How to treat chronic urticaria

Chronic urticaria generally has a long course, often more than six weeks. There are many causes of chronic urticaria, such as diet like fish and shrimp, drugs like penicillin, viral infection, biological factors and physical factors. How to treat chronic urticaria? What methods can help patients recover?

Chronic urticaria usually causes many plaques to appear on the trunk, face, and limbs. These plaques sometimes disappear and sometimes reappear, causing itching. If it is not treated, it can last for a long time and it can easily affect people's lives. So it must be treated. How to treat chronic urticaria?

1. Use antihistamines

Most patients can achieve satisfactory results after treatment with antihistamines, but a few patients are more stubborn. For stubborn and intractable urticaria, the dosage can be increased or combined medication can be used. H1 receptor antagonists have strong anti-histamine and anti-other inflammatory mediator effects and are effective in treating all types of urticaria. Commonly used H1 receptor antagonists include diphenhydramine, cyproheptadine, chlorpheniramine, acrivastine, cetirizine, mizolastine, loratadine, ebastine, azelastine and desloratadine. Two different types of H1 receptor antagonists can be used together or in combination with H2 receptor antagonists (cimetidine, ranitidine). Antalol has strong antihistamine, anticholine and sedative effects, and is also very effective in relieving itching. It is effective for acute, chronic urticaria and cold urticaria. Doxepin is a tricyclic antidepressant mainly used to treat depression and anxiety neurosis. This drug also has strong anti-H1 and H2 receptor effects. It is particularly effective for chronic urticaria and has fewer side effects. Doxepin is a better choice of drug for patients with urticaria who are not responsive to traditional antihistamines.

2. Choose drugs that inhibit mast cell degranulation

Ketotifen inhibits mast cell degranulation and prevents the release of inflammatory mediators by increasing the concentration of cAMP in the body. Its inhibitory effect is stronger and faster than that of sodium cromoglycate and it can be taken orally. Tranilast reduces histamine release by stabilizing mast cell membranes.

3. Glucocorticoids

It has strong anti-inflammatory and anti-allergic effects. It can stabilize mast cell membranes and lysosomal membranes, inhibit the release of inflammatory mediators and lysosomal enzymes; constrict blood vessels and reduce exudation. It has good effect on urticaria, especially suitable for acute urticaria, serum sickness urticaria, pressure urticaria and autoimmune urticaria. Commonly used drugs include prednisone and Diprosone. In emergency situations, use hydrocortisone, dexamethasone, or methylprednisolone intravenously.

4. Immunosuppressants

When patients with chronic urticaria have an autoimmune basis, the disease recurs, and the above treatments are ineffective, immunosuppressants can be used. Cyclosporine has a good therapeutic effect. Azathioprine, cyclophosphamide, methotrexate and immunoglobulin can all be tried. Tripterygium wilfordii also has a certain therapeutic effect.

5. Non-specific anti-allergic therapy and other therapies

Drugs such as 10% calcium gluconate injection, 10% sodium thiosulfate, 6-aminocaproic acid, reserpine, and aminophylline can be tried.

6. Handling of special situations

If urticaria is caused by infection, anti-infective drugs are used for treatment. For cold urticaria, among the antihistamines, cyproheptadine, doxepin, ketotifen, hydroxyzine and imazolidinone are more effective; vitamin E, cinnarizine and H2 receptor antagonists can be used in combination. Azatidine has a good effect on cold urticaria through its antihistamine, anticholine and anti-5-hydroxytryptamine effects. For solar urticaria, in addition to the antihistamines hydroxyzine or chlorpheniramine, hydroxychloroquine, thalidomide or chlorpheniramine can also be taken.

Now that we know how to treat chronic urticaria, we hope that patients can choose the treatment method that suits them according to their own situation. Some medicines may not be suitable for patients, so they must be used under the guidance of a pharmacist. For people with allergies, they should avoid eating foods that are prone to allergies, such as fish, shrimp, leeks, etc.