Types of Urticaria

1. Acute Urticaria: Acute urticaria typically lasts for a few hours to days and is often triggered by specific factors such as allergic reactions to food, medications, insect stings, or infections. It can also be triggered by non-allergic factors such as stress, heat, cold, or pressure on the skin.

2. Chronic Urticaria: Chronic urticaria persists for six weeks or longer and may recur intermittently for months or even years. It can be more challenging to identify the underlying cause of chronic urticaria compared to acute urticaria and may require further evaluation by a healthcare professional.

Causes and Triggers

Urticaria can be triggered by various factors, including:

• Allergens: Common allergens such as certain foods (e.g., nuts, shellfish, eggs), medications (e.g., antibiotics, aspirin, NSAIDs), insect stings, pollen, pet dander, and latex can trigger allergic reactions leading to urticaria.

• Non-Allergic Factors: Non-allergic triggers such as physical stimuli (e.g., pressure, friction, cold, heat), emotional stress, infections (e.g., viral or bacterial infections), and certain underlying medical conditions (e.g., autoimmune disorders, thyroid disease) can also trigger urticaria.

Symptoms of Urticaria

The primary symptom of urticaria is the sudden appearance of raised, red or pink welts (wheals) on the skin. These welts may vary in size and shape and can be round, oval, or irregularly shaped. They are typically accompanied by itching or a burning sensation and may come and go within minutes to hours. In severe cases, urticaria can cause swelling of the lips, tongue, throat, or other parts of the body, leading to difficulty breathing or swallowing (angioedema).

Diagnosis

Diagnosing urticaria typically involves a thorough medical history, physical examination, and evaluation of symptoms. Your healthcare provider may inquire about possible triggers, recent exposures, medications, and medical history. In some cases, additional tests such as blood tests, skin prick tests, or allergy tests may be conducted to identify specific allergens or underlying conditions contributing to urticaria.

Treatment Options

Treatment for urticaria aims to relieve symptoms, identify and avoid triggers, and prevent recurrence. Depending on the severity and duration of urticaria, treatment options may include:

1. Antihistamines: Oral antihistamines are the first-line treatment for relieving itching and reducing the appearance of hives in urticaria. Non-sedating antihistamines such as loratadine, cetirizine, or fexofenadine are often recommended for daytime use, while sedating antihistamines such as diphenhydramine may be used at night to promote sleep.

2. Topical Treatments: Calamine lotion or corticosteroid creams may be applied topically to soothe itching and reduce inflammation associated with urticaria. However, topical treatments are typically less effective for widespread or severe cases of urticaria.

3. Oral Corticosteroids: In cases of severe or persistent urticaria that do not respond to antihistamines, short-term courses of oral corticosteroids such as prednisone may be prescribed to reduce inflammation and relieve symptoms. However, long-term use of oral corticosteroids is generally not recommended due to potential side effects.

4. Other Medications: In some cases, other medications such as leukotriene receptor antagonists (e.g., montelukast), H2-receptor antagonists (e.g., ranitidine), or immunosuppressive agents (e.g., cyclosporine) may be prescribed for refractory cases of urticaria.

5. Avoidance of Triggers: Identifying and avoiding triggers such as allergens, stress, heat, or pressure on the skin can help prevent recurrence of urticaria. Keeping a diary to track symptoms and potential triggers may be helpful in identifying patterns and triggers.

Prevention

While it may not always be possible to prevent urticaria, certain preventive measures can help reduce the risk of recurrence and minimize symptoms. These include:

• Avoiding known triggers such as allergens, certain foods, medications, insect stings, and environmental factors.

• Practicing good skin hygiene and avoiding harsh soaps, detergents, and skincare products that may irritate the skin.

• Managing stress through relaxation techniques, mindfulness, and stress-reduction strategies.

• Seeking prompt medical attention for underlying medical conditions or infections that may contribute to urticaria.