NHS Choices Condition
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Treatment for acute urticaria may not be required, as the symptoms are mild and the condition can get better on its own within a few days and not return.
If the symptoms of acute urticaria are more serious or the condition persists,Â you can consult your pharmacistÂ and buy an antihistamineÂ over the counter, or consult your GP for a prescription of antihistamines (see below).
Your GP may also prescribe you corticosteroid tablets if symptoms are severe. Return to your GP if the symptoms get worse or there is no response to treatment after two weeks.
Antihistamines block the effects of histamine, so they should stop the symptoms of itchiness and reduce the rash. Examples of antihistaminesÂ include:
Modern antihistamines do not cause drowsiness in most people, but there are some exceptions.Â See how you react to the antihistamine before driving or operating heavy machinery. Modern antihistamines may cause drowsiness if taken with alcohol.Â Always read the information leaflet for your medication.
If you are having problems sleeping at night due to particularly itchy urticaria, your GP may give you additional antihistamines that are known to cause drowsiness, such as chlorphenamine or hydroxyzine.
Antihistamines are normally not prescribed during pregnancy. This is because they have not been established as being entirely safe. However, your GP may recommend chlorphenamine if they feel that the benefits outweigh the risk.
There are several thousand known cases of pregnant women taking chlorphenamine, and there is no evidence that it harmsÂ unborn babies.
You may beÂ prescribed a short course of high-dose corticosteroid tablets, such as prednisolone. Corticosteroids suppress your immune system and therefore can suppress the symptoms of urticaria.
Possible side effects of corticosteroid tablets include increased appetite and weight gain, mood changes andÂ insomnia.
Treatment for chronic urticaria involves helping you to control your symptoms and avoiding any triggers that make the symptoms worse.
If you have chronic urticaria and angioedema, you should be referred to an immunologist (a specialist in the immune system), an allergist or a dermatologist (a specialist in skin conditions). This is because angioedema is potentially more serious as it can cause breathing difficulties.
If you only have chronic urticaria but the symptoms persist despite treatment, you should also be referred.
The symptoms of chronic urticaria is treated with antihistamines. You may have to take them regularly for as long as the symptoms last. As with acute urticaria, you may be given a combination of 'non-drowsy' and 'drowsy' antihistamines to help you sleep.
Menthol cream can be used as an alternative or in addition to antihistamines as it has been shown to relieve itchiness. Your GP can prescribe this.
More serious episodes of urticaria can be treated with short doses of corticosteroid tablets, such as prednisolone. Possible side effects of corticosteroid tablets include increased appetite and weight gain, mood change,Â and insomnia. Long-term use of corticosteroids in chronic urticaria is not recommended.
There is controversy over the role of diet in people with chronic urticaria.Â There are two groups of chemicals in foods that may trigger urticaria: vasoactive amines and salicylates. Avoiding or reducing the intake of these chemicals mayÂ possibly improve the symptoms.
You may wish to keep a food diary to see if avoiding a certain food helps your symptoms. If you restrict your diet, consultÂ a dietitian, who can make sure that you are not avoiding foods unnecessarily, and that your diet is adequate.
Foods that contain vasoactive amines, or cause histamine release, include:
Salicylates are naturally occurring aspirin-like compounds that are found in a wide variety of foods of plant origin.Â You can tryÂ cutting down on these butÂ do not completely avoid them.Â Foods that contain salicylates include:
- orange juice
For more information on following a low-histamine diet, see Allergy UK: histamine intolerance.Back to the Embarrassing Bodies Condition Guide or view information about Nettle rash on www.nhs.co.uk »
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