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Delayed Pressure Urticaria

Common, Often Disabling Disease


Updated June 06, 2014

Delayed pressure urticaria is a type of chronic hives called physical urticaria because the hives are caused by a certain stimulus on the body. In this case, the stimulus is pressure that's applied to the skin. Delayed pressure urticaria is common. One investigator found that 37% of people with chronic hives had this type of urticaria.

Areas of the body that often develop delayed pressure urticaria include:

  • Under the waistband of tight clothes
  • Under the elastic part of socks
  • Buttocks after sitting for a long time on a hard surface
  • Feet in tight shoes
  • Soles of feet after walking or climbing a ladder
  • Palms after manual labor


The hives of delayed pressure urticaria are deeper and more painful than hives caused by other stimuli and they start 2 to 6 hours after pressure is applied to the body. The hives last from 8 to 72 hours and many people get a low-grade fever, fatigue, chills, muscle aches, and headaches with the hives. The disease is chronic, lasting on average for 9 years.


Delayed pressure urticaria is diagnosed based on the appearance of the rash in areas where pressure has been applied to the skin. No lab tests help diagnose this physical urticaria.


Delayed pressure urticaria can be a disabling disease. Avoiding pressure to the skin is difficult. It involves not sitting or standing on hard surfaces for prolonged periods of time and not wear tight clothing. Many people require oral corticosteroids to control symptoms.


Grattan, Clive and Anne Kobza Black. "Urticaria and Angioedema." Dermatology. 2nd. Ed. Jean Bolognia. New York: Mosby, 2008: 261-76.

Guldbakke, KK, and A Khachemoune. “Etiology, classification, and treatment of urticaria.” Cutis. 79(2007): 41-9.

Habif, Thomas. "Urticaria and Angioedema." Clinical Dermatology, 4th Edition. Ed. Thomas Habif, MD. New York: Mosby, 2004. 129-61.

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