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Urticaria - Management
How should I treat recurrent or persistent urticaria?
- Manage any underlying associated diseases (e.g. H. pylori infection, thyroid disease, connective tissue disorder), although there is limited evidence that correcting these conditions will improve the urticaria itself.
- Offer a non-sedating antihistamine to control daytime symptoms.
- Consider giving an additional sedating antihistamine at night if the itch is interfering with sleep.
- Topical menthol 1% cream can be used as an alternative to, or in addition to, an oral antihistamine.
- For a severe 'flare up', give a short course of oral corticosteroids (e.g. prednisolone 40 mg daily for 3–5 days) in addition to an oral antihistamine.
- If rebound symptoms occur after a short course of corticosteroids seek specialist advice. Repeat courses of steroids are not recommended.
In depth
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