Antihistamines for urticaria in adults. Hormonal ointments for hives. Urticaria: symptoms of this disease

Exist various means from urticaria, which help get rid of unpleasant symptoms. And deal with pathological condition can be both with the help of drugs, and by contacting folk ways. Also important is the diet for urticaria, which underlies the therapy.

By its nature, urticaria is a rash, most often of an allergic etiology, which occurs with dermatological diseases. This phenomenon can hardly be called a separate disease, it is rather concomitant symptom which may accompany allergic state of shock, bronchial asthma or other autoimmune diseases. But an independent manifestation of urticaria occurs extremely rarely. How to treat urticaria to eliminate this condition?

It is recommended to control the condition in this pathology with H1-antihistamines. Target drug therapy is to reduce symptoms - itching, volume and size of the rash.

There are no drugs that can completely control the condition, without possible side effects.

Since each patient has an individual reaction to antihistamines, it may be necessary to change drugs or a combination of several drugs, changing the dosage, for example, higher than that recommended by the instructions. The first second-generation antihistamines that were tried to treat urticaria, Astemizol and Terfenadine, were banned from use, as they periodically caused cardiac arrhythmias.

none antihistamine medicine not free from teratogenic effects, but older antihistamines, including chlorpheniramine, are used to treat pregnant women.

Experts warn that any drug with an antihistamine effect can worsen the symptoms that accompany hives. What this is due to is still unknown, but experts suggest that this may be a reaction. toxic effects on membrane partitions mast cells.

Second generation H1 receptor antagonists

These urticaria pills are today the main choice for the treatment of this condition. Studies have shown that drugs in 2/3 of cases alleviate the course of pathology. This group of drugs includes the following drugs:

ebastine- it helps with urticaria and does not cause side effects;
Loratadine- does not have a pronounced sedative effect and does not interact with other drugs;
Mizolastin- efficient antihistamine, however, it is not recommended to increase the dosage;
cetirizine- a derivative of hydroxyzine, since the active substance is excreted by the kidneys, the drug is prescribed with caution in old age; occasionally can cause drowsiness, especially often this occurs when the dosage is increased;
Akrivastine- it is recommended to take it in combination with other antihistamines for urticaria.

It should be noted that such tablets do not have such side effects as drowsiness, lethargy and various cholinergic effects. However, there is a possibility of individual reactions to drugs, besides, when taking them, you should not take alcohol.

In general, the listed antihistamines are quite effective, although they do not cure urticaria completely, but eliminate its symptoms. In addition, they are recommended to be taken for prevention.

Third generation H1 receptor antagonists

This group includes active metabolites of the second generation, while their side effects are even more reduced:

Fexofenadine - active ingredient is an active metabolite of terfenadine - fexofenadine hydrochloride. But at the same time, it is devoid of cardiotoxic properties. Analogues in composition are drugs such as Telfast, Fexofast, Gifast and etc.
Desloratadine- an active metabolite of loratadine, has a strong antihistamine effect, is an anti-allergen in vitro. Studies have shown that the drug is better at reducing the symptoms of urticaria than placebo, but the drug has not yet received approval for this pathology.

Classical antihistamines and glucocorticosteroids

These urticaria medicines are prescribed if sedative action is a positive point, for example, they help to fall asleep at night with itchy sensations.

This group includes drugs, the active substance of which are the following components:

chlorpheniramine maleate;
hydroxyzine hydrochloride;
diphenylamine hydrochloride.

Glucocorticosteroid drugs. Medicines in this category are prescribed when urticaria is diagnosed in an autoimmune chronic form. In addition, it is advisable to take them with severe course pathology, or when other medicines do not give positive dynamics.

This category includes drugs such as Prednisolone(analogues: Decortin, Solyu-Decortin. Metipred), Dexamethasone(analogues: Dexazon, Dexamed, Maxidex, Dexafar, etc.). Glucocorticoids are recommended for short-term therapy, the duration of administration should not exceed 7 days.

Dexamethasone has anti-inflammatory, anti-allergic, desensitizing, immunosuppressive, anti-shock and anti-toxic effects. The active substance of the drug Dexamethasone and its analogues is a methylated derivative of prednisolone.

The second drug related to hormonal drugs, - Prednisolone, with urticaria, is rarely prescribed, since, having a powerful anti-allergic effect, it has a number of contraindications. For example, it is not prescribed for children, as it can slow down the growth of young patients.

Prednisolone and Dexamethasone are fully justified in anaphylactic shock,. At severe forms urticaria they can be prescribed for simultaneous administration in drip form.

Why is dietary nutrition prescribed for nettle fever

Since urticaria is mainly a manifestation of allergies, a certain diet is recommended for the patient for any of its origins. Due to the fact that with an allergic reaction to products it is not always possible to immediately identify the allergen, specialists tend to prescribe an elimination diet food. It is used only for adult patients and exclusively in a hospital after a comprehensive diagnosis.

Diet for hives includes therapeutic fasting for 3-5 days. At this time, the patient is recommended to drink about one and a half liters of water and do intestinal lavage. After the "hungry" period, the patient's diet gradually includes various products, every second day it is allowed to use one new dish. First go vegetable dishes, then dairy products, cereals, fish, lean meat, etc. Foods that may be allergens are included in the diet last.

Such a diet for hives and other manifestations of allergies gives doctors the opportunity to observe how the body reacts to various food, find out what caused the rash, and make a diet that excludes unwanted foods. But such fasting is not always allowed due to various chronic ailments at the patient. Then it is more expedient to prescribe a low-allergenic diet food.

hypoallergenic diet

The basic rules of a hypoallergenic diet (regardless of the type of urticaria) include the following aspects that require attention:

Keeping a food diary, which records all the foods eaten, the portion size and the body's reaction to them.
A menu is drawn up with the maximum number of products, of course, from the list of allowed foods.
You can eat only those dishes that are prepared at home.
The water regime should be observed, the volume of water drunk should be 1.5-2 liters.
Food should be consumed in small portions, trying to avoid overeating.
More preference should be given in healthy ways cooking - baking, boiling, steaming, while avoiding frying.

