Urticaria refers to a group of disorders in which red patches and weals occur in the skin. Urticaria, or hives, is a common skin condition that affects 15-25% of the population at some point in their lives. Urticarial disease is thought to be caused by the release of histamine and other mediators of inflammation (cytokines) from cells in the skin. Some hives are caused by allergies to such things as foods and medications, but the large majority of cases are not allergic, and no specific cause for them is ever found. Urticaria is classified as either acute or chronic. Acute urticaria is defined as urticaria that has been present for less than 6 weeks. Chronic urticaria is defined as urticaria that has been continuously or intermittently present for at least 6 weeks. Chronic urticaria is referred to as chronic idiopathic urticaria.

Urticaria affects about 20% of people at some stage of their lives. Hives can sting, be painful, and can leave bruises on your child’s skin. A child with hives may have additional symptoms depending on what is triggering the hives. Treatment of hives are depends on urticaria types. The most commonly used oral treatments are antihistamines, which help oppose the effects of the histamine leaked by mast cells. Other sedating antihistamines that are sometimes used to treat hives include hydroxyzine (Atarax) and cyproheptadine (Periactin). Non-sedating antihistamines, including allegra, Claritin, Clarinex, and Zyrtec, are also used to treat hives, expecially hives that last longer than 6 weeks. Psychological treatments such as stress management can sometimes lessen severity and occurrence.

Oral corticosteroid such as Prednisone is sometimes prescribed. Tricyclic medications such as amitriptyline, nortriptyline and doxepin (which have antihistaminic and neuropathic properties). Topical therapies for hives include creams and lotions which help numb nerve endings and reduce itching. Avoid aspirin and codeine. Some urticaria is aggravated by salicylates, amines, tartrazine (numbered 102 in the list of ingredients on the container), benzoates (210-220) and other food chemicals. Oral steroids (prednisone, Medrol) can help severe cases of hives in the short-term, but their usefulness is limited by the fact that many cases of hives last too long for steroid use to be continued safely. Cool the affected area with a fan, cold flannel, ice pack or soothing moisturising lotion.

Urticaria (Hives) Treatment and Prevention Tips

1. Oral steroids (prednisone) are useful for severe acute urticaria.

2. Ultraviolet radiation treatment (narrowband UVB or PUVA).

3. Antibiotics and antifungal agents, used to clear an assumed underlying infection.

4. Tricyclic medications such as amitriptyline, nortriptyline and doxepin.

5. Do not take the medications your doctor has told you to avoid.

6. Avoid aspirin and codeine.

7. Reduce your intake of acidic fruits.

8. Avoid alcohol (it causes the surface blood vessels to dilate).

9. Try not to overheat.

10. Cool the affected area with a fan, cold flannel, ice pack or soothing moisturising lotion.


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