The Itch: Allergies, Asthma, Eczema & Immunology

#163 - Understanding Chronic Spontaneous Urticaria: Hives Demystified

Join Kortney and Dr. Payel Gupta as they unpack chronic spontaneous urticaria. Together, they define what hives actually are, explain how CSU is different from an allergic reaction and other types of hives, and walk through what is happening under your skin to cause all that itching.

This episode was originally published June 6, 2024. We re-released it on June 25, 2026 with a new intro as the perfect foundation before our episode on the new chronic urticaria guidelines.

Do you get hives and have no idea why? Then this episode is for you.

What we cover in this episode about chronic hives:

• What hives really are. Urticaria is the medical word for hives, and the two signs are that it itches and it comes and goes.
• CSU versus other hives. How CSU differs from inducible hives (CINDU) and from an allergic reaction.
• Histamine and the itch. Why histamine drives the swelling and itch, and why scratching feels so good.
• What makes hives flare. CSU has no true trigger, but stress and other culprits can set off your mast cells.

The Itch Podcast Hives Episodes

Explore our full catalog of hives episodes

Diagnosis and the basics

• Ep. 76 Diagnosing Chronic Spontaneous Urticaria
• Ep. 128 Is Chronic Spontaneous Urticaria an Autoimmune Disease?
• Ep. 90 Challenges in Diagnosis and Treatment of Chronic Urticaria in Skin of Color

Treatment

• Ep. 78 Chronic Spontaneous Urticaria Treatments
• Ep. 131 What Is a BTK Inhibitor?
• Ep. 147 The REMIX Trial: Remibrutinib for Chronic Hives  
• Ep. 116 Why Fexofenadine Is Considered a Truly Non-Sedating Antihistamine

Living with chronic hives

• Ep. 148 How Do You Know Your Chronic Hives Are Under Control? 
• Ep. 122 Mortality in adult patients with chronic spontaneous urticaria: A real-world cohort study 
• Ep. 80 Chronic Spontaneous Urticaria Myths and Misconceptions
• Ep. 79 Living with Chronic Spontaneous Urticaria: A patient story
• Ep. 91 A Patient's Experience with Chronic Urticaria and Skin of Color
  
• Ep. 107 Hives in the Latinx Community
  
  

______

This podcast is made in partnership with Allergy and Asthma Network. 

We thank Novartis for originally sponsoring this episode.

This podcast is for informational purposes only and does not substitute professional medical advice. Any mention of brands is also informational and not an endorsement. Always consult with your healthcare provider for any medical questions or concerns.

 

#162 - JAK Inhibitors for Eczema: A non-steroidal option

Treatment options for eczema have come a long way, with many new non-steroidal choices. One type is the JAK inhibitor, which offers two things people have long wanted: a non-steroidal option and a more advanced option that, unlike a biologic, does not require injection.

Kortney and Dr. Payel Gupta sit down with returning guest Dr. Nicole Chase, to break down what a JAK inhibitor actually is, how the pill and cream versions differ, how JAK inhibitors compare to biologics, and what to know about safety. They also cover what is new, including a topical JAK now approved for children as young as two.

What we cover in this episode about JAK inhibitors for eczema

• What eczema really is. 
• How JAK inhibitors work. 
• Pills versus creams. 
• JAK inhibitors versus biologics. 
• Safety and side effects. 

Made in partnership with The Allergy & Asthma Network.

Thanks to Incyte for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#161 - BREATHE: The Digital Asthma Management Tool

Most adults with asthma never receive education about managing their condition, even though it is proven to help with better asthma control. The reason comes down to access. In this episode, we explore a digital platform called BREATHE, built from the ground up to change that.

Dr. Payel Gupta and Kortney sit down with the two lead authors behind “Development and Usability of a Digital Asthma Self-management Education Platform: BRinging Exercise, Asthma Assessments, and TeacHing to Everyone (BREATHE)” published in JACI: In Practice, March 2026. De De Gardner and Sheryl Flynn, CEO, talk about how BREATHE was developed, what the app includes, and what the data showed after patients and providers put it to the test.

What we cover in this episode about asthma self-management

• Asthma self-management education and why most adults never receive it.
• How BREATHE was built using a user-centered design process, shaped by what adults with asthma and healthcare providers said they actually needed.
• What the BREATHE platform includes: asthma lessons, validated control assessments, and an Asthma Action Plan, all in one app, in English and Spanish.
• What the usability study found: adults rated the app in the 81st percentile, providers rated the dashboard in the 76th percentile, and 80% considered making a behavior change after just two weeks.
• Where the program is now and where it is going, including how to access the free Allergy and Asthma Network Virtual Asthma Coaching Program today.

Allergy and Asthma Network Virtual Asthma Coaching Program and the Spanish program.

