Proper urticaria treatment depends on the cause of the urticaria or hives outbreak. Outbreaks occur when mast cells in the skin produce histamine, which causes the raised itchy areas known as hives. Hives range in size from 1/8 inch to several inches across and may blend together in a large mass or plaque. Allergic reactions, viral infections and temperature extremes may trigger urticaria, but many outbreaks arise from unknown causes. Although hives usually subside on their own within 24 hours, treatments such as antihistamines and corticosteroids can relieve the itching and swelling. In rare cases, such as severe allergic reaction, outbreaks can include breathing difficulty and shock. A doctor can determine the cause of outbreaks by asking the patient questions about symptoms and lifestyle.
Oral antihistamines are a common type of urticaria treatment. First-generation H1 antagonists, such as diphenhydramine and chlorpheniramine, cause drowsiness and are usually not the first choice of treatment. Patients who take first generation antihistamines should not drive or operate heavy machinery. Second-generation H1 antagonists, such as loratadine and fexofenidine, are more popular drugs because they usually do not cause drowsiness. A particularly effective treatment method combines H1 antagonists and gastric acid-reducing H2 antagonists. Antihistamines are available by prescription or as over-the counter preparations. A doctor may recommend regular antihistamine intake as a preventive treatment.
For severe urticaria outbreaks which do not respond to antihistamines, a doctor may prescribe corticosteroids such as prednisone or prednisolone. Corticosteroids reduce inflammation and prevent histamine production. This type of urticaria treatment involves either a single injection or a five- to seven-day prescription for oral corticosteroids. These drugs are usually prescribed for short-term use because prolonged or repeated use can cause thinning skin, facial swelling and other side effects. An epinephrine injection is a type of treatment which constricts blood vessels in severe outbreaks.
Foods that can cause hives include chocolate, eggs, milk, nuts, seafood and wheat; food additives and preservatives are also common triggers. Drugs that can cause outbreaks include aspirin, codeine and non-steroidal anti-inflammatory drugs such as ibuprofen. Urticaria treatment may involve lifestyle changes, such as avoiding food or drug triggers. Physical stimulation, such as hot or cold temperatures, scratching, exercise or a tight belt can trigger some urticaria outbreaks. To prevent this type of outbreak, a patient can wear loose-fitting clothing, bathe in lukewarm water instead of hot water, and avoid prolonged sun exposure. A cool compress is an effective treatment for this type of outbreak. Keeping a symptom diary for one or two weeks can help a patient track outbreaks and triggers.
Urticaria Treatment – The Conclusion
Chronic urticaria outbreaks, which last more than six weeks, are difficult to treat. Although these outbreaks are sometimes related to hormonal changes, infections or autoimmune disorders such as lupus, they often have unknown causes. Stress is sometimes associated with outbreaks, but it does not appear to cause hives on its own. Doctors may prescribe low-dose tricyclic antidepressants, immunosuppressant drugs or anti-inflammatory creams for chronic urticaria. A doctor can determine the best urticaria treatment for each patient.