If the underlying trigger for urticaria can be identified, the offending agent can be avoided in the future. Sometimes keeping a food diary can help to identify the trigger. Treatment in those with known allergies may also include allergy shots.

Treatment for acute urticaria may include antihistamines, corticosteroids, and additional medications that treat allergic reactions. In most cases, the skin lesions resolve over a matter of weeks.

Most cases of urticaria can be treated on an outpatient basis. Those cases that fail to respond to antihistamine medications or cause swelling of the vocal cords or anaphylaxis need to be treated in the hospital.

Specific treatment options for urticaria include:

• Oral antihistamines (H1 antagonists):
• Diphenhydramine (Benadryl)
• Chlorpheniramine (Chlor-Trimeton)
• Fexofenadine (Allegra)
• Loratadine (Claritin)
• Cetirizine (Zyrtec)
• Levocetirizine (Xyzal)
• Desloratadine (Clarinex)
• Hydroxyzine (Atarax, Vistaril, Vistazine)
• Cimetidine and ranitidine:
• H2 antagonists are more effective when combined with other antihistamines (H1 antagonists)
• Topical corticosteroid creams:
• Clobetasol (Temovate)
• Hydrocortisone (Valerate, Westcort)
• Triamcinolone
• Oral corticosteroid medications:
• Prednisone (Deltasone, Orasone, Meticorten)
• Prednisolone (Pediapred, Prelone, Delta-Cortef)
• Methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol)
• Injections of epinephrine for severe allergic reactions:
• Epinephrine (Adrenalin, Sus-Phrine, Epi-Pen, Ana-Guard, Twinject)
• Leukotriene antagonist medications:
• Zafirlukast (Accolate)
• Montelukast (Singulair)
• Other immunomodulators:
• Cyclosporine
• Colchicine
• Dapsone
• IV gammaglobulin and plasmapheresis
• Tricyclic antidepressants:
• These medications have central and peripheral anticholinergic effects.
• Immunotherapy:
• Allergy shots

• Allergic reaction treatment

Physicians from the following specialties evaluate and treat urticaria:

• Allergy and Immunology
• Dermatology

Last Updated: Jun 7, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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