This podcast is made in partnership with the Allergy & Asthma Network.

#160 - Meet the President of the AAAAI, Dr. Carla Davis

We are continuing our series of interviewing thought leaders in the field of allergy and immunology. Dr. Gupta and Kortney sit down with Dr. Carla Davis, the president of the American Academy of Allergy, Asthma and Immunology.

What we cover in this episode about Dr. Davis and the AAAAI

• What the AAAAI is and why it matters to patients. A 7,000-member organization working behind the scenes to support allergy and immunology care across the US and around the world.
• Dr. Davis's path to the presidency. From her early experiences advocating as a fellow to her major pivot from Baylor to Howard University, the journey that shaped her priorities.
• Initiative: AAAAI Advocate. A new platform connecting patients and physicians directly to their legislators, making it easy to share your story and push for better access to allergy care.
• Initiative: AAAAI AI Task Force. A dedicated group bringing AI tools into allergy care, including AAAAI Ignite, a Netflix-style platform that helps members find and curate personalized allergy content.
• Initiative: The Collaborative Translational Mechanistic Research Seed Award. A $100,000 grant pairing laboratory scientists with clinical allergists to move new discoveries directly into patient care.

More resources

• • American Academy of Allergy, Asthma and Immunology
  • AAAAI Advocate platform
  • Allergy & Asthma Network health equity resources

 

This podcast is made in partnership with the Allergy & Asthma Network.

 

#159 - Food Allergy Anxiety in Teens: Risk-Taking, Social Pressure, and How to Help

Kortney and Dr. Payel Gupta are joined by Tamara Hubbard, MA, LCPC, a licensed clinical professional counselor and food-allergy parent. Together, they dig into what food allergy anxiety actually looks like in teenagers, why some teens take more risks as they get older, and what parents can do to support their teens without making things worse.

What we cover in this episode is about food allergy anxiety in teens:

• What makes teenagers a high-risk group for food allergy reactions. Independence is increasing at the exact same time parental oversight is decreasing, and that combination creates real safety concerns.
• What food allergy risk-taking actually looks like. It is not always what parents expect, and some of it is just teens figuring out how to belong.
• Food allergy social anxiety is its own distinct experience. The fear of looking different, being a burden, or standing out can drive behavior just as much as the fear of a reaction.
• Why parental anxiety matters more than most parents realize. The way parents talk about food allergies often directly affects how teens handle them.
• How to build confidence and ownership in your teen. What to do when a teen is either too anxious or not anxious enough.

***********

Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech and Kaléo for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#158 - Managing Food Allergy Anxiety in Kids

Food allergy anxiety in kids is real, and it does not always look like fear. It can show up as tantrums, clinginess, control-seeking behaviors, or a child who refuses to eat at a restaurant. Child life specialist and therapist Kelsey Mora joins Kortney and Dr. Payel Gupta to unpack what is really going on. 

What we cover in our episode about managing anxiety in kids

• Food allergy anxiety does not always look like anxiety. Tantrums, clinginess, and control-seeking behaviors can all be signs that a child is struggling.
• Language matters from the start. How parents explain food allergies to young children can build confidence or quietly reinforce fear.
• Separation anxiety and food allergies are connected. Dependence on parents can make it harder for kids to navigate school, parties, and social situations on their own.
• Practicing independence at home builds real-world skills. Exposure to allergens in a safe home environment teaches confidence and communication skills kids need everywhere else.

• Passing parental anxiety onto kids. Co-regulation starts with the caregiver, when parents are anxious, kids have a harder time calming down.

Helpful resources

• Food allergy anxiety information from Allergy & Asthma Network
• Kelsey's practice and services: childlifetherapist.com 
• Kelsey's workbooks and resources: themethodworkbooks.com 

***********

Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech and Kaléo for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#157 - Dating, Kissing, and Intimacy with Food Allergies

Mia Silverman, food allergy advocate, joins us to talk about the real emotional and practical side of dating with food allergies. From what the research says about kissing risks to setting boundaries to why your allergies might actually be the best filter you have.

What we cover in this episode about dating with food allergies

• When to tell someone about your food allergies. Mia shares why she brings up her allergies early and how she works it into her dating app profile without making it a big deal.
• Fear of rejection. Mia opens up about being ghosted and bullied, and how she learned to reframe rejection as a filter rather than a failure.
• The risks of kissing with food allergies. Dr. Gupta breaks down what the research actually says about allergens in saliva and what your partner can do to reduce the risk.
• Intimacy beyond kissing. From latex-free condoms to body fluids, Dr. Gupta covers what food allergy patients need to know about being safely intimate with a partner.
• Date ideas and setting boundaries. Mia shares practical tips for early dates, setting food-allergy rules, and keeping the conversation open without making it feel overwhelming.

