Acute spontaneous urticaria

Fortunately, the most common form of urticaria is acute urticaria or “acute spontaneous urticaria”, which lasts a maximum of six weeks (usually a few days to three weeks) and is usually easy to treat. Approximately one in five persons has such an episode at least once in her or his life.

In acute spontaneous urticaria, the typical symptoms, redness and hives, occur. The wheals cause intense itching and are sometimes also associated with burning and soreness of the skin. In some patients, angioedema (swelling of deep skin) also occurs. Severe acute spontaneous urticaria may also be accompanied by fever, headache, diarrhea, difficulty in breathing and swallowing, joint pain, and tiredness/fatigue.

Triggers

Triggers of acute urticaria are often infections such as colds. In adults, certain medications, particularly antipyretic analgesics (aspirin, diclofenac, ibuprofen), antibiotics (sulfonamides, penicillin, cephalosporins) and cardiac and antihypertensive drugs (beta-blockers, ACE inhibitors, diuretics) may cause an attack. Also, some allergies, such as food allergies, can trigger the symptoms of urticaria; however, these are not cases of true urticaria. Detergents and personal care products (shampoos, shower gels, or creams) are almost never triggers of acute urticaria.

Therapy

The symptoms of acute urticaria usually disappear by themselves within a few days. The therapy consists simply of antihistamines, namely those of the new generation, the so-called non-sedating, i.e. not sleepy-making, antihistamines.

Antihistamines—also called H1 blockers—are drugs that inhibit the effect of histamine by attaching themselves to the histamine receptors and blocking them. The cell bearing the receptor (e.g. a nerve cell) does not receive the signals of histamine and therefore does not respond. However, the binding does not last forever. Therefore, these drugs must be taken again and again.

If urticaria does not disappear, or keeps coming back, doctor and patient will start a detailed diagnosis after a few weeks.

If an acute urticaria is severe and is for example accompanied by angioedema, difficulty in swallowing, or breathing difficulties, other medications (such as cortisone) are used.

Of course, suspected triggers should, as far as possible, be avoided in the future.