General measures include avoidance of known physical triggers, certain medications, alcohol, overtiredness, stress, maintenance of a cool environment, and light clothing.
Oral antihistamines are the main treatment for urticaria. They relieve itch and suppress hives. They do not affect the underlying cause of the rash. Antihistamines may need to be taken intermittently or continuously until the urticarial disappears. It is recommended that they be taken on a regular basis if frequent hives are experienced because regular dosing is more effective. The main side effect of anti-histamines is drowsiness. Non-sedating anti-histamines are available and these are frequently prescribed, especially during the day.
If patients do not respond to antihistamines, additional medications such as cyclosporin and omalizumab may be recommended by the doctor.
A short course of oral steroids may sometimes be prescribed in severe cases.