What to eat and what not to eat

The list of prohibited foods for hives includes the following foods:

citruses.
Honey and other bee products.
Any nuts.
Cocoa drinks and products.
Mushrooms.
Coffee and coffee drink.
Spices and spices.
Soda, especially sweet.
Smoked products.
Pickles and dishes with marinades.
Sweet pastries, especially for store-bought products.
Baking from wheat flour of the highest and 1st grade.
Milk.
Chicken eggs.
Liver and other offal.
Orange and red fruits and vegetables.
Fatty varieties of fish and seafood.
Fatty meats.
Sausages.
Canned products.
Broths cooked on meat, fish, mushrooms.
Cheeses with spicy additives.
Sauces and ketchups.
Alcoholic drinks.

This is a general list, but it can be expanded by those products that definitely cause allergic reaction in a person suffering from urticaria.

In addition to the fact that the diet for urticaria involves the exclusion of many dishes, if it is followed, it is necessary to limit the consumption of certain foods. This is where sour cream comes in. butter, cream, cottage cheese, semolina, bananas. It is imperative to reduce salt intake to a minimum.

What then can you eat with this pathology? Despite the fact that the list is significantly reduced, it is still possible to draw up a nutritious full-fledged menu based on it. You can have the following:

Meat low-fat varieties- beef, veal, chicken, turkey, rabbit.
Vegetables of white and green color in raw and boiled form, greens.
Of fruits, apples, cherries, white currants, gooseberries, pears are allowed.
Among low-allergenic cereals, barley, oatmeal, buckwheat, rice groats, and millet can be noted.
Pasta, but preference should be given to products made from durum wheat.
Bakery products with bran in the composition and baked from flour with whole grains.
Among vegetable oils can be a product of olives and sunflower.
Cookies - biscuits.
Sugar is best replaced with a small amount of fructose.
From fermented milk products permitted is kefir, curdled milk, natural yoghurts, low-fat types of cottage cheese.
It is better to drink green tea.

During an attack of urticaria, adult patients are advised to follow a diet for one and a half months. The first 14-21 days are mandatory strict rejection of prohibited foods. Then, if the symptoms decrease, you can gradually introduce foods into the diet, but one at a time in 2-3 days and with a mandatory assessment of well-being. It is best to start with a low-allergenic food, and after 5-6 weeks you can switch to a normal diet.

ethnoscience

Urticaria can be treated with medication, or you can resort to safer folk methods. After all similar funds have no side effects (such as drowsiness) and in some cases are the only option available.

Home therapy is also aimed at eliminating unpleasant symptoms urticaria - skin itching and burning.

To reduce sensations, you can use ordinary ice, which should be wiped over the areas that cause this phenomenon. Ice will constrict the blood vessels and reduce inflammation.

To restrain yourself and not comb the rashes, you can use a lotion with camphor or menthol oil. The agent is applied to the affected areas. Additionally, you can take the usual baking soda, but in small dosages (at the end of the knife), this should be done 3 times a day. In order to quickly rid the body of toxic substances, it is necessary to drink plenty of water - 2-2.5 liters per day.

Affected skin needs moisture. To do this, it must be moistened as often as possible. This is especially true for places with rashes. You can reduce itching sensations with the help of oatmeal baths. To do this, dilute oatmeal in water and use the resulting colloidal mixture for baths or compresses. The duration of the procedures is 15-20 minutes.

Raw potatoes are good for rashes. It must be grated and thin layer spread over breakouts. 30-40 minutes is enough for the soreness to decrease, after which it is washed off. It is recommended to carry out potato procedures daily until the symptoms subside.

To strengthen immune system, you should take a tincture of valerian and hawthorn. They are taken together before going to bed. Since urticaria often occurs against the background stressful situations and experiences, it is desirable for the patient to avoid any nervous and mental shocks.

Recipes for hives

Among the common antiallergic recipes, the most effective are the following:

Mint tea. It is necessary to pour the crushed leaves with a glass of boiling water and insist for an hour. Take 3-4 times a day until the signs of pathology disappear completely.
Beet tincture. diced fresh vegetable poured with boiled cool water and infused for 5 days. The strained remedy is taken orally. You can also use the tincture externally, lubricating the affected areas.
Decoction of yarrow. A little chopped grass is taken, poured with boiling water, infused for 40 minutes. It should be taken before meals 3 times a day.
Marjoram baths. It is necessary to take a little dried plant and steam it in boiling water. The remedy is infused for an hour, after which it is necessary to add it to the water and take a bath.
Horseradish juice with honey. You should get fresh vegetable juice and add the same amount of natural honey. If the honey is thick, then it must first be held in a water bath. It is necessary to drink means 2 times a day - in the morning and in the evening.
Lemon rubs. After washing the affected areas with soap, rinse them thoroughly with water and wipe with a slice of lemon. Spread a mixture of honey on top and sea salt. Leave on for 10 minutes and rinse with warm water.

Summing up

Urticaria - unpleasant phenomenon which makes life difficult. However, it is quite possible to get rid of its symptoms, but it is advisable to do this under the supervision of doctors.

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The first "acquaintance" with urticaria can occur in absolutely every person after eating his usual foods, the same peanuts, chocolate or delicious strawberries, which can provoke increased secretion histamine due to chemical composition thereby increasing the permeability of the vessel walls.

Also, the development of the disease is possible after taking certain drugs of the aspirin and penicillin series, the abuse of vitamins, extreme heat, cold, or even scratches on the body.

The symptoms of hives are very difficult to confuse with other allergic reactions, since the rash that occurs on the skin always looks the same - in the form of red dots and blisters, accompanied by unpleasant sensations of itching. They have different size and usually disappear within a few hours.

It is not difficult for a specialist to make an accurate and correct diagnosis. But it is important to remember the following, that urticarial rash can occur in the presence of many diseases, such as, for example, neurodermatitis, etc.

