Urticaria can be managed through appropriate nutrition, in collaboration with a dietitian-nutritionist and the patient’s physician. This article discusses the dietary components that should be avoided when dealing with urticaria.

What Is urticaria?
Urticaria is a skin condition characterized by intense itching, with or without the presence of red skin. It is considered acute when symptoms last less than six weeks, and chronic when they persist for more than six weeks. Chronic urticaria may be either spontaneous or induced. The most common cause of urticaria is an allergic reaction triggered by medication, food consumption, or autoimmune diseases (such as rheumatoid arthritis or autoimmune thyroiditis).

Nutrition as an ally in the management of urticaria

In addition to pharmacological treatment, nutrition plays a key role in managing urticaria. Specifically, a low-histamine diet and a pseudoallergen-elimination diet are often recommended. The former is helpful because individuals with urticaria typically respond well to antihistamine treatment, and the latter aims to eliminate symptoms caused by allergic reactions. Another important factor in managing urticaria is the use of probiotic supplements, which can improve gut microbiota, as the gut environment may be affected by chronic urticaria.

Characteristics of a low-histamine diet for urticaria

In a low-histamine diet, foods that are fermented or processed are primarily avoided, as they tend to have high histamine levels. Therefore, fermented dairy products such as cheese, yogurt, and kefir should be excluded from the diet of someone with urticaria. Additionally, pickles and vinegar are known to exacerbate the condition, as well as fermented cured meats like sausages or salami. Certain vegetables and fruits should also be avoided, including spinach, tomatoes, and eggplants. Another key element of this diet is avoiding sourdough products and frozen, salted, or canned fish. Lastly, spices, condiments, sauces, and both alcoholic and carbonated beverages should be excluded.

Characteristics of a pseudoallergen-free diet for urticaria
As for the pseudoallergen-elimination diet, it is recommended for individuals who may be sensitive to certain foods known as pseudoallergens. This diet involves monitoring and documenting the consumption of foods that trigger allergic reactions and subsequent urticaria. These foods are then eliminated from the person’s diet and gradually reintroduced under the supervision of a multidisciplinary team to prevent recurrence or worsening of symptoms.

Therefore, fermented or processed foods, as well as certain vegetables, should be avoided during periods of urticaria flare-ups. Managing urticaria through diet is most effective when done under the proper guidance of a dietitian-nutritionist, in order to avoid developing a disordered relationship with food due to unnecessary dietary restrictions.

REFERENCES

Konstantinou GN, Podder I, Konstantinou G. Mental Health Interventions in Refractory Chronic Spontaneous Urticaria: A Call to Expand Treatment Guidelines. Cureus. 2025;17(3):e81443. doi:10.7759/cureus.81443

Cooke Z, Lynam K, Tuck C, Trakman GL. Naturally Occurring Food Chemical Components and Extraintestinal and Gastrointestinal Symptoms in Adults: A Systematic Review. Clin Exp Allergy. 2024;54(11):855–880. doi:10.1111/cea.14561