***********

Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech and Kaléo for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#156 - Is Your Asthma Worse Than It Should Be? Signs of Uncontrolled Asthma

If you have asthma, there is a good chance you have learned to live around it. You sleep with your inhaler on the nightstand. You skip the walk because you know it will leave you breathless. This is called uncontrolled asthma, and it is more common than you think. But here is the thing: none of that is normal, and none of it is something you have to accept.

Dr. Juanita Mora, allergist and immunologist, joins Kortney and Dr. Gupta to help patients figure out whether their asthma is actually being managed the way it should be, and what to do if it is not.

What we cover in this episode about asthma symptoms and control

• What well-managed asthma actually looks like. Dr. Mora explains what life should feel like when your asthma is properly treated, and why so many patients have accepted a version of their life that is smaller than it needs to be.
• Why frequent flare-ups are a warning sign. Why underlying airway swelling is dangerous and why catching it early matters.
• The Rules of 2. Five questions covering daytime symptoms, nighttime waking, rescue inhaler use, inhaler refills, and steroid use that can help you figure out if your asthma needs more attention.
• When to ask for a referral. If you are answering yes to any of these questions and your treatment plan is not changing, it may be time to push for a referral to an allergist or pulmonologist who has more tools to help.
• First steps you can take with ControlYourAsthma.org. Dr. Mora walks through the campaign website, available in English and Spanish, including videos, the Rules of 2 quiz, and access to a free asthma coach.

More resources

• ControlYourAsthma.org
• ControlarTuAsma.org
• Free Asthma Coach Program

__________

Made in partnership with The Allergy & Asthma Network.

Thanks to Sanofi-Regeneron for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

 

#155 - Did I Cause My Child's Food Allergy?

When a child is diagnosed with a food allergy, one of the first things many parents wonder is, "Did I do something wrong?" and "Did I cause my child's food allergy?" You question if it was something you ate or didn't eat during pregnancy, whether you breastfed long enough, or if you introduced foods too late. The guilt is real, and it is incredibly common.

Kortney and Dr. Payel Gupta sit down with Dr. Joanne Moreau, a board-certified allergist and immunologist, to unpack exactly how food allergies develop, and why no parent should carry the weight of blame.

What we cover in this episode about food allergy development and parent guilt

• How food allergies develop. The immune system, genetics, and environment all play a role, and science is still uncovering why.
• Food allergy genetics and family history. A parent with asthma, eczema, or hay fever raises a child's risk, even without a food allergy themselves.
• Pregnancy diet, breastfeeding, and food allergy. No conclusive evidence links what a mother eats during pregnancy, or whether she breastfeeds, to whether a child develops food allergies.
• Eczema and food allergy. Cracked or inflamed skin lets food proteins in before the gut can build tolerance, which can trigger sensitization.
• Early allergen introduction. Introducing allergenic foods between 4 and 6 months of age, and keeping them in the diet consistently, is one of the best tools we have.

***********

Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech and Kaléo for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

 

#154 - What Providers Need to Know About Uncontrolled Asthma

If you treat patients with asthma, this episode is for you. Not just allergists, but GPs, pediatricians, family medicine doctors, urgent care providers, and anyone who sees a patient with asthma in their practice.

Dr. Cherie Zachary, current president of the American College of Allergy, Asthma and Immunology, joins Kortney and Dr. Payel Gupta to talk about why uncontrolled asthma remains a serious and largely preventable problem, and what providers can do differently starting with their next patient visit.

What we cover in this episode about uncontrolled asthma

• The data behind the problem. ER visits, hospitalizations, and asthma deaths have not improved in years, and Dr. Zachary explains why that should concern every provider who treats asthma patients.
• An ER visit is a treatment failure. Dr. Zachary makes the case that any asthma patient who ends up in urgent care or the emergency room should trigger an immediate reassessment of their treatment plan, not just a course of steroids and a send-home.
• Five questions every provider should be asking. The episode walks through a standardized set of control questions designed to help providers catch uncontrolled asthma before it becomes a crisis, covering steroid use, ER visits, rescue inhaler use, nighttime waking, and daily activity limitations.
• Why patients normalize their symptoms. Providers hear what controlled asthma should actually look like, and why patients often don't volunteer the information needed to catch a problem.
• Who is most at risk. Dr. Zachary shares which patient populations are most likely to have uncontrolled asthma and least likely to be identified, and what providers can do to close that gap.

More resources about uncontrolled asthma

• ControlYourAsthma.org 

• Free AAN Asthma Coach Program

• Find an allergist

• Understanding Oral Corticosteroid Overuse in Asthma

Made in partnership with The Allergy & Asthma Network.

Thanks to Sanofi-Regeneron for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.