In this article, we will look at various options how to safely get rid of hives.

Helper drugs: urticaria pills

At the heart of the treatment this disease is the elimination of a possible irritant (allergen) from environment sick. After that, the body should be cleansed with plentiful drink, activated carbon, enemas and laxative methods. And only then you can proceed directly to treatment.

Hyposensitizing drugs can be attributed to laxatives - this is a 10% solution of calcium chloride IV and the antihistamine drug Benadryl. Desensitizing methods: intravenous infusion 30% solution of sodium hyposulfite every day, 10 ml for two weeks and 10% solution calcium chloride at the same dosage. In more severe cases your doctor may prescribe adrenaline and intramuscular injections of corticosteroids.

Most often, in the usual form of urticaria, doctors prescribe sedative and antihistamine tablets, for example, tavegil, diazolin, tazepam, pipolfen, phencarol, etc. In those dosages that correspond to a person's weight and age. And also to maintain immunity and normalize the condition digestive system most often prescribe vitamins, riboflavin, calcium, ascorbic and nicotinic acid, pyridoxine and other drugs, which must also correspond in dosage and age and weight of a person.

As an antipruritic drug, diphenhydramine can be excellent. But in those situations where hives are recurrent, most often the doctor prescribes corticosteroid hormones, such as prednisone or prednisolone.

Various physiotherapeutic procedures are also effective: these are various ultraviolet irradiations, faradic and static currents, wet wraps, therapeutic baths, souls, as well as hypnosuggestive in combination with conditioned reflex therapy.

If the course of the disease is extremely severe, the doctor prescribes glucocorteroids together with anabolic steroid drugs - as a rule, it is retabolil or nerobol.

To reduce the permeability of the walls of the vasculature and increase the tone of the capillaries, calcium gluconate, its chloride or glycerophosphate together with rutin, iron and salicylates are prescribed.

And then there is a method of drug-free therapy - the placebo effect, when most people are cured without any pills. One interesting experiment was carried out in which people were divided into two equal groups, one of which took antiallergic drugs, and the second ordinary starch tablets and vitamins without a single gram of antihistamine.

Two weeks later, the results showed that only 10 people were cured in the first group, and 25 in the second. Yes, it happens! You just need to believe in your recovery, like people from the second group.

How to get rid of hives: ointments

Ointments and creams will help you effectively fight the disease. They have, fortunately, minor side effects how they can be used long time. Typically refer to hormonal drugs, which include corticosteroid hormones, and are applied only externally to the urticaria lesions, while reducing itching and burning.

In the pharmaceutical industry, the abundance of ointments for hives is amazing. The most popular types include Elocom and Advantan, prednisolone ointment, Deperzolon, Lorinden C, Flucinar and Fluorocort. But before using any methods, you must first consult with a specialist doctor.

Also, doctors often use water-zinc pastes with 2 - 3% naftalan oil for patients with diffuse dermatitis. As an antipruritic agent, a 1% menthol solution is used, salicylic acid and calendula.

With a more acute course of urticaria, especially if it arose as a result of food or drug allergy, as a rule, magnesium sulphate is prescribed. It also helps very effectively. Castor oil, decoctions of celandine and marigold petals, and, of course, preparations from seaweed, which are always good for health.

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Urticaria treatment at home

Home methods always help us out when there is no way to go to the hospital for help. In the case of hives, there are certain approaches that you can take in your own home in order to eliminate unpleasant feeling itching and burning. Here is some of them.

For the first method, you will need ordinary ice. We'll try to freeze the hives. So, rub a piece of ice on the place where the rash appeared in order to blood vessels narrowed, and the edema subsided.

You can also act on the skin with a special camphor or menthol lotion, which will help reduce unpleasant itching. And if inside you simultaneously take a little drinking soda or burnt magnesia literally at the tip of a knife (no more than 3 times a day), the effect will be obvious.

Plentiful drink clean water always favorably affects the functioning of the body, but if you do not know how to properly treat urticaria in adults, try drinking Borjomi or others mineral water which will certainly not harm your well-being.

Do not forget to constantly moisturize the skin of the whole body by special means, because dry skin itself, even in healthy person tends to itch, and even more so for those who suffer from this type of allergy as urticaria.

If you love sports and do it regularly, remember that increased body heat can cause and greatly exacerbate hives, so if possible, you should temporarily stop exercising. Or limit them to a minimum so that your body does not overheat.

After exercise, taking an oatmeal bath will be beneficial for your skin, with which you can significantly reduce itching. To prepare it, you will need warm water (namely warm), into which you need to add a colloidal solution of oatmeal, distributing it evenly, and lie in it for no more than 15 minutes.

First aid for hives - everyone knows

This disease is one of those that tend to flare up without any warning, and on any part of the body and at any time. And, of course, each person should know what measures must be taken in the first place and what should be done before the ambulance arrives:

1. Stop the possibility of the allergen-irritant entering the patient's body.

2. During the day, do not give the patient food, at least until the doctor arrives.

3. Cleanse the body with sorbents, such as activated charcoal, polysorb, enterosgel or smectite.

4. Cleanse the intestines with an enema.

5. Give the patient as much liquid as possible, that is, pure mineral water.

6. An antihistamine won't hurt either.

7. soothe severe itching diluted mint tooth powder with baby powder or 1 teaspoon of baking soda per 200 g will help you. water.

8. Make cool lotions on the affected areas of the skin.

9. You can also massage the earlobes and the point between the lip and nose, but this should be done if the person is losing consciousness or suspected anaphylactic shock.

10. Drop your nose with any cold medicine.

Just do not overdo it - no alcohol, salt and vinegar, celandine tincture or anything else. No arbitrariness, wait for the doctor, otherwise you can only do harm.

Treatment of urticaria with folk remedies

Exists a large number of recipes traditional medicine, which have been helping people fight all sorts of diseases for more than one century. The following herbal remedies are very suitable for hives.

