From our previous website’s article collection. Dates, prices and treatment information reflect the original publication period.
Urticaria, commonly known as hives, is a dermatological condition characterised by the sudden appearance of raised, itchy, reddish plaques on the skin. Affecting approximately 20% of the population at some point in their lives, this condition presents in acute and chronic forms that each require different treatment strategies.
Distinguishing Acute from Chronic Urticaria
Acute urticaria is the form in which symptoms last fewer than six weeks. It is generally associated with allergic reactions, infections, or medication use, and in most cases resolves spontaneously.
Chronic urticaria is defined by symptoms persisting beyond six weeks. In chronic spontaneous urticaria, lesions recur without any identifiable external trigger. This significantly impairs patients' quality of daily life.
Factors That Trigger Urticaria
The underlying causes of urticaria are highly varied:
- Foods: Shellfish, eggs, tree nuts, peanuts
- Medications: Non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics
- Infections: Upper respiratory tract infections, Helicobacter pylori
- Physical factors: Cold, heat, pressure, sunlight, exercise
- Stress and emotional factors: Psychological stress can trigger flare-ups
- Autoimmune mechanisms: Immune system dysregulation plays a role in a significant proportion of chronic urticaria cases
Diagnostic Process
In acute urticaria, a detailed medical history is often sufficient. Chronic urticaria requires a more comprehensive evaluation:
- Complete blood count and erythrocyte sedimentation rate
- Thyroid function tests and thyroid antibodies
- Total IgE level
- Infection screening
- Autoimmune markers where indicated
The Urticaria Activity Score (UAS7) is used to objectively monitor disease severity.
Current Treatment Protocols in 2026
Urticaria management follows a stepwise treatment approach:
First Step
Second-generation antihistamines (cetirizine, desloratadine, bilastine, fexofenadine) are initiated at standard doses. Because these medications have low sedative effects, they do not adversely affect daily functioning.
Second Step
When the standard dose proves insufficient, the dose of the same antihistamine may be increased up to fourfold. This approach is considered safe according to current guidelines.
Third Step
In patients who fail to respond despite dose escalation, omalizumab (an anti-IgE monoclonal antibody) is introduced. Administered as a monthly subcutaneous injection, this biological agent demonstrates high efficacy in chronic spontaneous urticaria.
Fourth Step
In refractory cases, immunosuppressive agents such as ciclosporin may be considered under specialist supervision.
Lifestyle Recommendations
In addition to medical treatment, the following measures help manage symptoms:
- Avoiding known triggers
- Choosing loose, cotton clothing rather than tight or synthetic garments
- Avoiding excessively hot showers and baths
- Practising stress management techniques
- Limiting alcohol and spicy food consumption
The Abel Beauty Approach
At our clinic, patients with chronic urticaria are assessed using a multidisciplinary approach. Through investigation of the underlying causes, personalised treatment planning, and regular follow-up, we aim to maximise our patients' quality of life. If you are experiencing recurrent hives, please contact us for a specialist evaluation.
This article is for informational purposes only. Please consult a qualified physician for treatment decisions.
