Top 4 Chronic Urticaria Centers in Portugal: Where to Find Specialist CSU Care

Living with chronic spontaneous urticaria (CSU) can be exhausting. Hives may appear without warning. Itching can interfere with sleep, work, and everyday plans. Some people also experience angioedema, which causes deeper swelling, often around areas such as the lips or eyelids.

When symptoms continue despite initial care, finding a team with specific experience in chronic urticaria can become important.

Portugal has several specialist centers recognized through the international UCARE network. UCARE stands for Urticaria Center of Reference and Excellence. These centers focus on urticaria and follow defined standards for specialist care, education, and research.[1,2]

This guide looks at four Portuguese centers currently listed in the UCARE directory. They are presented as an overview rather than a ranking.
‍

{{get-started}}
‍

What is chronic spontaneous urticaria?

Chronic spontaneous urticaria is a form of chronic urticaria in which wheals, angioedema, or both occur repeatedly without a specific external trigger explaining each episode.[3]

“Chronic” generally means the condition continues or repeatedly returns for more than six weeks. “Spontaneous” distinguishes CSU from chronic inducible urticaria, where symptoms can be triggered by specific stimuli such as pressure, cold, or heat.

If you are new to the condition, mama health's guide to chronic spontaneous urticaria explains its symptoms, possible causes, and factors that may worsen hives.

CSU is more than a skin problem. Persistent itching, visible wheals, swelling, interrupted sleep, and uncertainty about the next episode can affect work, social activities, and quality of life.[3]

That unpredictability can be one of the hardest parts. You may have days when your skin is relatively calm followed by a sudden return of symptoms without an obvious explanation. Our guide to common CSU triggers such as food, stress, and heat looks more closely at why flares can sometimes seem unpredictable.

What is a UCARE center?

A UCARE center is a specialist urticaria center recognized by the Global Allergy and Asthma Excellence Network (GA²LEN).[1]

UCARE stands for Urticaria Center of Reference and Excellence. Certification is designed to identify centers with specific expertise and established standards in urticaria care.

According to the Portuguese Society of Allergology and Clinical Immunology (SPAIC), certification assesses centers against 32 criteria covering areas such as infrastructure, adherence to international recommendations, research, education, and communication.[2]

This does not mean that everyone with CSU needs to attend a UCARE center. Many people can receive appropriate care through their usual healthcare team. A specialist center may become particularly relevant when symptoms are difficult to control, the diagnosis is uncertain, or more specialized assessment is being considered.

Which chronic urticaria centers are available in Portugal?

The current international UCARE directory lists four centers in Portugal.[1] They are located in Lisbon, Coimbra, and Vila Nova de Gaia.

1. Hospital de Santa Maria — Lisbon

Department: Immunoallergology
Location: Avenida Professor Egas Moniz, Lisbon
UCARE certification: Since 2018
UCARE lead: Dr. Célia Costa[1]

Hospital de Santa Maria has a dedicated Chronic Urticaria Unit within its Immunoallergology service.

The hospital states that its urticaria unit was created in 2005 and became an internationally recognized UCARE center in 2018. It provides specialized care for people of different ages with chronic urticaria and also participates in education and clinical research.[5]

For someone living with persistent or difficult-to-control CSU, the center's combination of immunoallergology and dedicated urticaria expertise may be relevant to discuss with their current healthcare professional.

2. Centro Hospitalar Universitário de Coimbra — Coimbra

Department: Dermatology
Location: Praceta Carlos da Mota Pinto, Coimbra
UCARE certification: Since 2017
UCARE lead: Prof. Margarida Gonçalo[1]

The Coimbra center stands out because its UCARE service is based within dermatology rather than immunoallergology.

That can be useful to know because chronic urticaria sits at the intersection of several specialties. Depending on a person's symptoms and medical history, dermatologists and allergists or immunologists may both be involved in assessment and care.