Prepare an infusion of 4 teaspoons of peppermint, pour 300 ml of boiling water over it and let this decoction brew for at least 1 hour. It is necessary to take 50 ml 3 times a day.

50 gr. nettle pour 500 gr. vodka, cover and put for 7 days in a dark place. Stir occasionally, then strain and take 1 teaspoon 3 times a day.

Rinse ordinary beets thoroughly, then cut into small pieces and put them in a 2-liter container, pour cold water and let it infuse in a warm place for at least 6 days. It should be taken 1 tablespoon 1 time per day, and you can also wipe the places of rashes on the skin.

You can make dough in water, which will help you fight hives. To do this, take rye flour 500 gr. and wormwood herbs 100 gr. Knead it and put it under the film for half an hour, then the resulting should be adjusted to the affected areas of the skin for 20 minutes, then rinse with warm water.

Millennium herb tincture. To do this, you will need 1 cup of grass pour 200 gr. boiling water and let it brew for at least 40 minutes. Take the resulting mixture 3 times a day, 1/3 of a glass before meals.

Celery root has not only an excellent diuretic effect, but also helps you cope with hives. To do this, you need to grate the root on a grater and squeeze it well through cheesecloth. The resulting tincture take 1 tablespoon 3 times a day for an hour before meals.

For a calm state of health and as a tonic for the whole body, you can use a tincture of hawthorn and valerian. To do this, mix these two ingredients in equal amounts and take 35 drops at bedtime with clean water.

With urticaria, dermatitis, fungal infections and others allergic rashes helps very effectively raw potatoes, which must be peeled, cut into thin slices and applied to the affected skin for 40 minutes. After washing off with warm water.

Marjoram tincture, which is used for bathing. It should be prepared as follows, you will need 400 gr. plants pour 4 liters of boiling water and let it brew a little. Then it can be safely added to the bath.

Also very effective decoctions for a bath, you can consider an infusion of oak bark, juniper, elderberry and chamomile.

For lovers of spicy: horseradish juice should be mixed with honey in equal amounts and taken 1 teaspoon 3 times a day.

By the way, back in the days of our great-grandmothers, people used cast-iron utensils instead of enameled ones. So, in order to get rid of hives, they made an infusion of nettles. As the saying goes, "a wedge is knocked out with a wedge." After it was infused, they poured it into a basin (for us, a bath) and bathed in such a decoction. After 3-4 such procedures, the disease completely evaporated.

Diet for hives: a list of prohibited foods

If you take into account the fact that the symptoms of the disease very often develop as a result of eating certain foods, then completely eliminating them will help you significantly improve your overall well-being.

But before limiting them, it is necessary to determine which ones. To do this, gradually eliminate one product from your diet over a couple of months, while observing how your body reacts to it.

By and large hypoallergenic diet used for all types of allergies. With it, you can not only diagnose a possible allergen, but also use it in medicinal purposes. Once you understand which product causes you allergic reactions, you will be able to control the situation from now on constantly.

First of all, a person suffering from allergies should exclude allergenic foods from their diet. products high risk , which include:

Fruits and berries: apples, strawberries, cherries, plums, grapes, melon, pineapple, pomegranate, persimmon, raspberries, strawberries, blackberries, blueberries, sea buckthorn.

Vegetables: tomatoes, peppers, pumpkin, beets, sorrel, eggplant and sauerkraut.

Dried fruits: raisins, figs, dried apricots, dates and compotes made from them.

Of course, citrus.

Carbonated sweet drinks.

Yoghurts, milk, some types of cheese,.

Marmalade, chocolate and some types of sweets.

Coffee, cocoa, spirits.

Seafood and.

Eggs.

Sausages, sausages, sardels, especially smoked and semi-smoked.

Home and shop preservation.

Flour products, including pasta.

They are followed products with medium activity , but, nevertheless, it is also desirable to limit their intake, these include:

Rye, wheat, buckwheat and corn.

Potatoes, green peppers and peas.

Peaches, bananas, apricots, currants and cranberries.

Fatty pork, lamb, horse meat, rabbit and turkey meat.

Well, last but not least low allergenic products , but you should also try to exclude them from your diet:

Butter, kefir, fermented baked milk, cottage cheese and yogurt.

and sunflower.

Rice porridge, barley, semolina and oatmeal.

Lean pork and beef.

Some types of fish.

Kidneys, liver and tongue.

Bread.

Black tea.

Mineral water non-carbonated.

Dried fruit compote and dried fruits themselves.

Green apples, pears and gooseberries.

Cucumbers, patissons, turnips, zucchini, dill, cabbage, broccoli, spinach.

The most important thing to remember is that before choosing a particular diet, it is necessary to take into account the characteristics of a particular person. The choice of products should be purely individual and only under the supervision of a doctor, because someone may have a reaction to a highly allergenic type, and someone to a low-allergenic one.

A hypoallergenic diet will need to be followed by adults for at least 3 weeks, and one is enough for children. And if at this time you feel relief, then you can try to gradually introduce the excluded products back into your diet. daily ration, beginning with a small amount no more than once every 3-4 days. The recurrence of allergic reactions means that you need to rule out this allergenic product once and forever.

This procedure should be carried out with each product, because urticaria can be caused by one or more allergens. Of course, this stage of an individual diet has some difficulties, because it may happen that you exclude most of the useful products and the food will be unbalanced. Therefore, follow these recommendations only under the guidance of a doctor.

An approximate diet for hives:

First day . Take any one product, for example, boiled vegetables or a piece of beef, chicken or fish, but not more than 100 grams, and try to eat it in the morning on an empty stomach. If nothing happened (in the sense of an allergic reaction), then eat the same product during the day 4 times 200 g each.

Second day . Do the same as on the first day.

Third day . You can add to this product that you are already using, another one, for example, dairy, according to the same principle.

Fourth day . The same thing you did on the third day.

And so gradually every other day you introduce one new product into your diet, and if there is no reaction to them, then they can be consumed without any fear, but only a little.

