Urticaria attacks can be bothersome and uncomfortable conditions. But they are mostly harmless and if the attack is transient and mild, no treatment may be needed. Most of the time, they resolve on their own and may not come back. But for acute and chronic urticaria, your GP will prescribe antihistamine and other medicines for rash control. But it is imperative to identify the triggers and avoid them diligently.
In case of a severe urticaria attack, your GP will refer to an allergist/dermatologist for specialty consult who will determine the treatment plan after checking the nature and extent of your urticaria.
Antihistamine tablets reduce the rash and some can stop the itch-scratch cycle – especially at night. Corticosteroids can suppress urticaria by suppressing the immune system.
- Antihistamine tablets
- Chlorphenamine (sleep-inducing).
- Hydroxyzine (sleep-inducing).
- Cortisones (short-term)
- Biologicals-cyclosporins and intravenous immunolgobulins and plasmapheresis indicated in selected cases of autoimmune chronic urticaria where antihistamines have failed to control the disease.(these drugs still need a lot of research)
- Antibacterial tablets.
- Anti-inflammatory tablets.
- Through injection – in case of acute attacks
- Epinephrine injection.
- Epi-Pen that can be self-administered.
- Topical medications
- Menthol cream.
- Phototherapy – exposing areas with urticaria to UV light can help in clearing persistent rash.
- Narrowband ultraviolet B (NUVB).
Home remedies /tips
Avoiding triggers that cause the urticaria is most crucial. It may take patient and conscientious effort to know what triggers your urticaria. Some tips are –
- Avoid tight-fitting outfits that may irritate the skin.
- Avoid use of wool, synthetics next to the skin.
- Avoid hot showers/baths; especially after an urticaria attack.
- Use cool baths, compresses to relieve the itchy/burning rash.
- Avoid direct sunlight, especially when it is peak between 10 a.m. to 4 p.m.
- Avoid strenuous exercises, activities that make you sweat.
- Manage your stress and traumatic conditions with counselling etc.
- Avoid possible triggers that may cause allergic reactions like foods containing vasoactive amines which cause histamine release like
Sudden urticaria attack
In case you have a sudden and severe urticaria attack at home, seek medical help at once. Call an ambulance or go to emergency room. If you know the trigger, avoid additional exposure. Take 15-20 ml of liquid or one-two tablets of diphenhydramine (Benadryl). If you have been prescribed an Epi-Pen, inject yourself to get relief immediately and get medical help. If conditions like angeoedema manifests in the throat, it can be life-threatening and need emergent medical attention.
- Indian Journal of Dermatology, Venereology & Leprology – A comparative study of various therapeutic regimens in urticaria (Amiyakuamr Mukhopadhyay, S Nitin Vora, Jayend Dave) view
- American Association of Dermatology – Hives: Diagnosis, Treatment & Outcome view
- NHS – Nettle Rash Treatment view
- Emedicine Health – Hives and Angioedeme view
- WebMD – Hives and Urticaria view
- University of Maryland Medical Center – Urticaria view