Treatment Options

As I couldn't identify much in the way of a cause or trigger I researched every single thing that I possibly could about treatments for urticaria. The thing that resonated most with me was a passage I read that said 'people tend to under treat their urticaria'. Yep, that was me. I was taking antihistamine when I had an attack and wondered why nothing really improved.

So, I needed to come down hard on my urticaria and kick it into check.

Phase 2: Demand the right treatment:

From my internet based research I tried to consolidate the information into something I could discuss with my doctor. As my wedding was fast approaching I didn't have time to visit an allergy specialist, go through testing and trial new drugs, especially after I had such limited success in the past so I needed to treat myself. So, what to ask for?

ANTIHISTAMINE: H1 Receptor Antagonists

I am based in Australia so I will use the 'technical' names for the drugs rather than the brand names I have used as this confused the hell out of me when researching and different brand names contain different ingredients in other countries.

I have tried Fexofenadine (some success but not a lot, I got this from the allergy clinic in the UK but have not used this in Australia), loratedine (no success) and cetirizine.

I take cetirizine each morning and although I am unsure as to whether it really helps I figure it is better to take it than not, especially as I have air borne allergies too so it kills two birds with one stone. The idea is to build up a level of antihistamine over time to help to supress the allergic reaction. Cetirizine was mentioned a lot as a good daily tablet for hives and can be taken with an additional antihistamine tablet of another type at night I believe, however I am not a doctor so don't quote me on that. My doctor told me that it is possible to take a higher than normal dose of antihistamine with no adverse affects if you require it.

There are numerous other options when it comes to antihistamines and as I had only had limited success I did a ton of research on them.

I found that the majority of people online mentioned Benadryl as being the best antihistamine available for the treatment of hives. Benadryl in the United States is not the same as Benadryl in the UK or Australia. In the UK it is a brand name and does not have the same ingredients, in Australia it is a cough mixture and does not have the same ingredients so neither of these will be any use to urticaria sufferers. As I had never tried this dru I decided it was worth a shot.

The clinical name for the US version Benadryl, the one that kept being mentioned, is Diphenhydramine. I asked my doctor to give me a prescription for Diphenhydramine, as it turned out I didn't need a prescription. You can buy Diphenhydramine over the counter. It is sold as a sleep aid and is called SnuzAid. It comes in packs of 10 and is about $10. It is an older antihistamine, hence why not commonly available for the treatment of hives/allergies due to the drowsiness it causes.

http://en.wikipedia.org/wiki/Diphenhydramine

So I began taking one diphenhydramine tablet every night (and cetirizine each morning as it is non drowsy) and as if by magic, my night time hives have calmed considerably. Previously I woke every morning covered in hives on my legs and often my face and had trouble sleeping as they were so uncomfortable. Since I started taking the SnuzAid I have not had any new wheals appear overnight and no itching at all, plus the fact that the tablet is a sleep aid helps to counteract the insomnia caused by the steroids I am taking. I attribute the decent sleep and lack of hives to the Diphenhydramine as there is such a big time break between my taking the steroids at lunchtime and then the following morning and I am still getting evidence of hives during the day which I don't have at night or when I wake. I would like to take the diphenhydramine in the day but am concerned about the side effects of it so not really a possibility unless I have a terrible attack closer to the wedding.

ANTIHISTAMINES: H2 Receptor Antagonists

Cimetidine (I have tried this with no success) There are others including Famotidine, Lafutidine, Nizatidine, Ranitidine, Roxatidine but I haven't tried these. I discussed this with my doctor but he was frankly clueless when it came to treatment of urticaria. I decided not to try taking H2 and H1 and just see if I could control it without.

STEROIDS:

Yep. This is an emergency situation so I chose to go down the steroid route. If it was not the most important day of my life perhaps I would have chosen not to use steroids but desperate times call for desperate measures. I railroaded my doctor into prescribing me prenisolone 25mg. I take one tablet in the morning with food, one at lunch time with food so 50mg a day. To date I have been taking them for 3 weeks.

Previously when I had attacks of urticaria steroids were of very little help. I even took them as a preventative when I had special events coming up so as my uni ball and my graduation and still had horrendous attacks of hives on both of these days. I was hopeful but skeptical that they would work this time. Originally I was only going to start taking them 3 days before the wedding but I decided that this was too risky in case they didn't work so I started them about 5 weeks before the wedding.

My doctor suggested two weeks at 50mg, then a week at 25mg and then gradually weening myself off them by taking half a tablet and then every other day and so on. However I found that when I was late taking the tablets one day my hives returned so I am continuing the high dose and will attempt to lower the dosage nearer to the date.

It took about a week for the prednisolone to begin to work and I was so disappointed because I really had hoped it would be a miracle cure, and other people online said they got immediate relief or even a dramatic change after 3 days. It took a long time (at least thats what it felt like to me) for any real improvement and I started all treatments in one go so who knows which element has really helped my hives but I'm not cutting anything out right now.

ALTERNATIVE THERAPIES/ NATURAL STUFF:

I cut out apple cider vinegar as some sites said that vinegars actually make hives worse, and as it wasn't making them better there was no benefit.

I did find out that some people put cream of tartar on hives. I also read about a lady who drank it and that cured her hives. So now each morning I make up a drink bottle of water and teaspoon of cream of tarter and drink it. Even if it has no real affect it isn't doing me any harm.

I still take some supplements but they have not made any improvement to my hives.

THINGS I AM AVOIDING:

Alcohol: I don't drink any alcohol at all and have not drunk alcohol for some years so I would suggest to anyone struggling with hives that cutting out the booze completely is a good way to go, painful as that might be. I found a lot of info that said alcohol makes hives worse but also saw people suggest that drinking alcohol will help calm you down and improve hives, I am not convinced. I am 100% certain that the chemicals used in processing alcohol such as sulphites etc made my hives dramatically worse so I am not going near the stuff!

Tea and Coffee: I don't drink coffee but I love tea. I did find that tea seemed to be a stimulant and therefore made my hives worse so I have cut it right down to one cup of caffeine based tea every other day at most. I started drinking chamomile and green tea but too much herbal tea also seemed to make my hives worse. Instead I just try to limit myself to a few cups of peppermint and maybe one green tea.

Medications: I don't take any NSAID's, aspirin, ibruprofen etc at all.

White flour, gluten and processed foods: I have tried to stear away from anything over processed like biscuits and so on, I have switched to rye bread and try not to eat a lot of pasta and so on. As Im trying to keep my weight under control to fit into my wedding dress this isn't such a bad thing! I just found that my hives seemed worse when I'd eaten a lot of junk food.