The UCARE network lists the Coimbra center as certified since 2017, making it one of the longer-established Portuguese centers in the network.[1]

3. Centro Hospitalar Universitário de Lisboa Central — Lisbon

Department: Immunoallergology
Location: Rua Jacinta Marto, Lisbon
UCARE certification: Since 2022
UCARE lead: Dr. Paula Leiria Pinto
UCARE deputy: Dr. Sara Prates[1]

A second UCARE-listed option is available in Lisbon through the Immunoallergology service of Centro Hospitalar Universitário de Lisboa Central.[1]

The center has been UCARE-certified since 2022. Its presence gives people in the Lisbon region more than one specialist service listed by the international UCARE network.

Hospital names and organizational structures within Portugal's public health system can change over time, so it is worth confirming the current service name and contact route before arranging an appointment.

4. Centro Hospitalar Vila Nova de Gaia/Espinho — Vila Nova de Gaia

Department: Immunoallergology / cutaneous pathology
Location: Rua Conceição Fernandes, Vila Nova de Gaia
UCARE certification: Listed by UCARE
UCARE lead: Dr. Maria Isabel Rosmaninho[1]

For people in northern Portugal, the UCARE directory lists the specialist service in Vila Nova de Gaia.[1]

SPAIC has also identified Vila Nova de Gaia as a Portuguese UCARE location for people with difficult-to-control urticaria.[2]

Its northern location may make it a more practical specialist option for some people living around Porto and other parts of northern Portugal, depending on referral pathways and availability.

How do these four Portuguese urticaria centers compare?

All four centers are part of the UCARE network, so this list should not be read as a “best to worst” ranking.[1]

CenterCitySpecialist areaUCARE statusHospital de Santa MariaLisbonImmunoallergologyCertified since 2018Centro Hospitalar Universitário de CoimbraCoimbraDermatologyCertified since 2017Centro Hospitalar Universitário de Lisboa CentralLisbonImmunoallergologyCertified since 2022Centro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de GaiaImmunoallergology / cutaneous pathologyUCARE-listed

The most suitable service can depend on where you live, how Portugal's referral system applies to you, your previous assessments, and whether you have other health conditions that need to be considered.

UCARE status is useful because it indicates dedicated expertise in urticaria. It does not mean that other dermatology or immunoallergology services in Portugal cannot provide appropriate chronic urticaria care.

When could specialist CSU care be worth discussing?

Specialist assessment may be worth discussing when chronic urticaria remains difficult to control, significantly affects everyday life, or has features that require further evaluation.[3,4]

For example, a healthcare professional may consider specialist input when symptoms persist despite initial management, when angioedema is an important part of the condition, or when the appearance or duration of individual skin lesions is unusual.

If your current treatment is providing limited relief, our article on what happens when antihistamines aren't enough for CSU explains the next steps described in current international guidance.

Current guidance emphasizes a structured approach to chronic urticaria rather than extensive testing for every patient.[3] The medical history, appearance and timing of symptoms, possible inducible triggers, medications, and relevant health conditions can all help guide what happens next.

The goal is not necessarily to find one hidden “allergy.” CSU is called spontaneous precisely because individual outbreaks do not have a clear external trigger.

What treatments might be discussed at a specialist urticaria center?

Treatment for chronic urticaria usually follows a stepwise approach, but the appropriate option depends on the individual and should be discussed with a qualified healthcare professional.[3,4]

International guidelines use second-generation H1 antihistamines as the first-line pharmacological approach. When symptoms remain uncontrolled, guideline-based care can involve adjusting the antihistamine strategy and, for some patients, considering additional therapies.

For a fuller explanation of the treatment pathway, read mama health's guide to chronic spontaneous urticaria treatment options.

For some people whose CSU remains uncontrolled despite antihistamines, biologic treatment may also be discussed. Omalizumab is one established option. If this comes up during a specialist consultation, our guide to starting a biologic for CSU explains common questions around omalizumab, benefits, side effects, and what patients may want to discuss with their doctor.

The international urticaria guideline was updated in 2026, reflecting continuing developments in how chronic urticaria is understood and managed.[3]

A specialist consultation can also help distinguish CSU from chronic inducible urticaria and from other conditions that can sometimes resemble hives.

