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NHS Choices Condition

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Acute urticaria

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, you can consult your pharmacist and buy an antihistamine 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 antihistamines include:

  • cetirizine
  • fexofenadine
  • loratadine

Modern antihistamines do not cause drowsiness in most people, but there are some exceptions. See how you react to the antihistamine before driving or operating heavy machinery. Modern antihistamines may cause drowsiness if taken with alcohol. 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 harms unborn babies.

Corticosteroid tablets

You may be 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 and insomnia.

Chronic urticaria

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

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.

Corticosteroid tablets

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, 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. There are two groups of chemicals in foods that may trigger urticaria: vasoactive amines and salicylates. Avoiding or reducing the intake of these chemicals may 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, consult a dietitian, who can make sure that you are not avoiding foods unnecessarily, and that your diet is adequate.

Vasoactive amines:

Foods that contain vasoactive amines, or cause histamine release, include:

  • shellfish
  • strawberries
  • tomatoes
  • fish
  • chocolate
  • pineapple


Salicylates are naturally occurring aspirin-like compounds that are found in a wide variety of foods of plant origin. You can try cutting down on these but do not completely avoid them. Foods that contain salicylates include:

  • tomatoes
  • spices
  • orange juice
  • raspberries
  • tea

For more information on following a low-histamine diet, see Allergy UK: histamine intolerance.

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