Hives treatment
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Effective Treatments for Hives (Urticaria)
Understanding Hives: Acute vs. Chronic Urticaria
Hives, also known as urticaria, are a common condition characterized by itchy, raised welts on the skin. They can be classified into acute and chronic forms. Acute urticaria lasts less than six weeks and is often triggered by allergens such as drugs or foods. Chronic urticaria persists for more than six weeks and frequently has no identifiable cause.
Standard Treatment Approaches for Urticaria
Antihistamines as First-Line Therapy
The primary treatment for both acute and chronic urticaria involves second-generation, non-sedating H1-receptor antihistamines. These medications are effective in reducing the symptoms of hives and are generally well-tolerated. For patients who do not respond to standard doses, increasing the dosage or adding other antihistamines may be recommended.
Algorithmic Treatment Approach
For chronic urticaria, a standardized algorithmic approach is often followed, as outlined by the Joint Task Force Practice Parameter and International Urticaria guidelines. This approach includes escalating steps of treatment, starting with antihistamines and progressing to more advanced therapies if necessary.
Advanced Treatment Options
Nifedipine for Chronic Idiopathic Urticaria
In cases where antihistamines are not effective, nifedipine, a calcium channel antagonist, has shown promise. A double-blinded, placebo-controlled, crossover trial demonstrated that nifedipine significantly improved hive count, hive index, and itch index in patients with chronic idiopathic urticaria who were unresponsive to antihistamines.
Traditional Chinese Medicine (TCM)
For pediatric patients with frequent, persistent, and difficult-to-treat hives due to multiple food allergies, integrative traditional Chinese medicine (TCM) therapies have been effective. A retrospective review of three pediatric cases showed that TCM treatments, including herbal baths and creams, led to complete remission of atopic symptoms within 7-9 months.
Conclusion
The treatment of hives involves a stepwise approach, starting with antihistamines and progressing to more advanced therapies for refractory cases. Nifedipine and traditional Chinese medicine offer additional options for patients who do not respond to standard treatments. The prognosis for most patients with urticaria is generally favorable, with many experiencing significant relief from symptoms through these various treatment modalities.
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