Before you start a diet, you need to drink a laxative and starve for several days, but only under the supervision of a doctor. And also drink more fluids, preferably purified water, at least 1.5 liters per day. And, of course, do enemas to completely cleanse your intestines.

During the diet, you can’t overeat, it’s better to try to make your diet varied and not repeated, because the constant use of the same product can lead to its accumulation in the body, which can later become a reason for an allergic reaction. Try to supplement your intake with vitamin B12, which is abundant in salmon and trout, as well as in whole grains.

Prevention for hives

If in a dream you scratch the rash a lot, you can wear knitted gloves at night so that there is no extra temptation. Or wrap a bandage around the affected area to avoid scratching the itchy area.

Apply frequent compresses to help soothe itchy skin. good option becomes a milk compress. To prepare it, you need to soak a towel in cold milk and apply it to the affected area of \u200b\u200bthe body for no more than 20 minutes.

Try to wear loose clothes and shoes so that the skin does not squeeze, because very often a rash in the form of hives appears on the body when it is compressed. And keep your skin moisturized as much as possible, especially if it's dry.

Treatment of urticaria in adults: what medications are prescribed

Doctors warn that urticaria in adults has a formidable complication - anaphylactic shock, which threatens life. They recommend starting treatment with medications immediately after the first signs of the disease.

Treatment of urticaria in adults is antihistamine drugs, sorbents, corticosteroids, ointments and homeopathic

Depending on the severity and nature of the disease, the following groups of drugs are prescribed:

antihistamine medicines;
sorbents;
corticosteroids;
hormonal ointments;
non-hormonal ointments;
homeopathic medicines.

Antihistamines for hives

Treatment for urticaria in adults (drugs listed below) is most commonly treated with antihistamines.

Table 1. Antihistamines

Name of drugs of the 1st generation	Description
Diphenhydramine	One of the popular effective drugs with urticaria. Has a large number of side effects. This (according to the instructions) is drowsiness, apathy, lethargy. Active substance chloropyramine. Appointed 2-3 times a day
Promethazine	Quickly blocks H-1 receptors, thereby stopping the action of histamine. Causes drowsiness and irritates mucous membranes
clemastine	Causes lethargy and drowsiness. It reduces vascular permeability. Has many contraindications
Name of drugs 2 generations	Description
Zyrtec	The basis of the drug is cetirizine. In the treatment of urticaria in adults, it is used at various stages of the disease. Very rarely causes drowsiness, only if a single dose is more than 10 mg. An adult needs 5 mg per day
Loratadine	Often prescribed for urticaria. Quickly sinks into the blood. Getting used to it does not occur, drowsiness does not appear. 1 tablet is enough for a day. Accepted 10 days
ebastine	Similar in properties to Loratadine, does not cause drowsiness even in large doses. It is taken in the amount of 10 mg per day. There are side effects, but they are very rare.
Name of 3rd generation drugs	Description
Levocetirizine	Another name for this drug is Ksizal. Its bioavailability is 100%. 1 tablet contains 10 mg and is administered to an adult 1 time per day. accepted long time, up to 18 months
Fexofenadine	This antihistamine has great bioavailability. Its effectiveness is higher than that of drugs of the 2nd group. There are very few side effects. Feksofast, Feksadin, Telfast - all these are commercial names this drug. For adults, the dose is 200 mg

What sorbents are prescribed for urticaria

Doctors advise starting the treatment of urticaria with cleansing the body. Cleansing the body with sorbents is needed in order to remove allergens from the body.

Sorbents have the ability to absorb any chemical and biological substances, allergic. Pharmacies sell a lot of sorbents. Here are the main ones:

activated carbon;
polysorb;
carbolene;
sorbolong.

Carefully! Sorbents remove allergens and toxic products from the body, but destroy some useful material. Therefore, doctors prescribe simultaneous reception drugs that normalize bowel function, and vitamins.

Corticosteroids in the treatment of urticaria in adults

Corticosteroids are prescribed by doctors in cases of:

lack of effect from the treatment of the patient with antihistamines;
the patient has Quincke's edema.

Attention! Corticosteroids are drugs used to treat hives in adults. However, these drugs not only affect the disease itself, but can also cause harm to health if used incorrectly.

They are used strictly according to the indications and under the supervision of a doctor.

Corticosteroids are available in different form. These are ointment, tablets and injections.

Hormonal ointments for hives

From the use of hormonal ointments, the healing effect comes much faster than from non-hormonal ones, but they have much greater contraindications and side effects. There are a lot of similar drugs in pharmacies.

The list contains only the most popular:

Prednisolone ointment. Indicated for the treatment of urticaria.

The instructions for this ointment say that its use is possible for no more than 14 days. The ointment is for external use only.

Advantan. It is available as a cream, ointment and emulsion. It is used only on the affected areas of the skin.

Thanks to the active substance (methylprednisolone aceponate), it successfully fights the manifestations of urticaria. The effect comes quickly - after 1-2 applications. The tool is popular due to the small number of side effects.

Soderm. The active substance is betamethasone valerate. It has the highest degree of effectiveness of all corticosteroids.

The duration of the drug is 3-4 weeks.

Elokom. A variety of forms of release of this drug (cream, ointment and lotion) allow the treatment of urticaria in adults at various stages of the disease.

The duration of the drug is affected by the rate of disappearance of signs of the disease, as well as the presence and severity of side effects. The medicine is applied 1 time to the inflamed skin.

Lorinden S. Joint action flumethasone and clioquinol, included in this medicine, inhibits the development of urticaria.

The ointment has softening and water-repellent properties. Ideal for patients with dry and thin skin.

Fluorocort. Refers to drug group glucocorticosteroids. The effect of this external ointment- anti-inflammatory and anti-allergic.

They are usually treated for 5-7 days. With a persistent course of the disease, the course of treatment is 25 days.

Clovate. A very powerful anti-allergic drug. Removes the manifestation of an allergic reaction in just a few minutes.

It has many contraindications and side effects.

