How to cure Urticaria?
Patient: Urticaria on her neck and arms and nothing ever seems to make it go away and stay away My poor sister has urticaria on her neck and arms and nothing ever seems to make it go away and stay away. Steroids work short term. Has anyone had any success with something different? She is only 25 and it really bothers her. Many thanks Doctor: Avoid any obvious triggers or exacerbating factors and try these simple measures: 1) Keep the skin cool, avoid getting hot from exercise and take lukewarm baths. Resist the temptation to rub the itchy skin and apply copious amounts of moisturizing creams to reduce dryness and itch. Avoid alcoholic drinks and foods containing additives. 2) Apply 1% menthol in aqueous cream to soothe the affected skin. 3) Avoid all aspirin or codeine containing medication (including ibuprofen, diclofenac and mefenamic acid). Only use paracetamol as a painkiller. 4) Carefully read Side Effects list of any other medication you are currently taking and avoid medicines that are known to trigger urticaria or angioedema. The mainstay of treatment is high dose ANTIHISTAMINE medication which may be necessary for prolonged periods (in excess of 6 weeks). Double conventional doses of antihistamines such as Cetirizine, Loratidine may be needed for symptom relief. Occasionally "stomach-ulcer treatment" medication is added. New leukotriene receptor antagonists used for asthma have produced some symptom relief in chronic urticaria.. Short courses of steroids may be necessary to settle more severe symptoms. Cortisone should not be used for prolonged periods of time as they may lead to stunted growth in children and osteoporosis in adults. Specialist investigations in Chronic Urticaria may be necessary to exclude other underlying illnesses or to confirm the presence of ?auto-antibodies? in the blood stream. The Autologous Serum Skin Test (ASST) is a good indicator of Auto-antibodies.  Highly specialised treatments may include Immunosuppressive drugs (Cyclosporine, Methotrexate, and Azathioprine), Androgens and Warfarin. Colchicine is useful in treating Urticarial Vasculitis. If available, Immunoglobulin injections, Plasmaphoresis or the use of novel anti-IgE monoclonal antibodies such as Omalizumab may be necessary. The future holds many exciting new therapeutic modalities including DNA Plasmid Vaccines