Treatments

Primarily treatment revolves around antihistamine use and most people with urticaria do respond to these. However, some people do not respond and a few get worse. It is considered good practice to give people a choice of two non-sedating antihistamines to see which one they respond best to and it may be necessary to prescribe in doses which exceed the manufacturer’s recommendations (Grattan and Humphreys, 2007). In acute type urticaria, oral steroids might be used for a short course and there is some evidence to show that ciclosporin can be helpful for those who are non-responsive to antihistamines (Grattan and Humphreys, 2007).

General advice to patients should also include avoiding things that appear to trigger the urticaria, e.g. fruits which contain salicylates. Aspirin is also likely to be problematic for those sensitive to salicylates and this should be avoided as should non-steroidal anti-inflammatories. General measures which may be helpful include keeping the skin cool (e.g. applying ice packs) and avoiding alcohol which is a vasodilator and make the skin feel hotter. Urticaria can be difficult to manage successfully and patients are likely to need ongoing support.