptomatic relief, and, in some cases, medical intervention. Here are some strategies for dealing with this urticaria kind

  • Preventative Measures

Preventing insect bites is the most effective way to manage papular urticaria. This may involve using insect repellent, wearing protective clothing, and avoiding areas with high insect activity, particularly during peak mosquito or sandfly seasons.

  • Topical Treatments

Over-the-counter or prescription topical treatments can help relieve itching and reduce inflammation. These may include calamine lotion, hydrocortisone cream, or antihistamine creams. Applying a cold compress to the affected area can also provide temporary relief.

  • Oral Antihistamines

Oral antihistamines are commonly used to alleviate itching and reduce the body’s response to insect bites. Non-sedating antihistamines like cetirizine or loratadine are often preferred as they cause less drowsiness.

  • Corticosteroids

Sometimes, healthcare providers may prescribe corticosteroid creams or oral corticosteroids to manage severe inflammation and itching. These medications should be used under medical supervision due to potential side effects.

  • Antibiotics

If scratching leads to open sores or infection, a healthcare provider may prescribe antibiotics to treat or prevent disease.

  • Immune Therapy

For individuals with recurrent or severe urticaria, allergen-specific immunotherapy may be considered. This treatment aims to desensitize the individual’s immune system to the specific insect allergens responsible for the condition.

  • Itch Management

Preventing itching is crucial to minimizing the severity of this condition. Keeping nails short, wearing gloves during sleep to prevent scratching, and using distraction techniques can help reduce itching and minimize damage to the skin.

  • Education and Awareness

Understanding the triggers and preventive measures for urticaria is essential. Educating affected individuals and their families about the condition, its motivations, and management can significantly improve their quality of life.

Complications and Long-Term Outlook

While often uncomfortable and distressing, Papular urticaria is not typically severe. It tends to improve with appropriate management and prevention measures. However, there are potential complications to be aware of, including:

  • Infection

Constant scratching of the bumps can lead to breaks in the skin, increasing the risk of infection. It’s essential to keep the affected areas clean and use antibiotics if necessary.

  • Emotional Impact

The chronic itching and discomfort of this condition can have a significant emotional impact, causing stress and anxiety. Seeking support from healthcare providers or mental health professionals can help individuals cope.

  • Scarring

While scarring is not an expected outcome of urticaria, repeated scratching can sometimes result in scar formation. It’s essential to prevent excessive scratching to minimize this risk.

Is Papular Urticaria Contagious?

Papular urticaria is generally not considered contagious. It is an allergic reaction to insect bites, often caused by mosquitoes, fleas, bedbugs, or other biting insects. The condition occurs when the immune system reacts to proteins in the insect’s saliva, leading to the development of papules or small, red bumps on the skin. However, if the symptoms worsen do not forget to contact a healthcare facility immediately.


The skin condition known as papular urticaria is frequently dwarfed by its more well-known cousins, eczema and hives. It is an uncomfortable condition that needs to be understood and managed properly, though, for individuals who are affected. Although there isn’t a single treatment plan that works for everyone, people can greatly enhance their quality of life and lessen the influence of this “itchy” culprit on their everyday lives by taking the appropriate preventive steps, managing their symptoms, and seeking medical attention when needed.


MetroBoston Clinical Partners is a well established and experienced research center in the greater Boston area. Under the leadership of qualified physicians and medical professionals, we coordinate a range of clinical research trials in Dermatology and Internal Medicine.

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