Urticaria: treatment
Urticaria, otherwise known as hives, is an itchy rash characterised by raised, red welts on the surface of the skin. The individual welts vary in size and tend to be transient, lasting from a few minutes to 24 hours. Urticaria is sometimes caused by an allergy to a particular substance, for example a certain food or medication.
Avoiding known triggers
It’s important to try to avoid any known or suspected causes of urticaria. (While it is often possible to determine the cause of acute urticaria — urticaria that lasts hours, days or a few weeks — the cause of chronic urticaria, which lasts longer than 6 weeks, and may last for months or years, is often unknown.)
Do not undertake a widespread exclusion diet unless a food trigger is confirmed. Salicylates, found not only in aspirin but also certain fruits, and food additives such as tartrazine and benzoates are relatively common triggers.
Oral antihistamines
Oral antihistamines are usually the main treatment for urticaria. They can relieve the itch and control the rash in most people. Non-sedating antihistamines are preferred, because they are effective, have few side effects and generally do not cause drowsiness.
Sedating antihistamines (the types that make you drowsy) should be used only if the itching is severe and sedation would be useful, for example, at night. It is vital that you are aware of the sedating effects and the risk of driving or operating machinery while taking these medicines, as reaction times may be reduced significantly.
Sometimes, a combination of antihistamines works better than a single antihistamine on its own.
Anti-pruritic (anti-itch) preparations
Application of topical anti-pruritic lotions and creams, such as calamine lotion, may provide symptomatic relief. Ask your doctor or pharmacist for advice.
Medications used for severe urticaria
An antihistamine injection is sometimes required to treat extensive urticaria, or severe urticaria that involves the eyelids and lips. Corticosteroid medications are also sometimes used to treat more severe cases of urticaria. Oral corticosteroids can help lessen swelling, itching and redness.
In cases of severe urticaria that is associated with anaphylaxis (a life-threatening allergic reaction), you may need an emergency injection of adrenaline. People who are prone to anaphylaxis need to carry an EpiPen (a device that can be used to give a shot of adrenaline in an emergency situation) with them at all times.
Last Reviewed: 19 April 2009
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