What should you bring to a chronic urticaria appointment?

Bringing a clear record of what you have experienced can make the conversation easier.

You may find it useful to prepare:

• Photos of wheals or swelling, especially when your skin looks normal on the day of the appointment
• Approximate dates of when symptoms began
• How often wheals or swelling appear
• How long individual wheals usually remain in the same place
• A list of medications you currently take or have previously tried
• Notes about whether symptoms affect sleep, work, exercise, or social activities
• Any patterns you have noticed around pressure, temperature, exercise, stress, infections, medications, or other circumstances
• Previous blood tests, allergy assessments, or relevant medical reports

If you are unsure whether something is a genuine trigger or simply a coincidence, mama health's guide to tracking food, stress, heat, and other CSU flares explains how to look for repeatable patterns without assuming that every flare has one identifiable cause.

You do not need to arrive with the cause figured out. A simple record of what happens and how it affects you can give your healthcare professional useful context.

Does diet matter when you are living with CSU?

Diet is rarely the underlying cause of CSU, although some people notice that certain foods or drinks coincide with worse symptoms.

There is no single diet that everyone with chronic spontaneous urticaria needs to follow. Broad or long-term elimination diets are not routinely recommended.

If food seems connected to your symptoms, our guide to diet and chronic spontaneous urticaria explains what current evidence says about food, possible aggravating factors, and dietary trials.

Some people also consider reducing dietary histamine. This is not necessary for everyone with CSU. mama health's low-histamine diet guide for CSU explains what this approach involves and the limitations of the available evidence.

Can stress make CSU feel worse?

Stress may aggravate CSU symptoms for some people, but CSU is not simply caused by stress.[3]

The relationship can also work in both directions. Persistent itching, swelling, disrupted sleep, and uncertainty about the next flare can themselves create considerable emotional strain.

Our article on stress, itching, and chronic spontaneous urticaria looks more closely at this relationship and discusses ways people may support their general well-being alongside medical care.

How can you choose between chronic urticaria centers in Portugal?

Location, specialist expertise, referral requirements, and your existing healthcare team can all influence which center is practical for you.

Portugal's UCARE centers are spread across Lisbon, Coimbra, and Vila Nova de Gaia.[1] That gives people in several regions access to internationally recognized urticaria expertise, although travel may still be necessary depending on where you live.

Before making plans, consider checking:

1. Whether you need a referral.
2. Whether the service currently accepts new patients.
3. Which documents or previous test results you should bring.
4. Whether your situation is better suited to dermatology or immunoallergology.
5. Whether follow-up can take place closer to home after specialist assessment.

Your current doctor or healthcare professional can also help you understand the referral options available in your situation.

What if you cannot reach a UCARE center?

Not being able to attend a UCARE center does not mean you cannot receive appropriate chronic urticaria care.

Dermatologists and specialists in allergy and clinical immunology outside the UCARE network may also have experience with CSU. International guidelines provide an evidence-based framework that can be used across many healthcare settings.[3]

If your symptoms remain difficult to manage, you could ask your healthcare professional whether additional specialist input would be useful and what options are available locally.

If swelling affects your tongue or throat, you have difficulty breathing, feel faint, or develop other signs of a severe allergic reaction, seek urgent medical care. Acute breathing or airway symptoms require a different level of attention from routine CSU follow-up.[4]

What should you remember about finding CSU care in Portugal?

You have options.

Portugal currently has four centers listed in the international UCARE directory, including services in Lisbon, Coimbra, and Vila Nova de Gaia.[1] These centers have dedicated expertise in chronic urticaria and participate in an international network focused on improving standards, research, and education.

But the right starting point does not have to be an internationally certified center. What matters is having your symptoms taken seriously, being able to explain how CSU affects your daily life, and having access to healthcare professionals familiar with chronic urticaria.

You can also explore mama health's broader chronic spontaneous urticaria resources for more information about living with CSU and questions that may come up between appointments.