Some people, usually those who have never suffered from allergies, are prone to think that hives is not a serious disorder and can never be compared to, let us say, heart attack. Their being in the wrong would be easily proved by those who perfectly know what allergy is and how it feels.
Indeed, itching, the most common symptom of hives, can be as troublesome as toothache – annoying, distressing, disruptive, and unbearable. Very severe cases of hives may also pose real danger to the life of a sufferer, for example, angioedema, or anaphylactic shock. Consequently, saying that any allergy in general and hives in particular is harmless would be a disclosureof complete ignorance of this issue.
Naturally, hives, as any other health disorder, have to be treated, the symptoms, no matter whether they are dangerous or harmless, should be lessened in order to help a sufferer return to his/her normal life rhythm as soon as possible.
To relieve the symptoms of hives a number of treatment options were developed. The method and medications usually depend on the severity of every particular case of hives.
Mild signs of the rash are often effectively controlled and eliminated with the help of over-the-counter (OTC) antihistamines – drugs, which suppress the action of histamine released in the body during hives outbreak.
OTC H1 antihistamines are short-acting drugs (Benadryl, Claritin, Chlor-Trimeton, Tavist and a number of others), which must be taken every 6-12 hours. Their biggest disadvantage is the occurrence of such side effect as sleepiness due to the sedating action. However, there is one exception here: loratadine (Claritin) has minimally sedating effect, thus it does not cause sleepiness.
Long-acting H1 antihistaminic agents are available by prescription. The examples are Hismanal, Zyrtec, Allegra, Atarax, etc. Long-acting loratadine (Claritin) is now available without prescription. These drugs are taken every 12-24 hours and do not cause sleepiness (except for Zyrtec). They are also used to treat angioedema symptoms.
Claritin and Zyrtec are said to be very effective and well tolerated by patients, showing excellent safety profiles. Hismanal has a long half-life, but is characterised with many drug interactions, some of which can be life-threatening. In general, a doctor has always a wide range of drugs to offer every patient upon evaluating particular to every case symptoms.
Type H2 antihistamines are nowadays used to lessen itching and swelling from hives, although they were primary developed to treat ulcers and are not approved by the American Food and Drug Administration for hives management. This type of medications (the examples are Zantac, Tagamet, and Pepcid) is combined with H1 antihistamines to increase the effect of both types of pills.
Antihistaminic agents are said to be one of the safest medicinal options to use during pregnancy. This feature is one more advantage of antihistamines. Nonetheless, physicians note that the use of any drugs, even the safest ones, should be avoided during pregnancy if it is possible to do without them.
Corticosteroids are considered to be an option for relieving a severe acute hives outbreak. They may be given by mouth or as an injection if it is necessary to reduce urticaria symptoms rapidly. Corticosteroids used for hives control are Deltasone, Medrol, and Decadron. Although these drugs seem to effectively lessen itching, swelling, and inflammation, they are usually serve as a short-term therapy, limited to one week only, due to their side effects.
H1 and H2 blocking drugs (for example, Sinequan) are also used to treat hives. However, they were developed as antidepressants, and their use for urticaria is not FDA approved. Many physicians choose to prescribe them, since they possess strong antihistamine effects. Their weak-point is a sedating influence on the human body.
Ultraviolet radiation is another therapy, which helps patients with chronic and solar urticaria, and dermatographism (a type of hives). In many cases 15 – 20 treatments are enough to achieve positive result and proceed with maintenance therapy. Phototherapy used to reduce hives symptoms is ultraviolet B light and psoralen with ultraviolet A photochemotherapy.
Epinephrine and oxygen are used in very severe cases of hives and in the majority of angioedema cases. They are aimed at fighting respiratory symptoms. Epinephrine is mainly given as an injection; if used orally, it provokes many undesirable side effects.
Antibiotics are said to have little, if any at all, effect on urticaria; however, they may be used in a limited number of cases if there is an underlying bacterial infection.
Topical creams and lotions are sometimes used to numb nerve endings and thus eliminate itching. However, this medicinal option is used more rarely than the others and is of little medicinal value.
It looks like there exists a number of ways to fight hives symptoms, and doctors can choose the most appropriate therapy for every patient. Hopefully, modern treatment options will help all the urticaria sufferers cope with their disease and suppress it to really become winners in this fight.
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Hives Treatment Options
(from the most commonly used to rare)
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Long-acting H1 antihistamines
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Short-acting H1 antihistamines
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H2 antihistamines in combination with long-acting H1 antihistamines
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Corticosteroids
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H1 and H2 blocking drugs (tricyclic antidepressants)
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Ultraviolet radiation
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Epinephrine
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Topical creams and lotions
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Antibiotics
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Ivanna
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