Hives (Urticaria)

Prevention

You can prevent hives by identifying and avoiding the particular circumstance or substance that triggered your skin reaction. If your doctor determines that you are allergic to insect venom, you may be advised to keep an epinephrine kit for emergency injections to prevent anaphylaxis. Keep the medicine in a convenient place if you work outside or play a sport. Keep an antihistamine in your medicine cabinet and take it the first signs of hives or itching. Older adults and people with heart disease should double check with their doctor before buying or taking antihistamines.

Treatment

To relieve most uncomplicated episodes of hives, your doctor may suggest that you apply calamine lotion and/or take a nonprescription antihistamine medication, such as chlorpheniramine (Chlor-Trimeton), clemastine (Tavist) or diphenhydramine (Benadryl). It is critical to relieve the itching because scratching can stimulate more hives and itching.

If these medications are not effective, you may be given a prescription medication such as cyproheptadine (Periactin), azatadine (Optimine) or hydroxyzine (Atarax or Vistaril). For people who have significant side effects from those medications, non-sedating antihistamines can be used, including loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra). For cases that are even more resistant to treatment, H2 receptor blockers might be added. These include ranitidine (Zantac), nizatidine (Axid), famotidine (Pepcid) or cimetidine (Tagamet). Doxepin (Adapin, Sinequan) is particularly helpful for people having a hard time sleeping at night. When other options fail, corticosteroids may be used to suppress the immune system in chronic urticaria or for frequently recurring episodes.