Non-hormonal ointments for urticaria

For urticaria, non-hormonal ointments are used. They do not affect activity. internal organs and are not addictive. Here is their list:

Zinc ointment has long been used to get rid of many skin diseases, including hives. It fights inflammation and redness of the skin well.

Zinc ointment is inexpensive, which is one of its advantages. Doctors allow it to be used during pregnancy and lactation.

Fenistil-gel is also a medicine used in the treatment of urticaria in adults.

This non-hormonal ointment reduces capillary permeability, eliminates itching and redness of the skin. The effect of its application is observed after a few minutes.

Nezulin. This gel contains extracts medicinal herbs- chamomile, plantain, licorice. There are in it essential oils and panthenol.

The medicine is applied at least 2 times a day. Only in this case puffiness disappears, burning and itching decrease. It also cools the skin well.

Nezulin improves cellular metabolism, which avoids recurrence allergies. Doctors prescribe it to people of any age.

Psilo is a balm. The active ingredient in this gel is diphenhydramine. It treats inflammation, itching and swelling.
Cream La Cree acts very gently, because it contains in its composition medicinal plants- string, violet, avocado oil. They relieve inflammation and eliminate itching.
Gistan also contains plant extracts. This is a series, lily of the valley, Birch buds, calendula.

Applies to all ages. There is only one contraindication - individual intolerance to the components.

Homeopathic remedies for hives

Table 2. Homeopathic preparations

Names	Description
Sulfur (grey color)	It is used to relieve itching from allergies in those people whose redness increases with heat, for example, at night under a warm blanket. Coolness reduces itching. A temporary exacerbation is considered positive factor. In homeopathic pharmacies there are ampoules of the drug with different dilutions. In tablets, Suifur-Heel is produced, which is a complex drug
Suifur jodatum (iodized sulfur)	It has the same effect as the previous drug. It is prescribed by homeopaths for patients with lean build and good appetite.
Urtica urens (stinging nettle)	Treats itching caused by hives. Lotions are made with a nettle solution (for 0.5 cups of water 1 tsp)
Rumex crispus (curly sorrel)	Helps those patients whose itching is aggravated by coolness
Natrium muriaticum (table salt)	The medicine is used for many types of allergies, including hives. In homeopathy, it is used in dilution of 3, 6, 12%

Injections for urticaria: in what cases is prescribed

Urticaria injections are the most effective and fastest way to get rid of it. They are prescribed for severe illness.

Urticaria is usually treated with injections in a hospital.

It's important to know! Many skin diseases have similar symptoms. Doctors warn that before treatment, it is necessary to conduct a thorough diagnosis.

For injections, hormonal and non-hormonal drugs are used:

Urticaria is clinically characterized by the appearance of itchy urticaria on the skin. A blister, the main morphological element of urticaria, is a limited swelling of the dermis in diameter from several millimeters to several centimeters, hyperemic along the periphery and paler in the center. With the spread of edema to the deep layers of the dermis and subcutaneous tissue, as well as mucous membranes, Quincke's edema (angioneurotic edema) is formed.

Quincke's edema is quite common. It is estimated that 15-20% of the population has experienced at least one episode of urticaria. The prevalence of all types of urticaria in children ranges from 2.1-6.7%.

AT last years classification of urticaria is widely discussed.

The etiological factors of urticaria are presented in .

Spontaneous urticaria

Spontaneous urticaria according to the duration of the course is divided into acute and chronic. Acute urticaria lasts up to 6 weeks. Chronic urticaria persists for more than 6 weeks, has an undulating course with alternating relapses and remissions.

Acute urticaria. Main etiological factors acute urticaria (UC) are foods and medicines. The development of urticaria is possible with allergies to epidermal allergens (cat, dog), house dust mites and pollen allergens, Hymenoptera venom (bees, wasps).

Most often, the disease is caused by the development of IgE-dependent allergic reactions. Many studies have shown high frequency OK in patients with atopic diseases. Analysis of clinical symptoms in children with food allergy, conducted by I. Dalal et al., made it possible to establish that OK alone or in combination with Quincke's edema was the most frequent clinical symptom food allergies and was observed in 74.4% of cases.

In a study conducted by T. Zuberbier et al., it was found that in 50.2% of patients with acute urticaria there were accompanying allergic diseases pollinosis, bronchial asthma, atopic dermatitis.

The development of urticaria may be due to the direct release of histamine and other biologically active substances from mast cells without the participation of immunological mechanisms. A number of food products medicines and chemical substances capable of causing degranulation of mast cells. Eating foods rich in histamine can also cause hives ( ).

Chronic urticaria (HC). According to most authors, the most common causes spontaneous chronic urticaria are infections - hepatitis, Helicobacter pylori-associated gastritis, staphylococcal and streptococcal infections. food products, drugs can also support chronic symptoms urticaria, but, unlike acute urticaria, the role of IgE-dependent reactions in the formation of symptoms is minimal.

Of great interest is the frequency of detection of autoantibodies to high-affinity IgE receptors (FceRI) and IgE in patients with CC. Autoimmune genesis of urticaria is confirmed by skin tests with autoserum. There is still no consensus on the role of autoantibodies in the formation of symptoms of urticaria, further research is needed.

Physical urticaria (PH) develops as a result of exposure to physical factors. The mechanism of the development of the disease is not well understood. Supposed important role mast cell degranulation in the formation of FC symptoms. Physical urticaria includes cold urticaria, solar urticaria, heat urticaria, dermographic urticaria, vibrational urticaria, and pressure urticaria.

Special forms of urticaria - cholinergic, adrenergic, aquatic.

Urticaria treatment

Treatment of urticaria depends largely on the form of the disease and causative factors. Nevertheless, the basic principles of therapy are the same, they include the following steps.

Exclusion or limitation of exposure to factors that cause urticaria.
Carrying out pharmacotherapy.
Detailed examination of patients, treatment of diseases that may be the cause of urticaria.

