What is the first-line treatment for acute urticaria?

What is the first-line treatment for acute urticaria?

• A. H1-antihistamines (2nd generation preferred)
• B. Corticosteroids
• C. Antibiotics
• D. Decongestants

Answer: (A)

Blocking histamine’s effects on the skin is the main approach to acute urticaria. H1-antihistamines do this by competing with histamine at H1 receptors, which reduces itching and the formation of wheals. Second-generation options are preferred because they cause much less drowsiness and cognitive slowing, making them safer and more tolerable for everyday use. Drugs like cetirizine, loratadine, and fexofenadine are commonly chosen and are typically taken once daily, started at symptom onset and continued until the rash resolves. In more severe cases, or if symptoms persist despite antihistamines, a short course of systemic corticosteroids may be added, but they’re not used routinely due to potential side effects. Antibiotics do not treat the mechanism of urticaria unless there’s a superimposed infection, and decongestants aren’t helpful for urticaria symptoms.

Blocking histamine’s effects on the skin is the main approach to acute urticaria. H1-antihistamines do this by competing with histamine at H1 receptors, which reduces itching and the formation of wheals. Second-generation options are preferred because they cause much less drowsiness and cognitive slowing, making them safer and more tolerable for everyday use. Drugs like cetirizine, loratadine, and fexofenadine are commonly chosen and are typically taken once daily, started at symptom onset and continued until the rash resolves.

In more severe cases, or if symptoms persist despite antihistamines, a short course of systemic corticosteroids may be added, but they’re not used routinely due to potential side effects. Antibiotics do not treat the mechanism of urticaria unless there’s a superimposed infection, and decongestants aren’t helpful for urticaria symptoms.