Pharmacotherapy. Patients with acute urticaria, exacerbation of chronic or physical urticaria for the purpose of buying acute condition in most cases, the appointment of second-generation antihistamines is indicated. In a more severe course of the disease, parenteral administration of first-generation antihistamines is advisable (there are no dosage forms for parenteral administration in H 1 -blockers of the second generation), as well as glucocorticosteroids.

Treatment of patients with chronic urticaria requires a lot of patience, close cooperation between doctor and patient. In patients, the quality of life is seriously affected: itching can affect daily activities, disrupt sleep, rashes on the face embarrass the patient, sharply limit his communication and professional activities. Patients need frequent long-term use antihistamines. Antihistamines of the first generation have a number of undesirable effects that limit their use. The sedative effect, impaired cognitive and psychomotor functions of the central nervous system are well known. nervous system. Low selectivity, binding of M-cholinergic receptors are manifested in the dryness of the mucous membranes of the oral cavity, in patients bronchial asthma the viscosity of sputum increases, which negatively affects the course of the disease. Urinary retention, constipation, possible increase intraocular pressure limit the prescription of drugs to patients with concomitant diseases. An equally serious drawback of H1-blockers of the first generation is a short-term effect, the need for 3-4 times a day is enough high doses. The decrease in therapeutic efficacy with long-term use dictates the need to change the drug every 10-14 days.

Antihistamines of the second generation (desloratadine, loratadine, fexofenadine, cetirizine, ebastine) do not have these disadvantages. All drugs are characterized by a high safety profile, no serious side effects, they are easy to use. New antihistamines are prescribed 1 time per day, regardless of food intake, no change of drugs is required, since high therapeutic efficacy is maintained with long-term use. It is possible to prescribe second-generation H1-blockers to patients with concomitant diseases for whom first-generation drugs were contraindicated.

Of course, second-generation antihistamines differ from each other. Before doctors general practice, dermatologists, pediatricians, the question arises: which drug to prescribe to the patient?

In recent years, a fairly large number of studies have been carried out in an attempt to determine which antihistamine is superior to others. Use in practical work the results of the comparisons made are difficult, since individual parameters were studied in selective groups of patients or healthy individuals, adequate dosages of the compared drugs were not always used. However, most researchers conclude that the new non-sedating antihistamines are comparable in terms of efficacy, safety, and ease of use. Patient preference may be a determining factor in choosing between second-generation antihistamines.

Given the involvement of histamine in the formation of all symptoms of urticaria, second-generation antihistamines are the drugs of first choice. In addition to the direct antihistamine action, new H1 blockers have anti-inflammatory activity. Their regular intake facilitates the course of the disease and improves the quality of life of patients.

For literature inquiries, please contact the editor.

We conducted a double-blind, placebo-controlled study of the efficacy and safety of the drug kestin (ebastine) in patients with chronic urticaria. The study included 40 patients with chronic urticaria aged 16-61 years. Women - 35, men - 5.

Prior to enrollment in the study, patients had not received systemic antihistamines for 7 days or more. Throughout the study, patients did not receive macrolides (erythromycin, clarithromycin) and azoles (itraconazole, ketoconazole). Patients did not have severe concomitant diseases. By ECG data there was no prolongation of the QT interval.

For 8 weeks, 30 patients received Kestin 20 mg/day and 10 patients received placebo.

Patients daily in the evening noted in the diary the severity of itching, the number and size of urticarial rashes. The dynamics of symptoms was assessed by the doctor during visits. The doctor and patients recorded the occurrence of adverse events, their manifestations and the necessary therapy. There were 3 visits in total: the first visit was the starting one, the second visit was 4 weeks later, and the third visit was 8 weeks after inclusion in the study.

Given that itching is the main symptom of urticaria, significantly reducing the quality of life of the patient, in and the dynamics of the severity of itching in patients after 4 and 8 weeks of therapy is given. In the group treated with kestin, all patients showed a regression in the severity given symptom. Among patients receiving placebo, the effectiveness of therapy was significantly lower - 5 (50%) patients were prematurely excluded from the study due to the lack of effect at the same time. The overall evaluation of efficacy indicates the high efficacy of kestin 20 mg / day in patients with chronic urticaria compared with placebo ( ).

During the entire period of observation in both groups, no sedative effect, serious adverse events, prolongation of the QT interval on the ECG was not noted.

Thus, second-generation antihistamines are highly effective and safe drugs. They are the drugs of first choice for controlling the symptoms of urticaria in most patients. At the same time, it should be emphasized that the achievement of pharmacological control of the symptoms of urticaria does not exclude the need for a thorough diagnostic search, identification possible causes development of urticaria.

I. V. Sidorenko,candidate medical sciences, docent
T. V. Zakharzhevskaya, Candidate of Medical Sciences
A. V. Karaulov, doctor of medical sciences, professor
MMA them. I. M. Sechenov, Moscow

To answer the question of how to treat urticaria, you must first understand what kind of disease it is and what causes it.

Urticaria, or nettle fever, dermatologists call dermatosis of an allergic nature, in which the rash resembles a nettle burn. The disease can develop at any age, it is observed in both children and adults.

There are several types of nettle fever, according to the nature of the course, there are three forms: acute, recurrent and chronic. Last form observed mainly in adult patients, the disease usually lasts for years.

Depending on the type of stimulus, there are the following types diseases:

Allergic. With this form, the rash is a reaction to a variety of allergens - drugs, foods, etc.
Dermographic. A type of dermatosis in which a rash appears as a result of mechanical action on the skin - pressure, friction, etc.
Physical. With this form of the disease, the rash appears when physical impact on the skin - cold, heat, ultraviolet, etc.

Mechanism of development and symptoms

Let's figure out why hives appear. The mechanism of formation of rashes on the skin is well understood. A rash appears as a result of excessive production of histamine, a substance that provokes the appearance of characteristic skin reactions.

Histamine increases the permeability of the vascular walls, so excess fluid enters the tissues surrounding the vessels. Because of this, a rash forms on the skin, and in severe cases, Quincke's edema develops.

There are many reasons for the development of urticaria, among them:

congenital hypersensitivity of the body to certain substances;
genetic predisposition to autoimmune reactions - the production of antibodies to body tissues;
metabolic disorders caused by impaired functioning of the digestive tract;
foci of infection carious teeth, gynecological diseases, sinusitis, etc.);
worm infection;
nervous disorders, overwork, stress;
intolerance to certain drugs.

Treatment

Without a complete examination of the patient, no doctor will be able to answer the question of how to get rid of urticaria quickly and permanently. The fact is that in order to achieve success in treatment, it is necessary to understand what causes provoked a skin reaction.

But in any case, the treatment will be multi-stage and rather complicated. It will be necessary not only to decide how to relieve itching with hives and eliminate rashes, but also to take measures to prevent recurrence of the disease.

Therefore, at the first stage, it is necessary to identify and eliminate the factors leading to the formation of a rash.

The exclusion of contact with the influence factor is the most efficient way treatment of this disease.

Unfortunately, the provoking factor can not always be identified, even after a series of tests and samples. In this case, we are talking about idiopathic cases of urticaria. It is not always possible to completely exclude the influence of a provoking factor, for example, if it is a reaction to sunlight or temperature fluctuations.

In any case, when deciding how to cure urticaria, you will need to try to minimize the impact harmful factor. With cold urticaria, you need to dress warmer, with heat - do not go to the sauna, exclude hot baths.

In the treatment of physical urticaria, the method of developing tolerance is used. To do this, systematic exposure of the skin to the identified adverse factor with a gradual increase in intensity is carried out. The effects will need to be carried out for a sufficiently long time and necessarily systematically, until the body acquires resistance and no longer reacts with the formation of a rash.

If the provocative substance is any drug or product, then it is necessary to completely exclude the intake of this substance inside. The patient must know the list of drugs prohibited for him and warn doctors about this.

Medication treatment

Now let's figure out how to treat hives with medication. In almost all cases, patients are prescribed antihistamines. These drugs reduce the content of histamine in the blood, which leads to the elimination of the main symptoms - itching, swelling, rashes.

Today, treatment is carried out with drugs belonging to the second and third generation of antihistamines. These are drugs such as Erius, Telfast, Zirtek, etc. The drugs give a pronounced effect and do not cause bouts of drowsiness. Choose a drug and determine how much and in what dosages the doctor should take it!

But the use of drugs, which include acetylsalicylic acid, ACE inhibitors and codeine with urticaria are categorically excluded, as they can provoke an exacerbation.

In severe cases, for the treatment of adult patients, glucocorticosteroids in the form of injections may be prescribed. However, they cannot be used constantly due to the large number of side effects.

Additionally, the following funds are prescribed:

sorbents, since in the treatment of urticaria one should try to remove toxins as quickly and efficiently as possible;
sedatives, if the cause of the rash is psycho-emotional stress;
calcium chloride in the form of droppers to reduce the overall sensitization (sensitivity) of the body;
topical ointments to relieve itching and quick recovery skin.

Which drugs should be used for external treatment, and how much they should be used, the doctor decides individually for each patient.

In mild cases, it is sufficient to use a lotion with metol or Fenistil-gel; in severe cases, hormonal ointments are used.

In the treatment of the chronic form of the disease, physiotherapy procedures can be prescribed. During treatment allergic form dermatosis, radon and hydrogen sulfide baths, current treatment, UV irradiation, as well as all procedures that have a hardening effect on the body and have a beneficial effect on the state of the nervous system, have a good effect.

Treatment of comorbidities

When deciding how to deal with hives, it is important to eliminate the foci of infection. For this, adult patients are referred for a consultation with an otolaryngologist, dentist, gynecologist (urologist). When identifying infectious diseases specific analyzes are carried out to determine the pathogen and select a drug to suppress it.

For suppression bacterial infections sulfonamides and antibiotics are prescribed, if viral or fungal infections are detected, they are selected antiviral drugs and antimycotics.

Except specific treatment patients are prescribed:

probiotics to support microflora;
vitamins;
immunomodulators.

Often after healing chronic infections hives rash resolves without further treatment.

In adult patients, chronic urticaria is often associated with diseases of the internal organs or endocrine disorders. Therefore, to get rid of dermatosis, efforts must be made to get rid of the underlying cause.

Diet

Achievement positive result in the treatment of urticaria caused by food allergies, drug therapy will not be enough. It is necessary to adhere to a special hypoallergenic diet.

The ban includes products that irritate the digestive tract:

hot spices, fried foods, smoked delicacies;
rich broths;
fast food;
canned food;
products containing a large number of artificial additives.

It will be necessary to abandon highly allergenic foods:

chocolate
red fruits and berries;
citrus fruits.

The main rule is the complete exclusion of products that cause an allergic reaction. The list of these products is compiled individually, after conducting allergic tests.

Treatment with folk methods

In the treatment of adult patients, alternative methods can also be used. Here are the recommendations traditional healers to get rid of nettle fever:

Tea from a row. You should replace morning coffee with infusion of a string. The herb should be brewed like regular tea and drunk after a 20-minute infusion. It is important that the drink has a golden hue, and for this you need to know exactly how much to infuse the herb. If the infusion turned out to be cloudy or green, then it was prepared incorrectly and should not be drunk.
Therapeutic baths. You can take baths with decoctions of celandine, valerian root, chamomile, sage. Brew 5 tablespoons of herbs or a mixture of herbs with a liter of boiling water, leave for one hour. Then pour the infusion into the bath. You do not need to lie in the bath for a long time, 10 minutes is enough. Then go out without wiping the body with a towel, dry in the air.
Celery juice. Prepare juice by rubbing celery on a grater and squeezing through cheesecloth. Take three times a day for a teaspoon until the symptoms of urticaria disappear.

Patients should understand that no matter how much they are treated folk methods or medicines, can only be eliminated external manifestations illness. To permanently get rid of the disease, it is important to exclude contact with the allergen. Only in this case, it can be expected that the rash on the body will no longer appear.