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3 Things Patients Need in Their Hives Toolkit

Medically Reviewed By Debra Sullivan, Ph.D., MSN, R.N., CNE, COI

Urticaria — or hives — can be an extremely frustrating condition for patients, especially if it becomes chronic or causes a lot of discomfort. Patients can learn how to self-manage their hives and ease the itching. 

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Urticaria and chronic urticaria, in particular, can be challenging to treat. Many patients continue to have symptoms despite treatment. The itching and other symptoms can negatively affect sleep, emotional health, self-esteem, and quality of life.

Knowing symptoms could happen anywhere at any time may cause patients to withdraw socially. It is important to provide them with tools they can use in any place or at any time to relieve their symptoms.

Consider recommending these items for your urticaria patients when putting together a treatment toolkit.

1. Urticaria trigger diary

Identifying and tracking hives triggers is one of the most important steps in managing urticaria. Your patients’ participation in this plays a big role in their treatment.

If your patients with hives are not keeping a trigger diary or journal already, this can be the first suggestion for their hives toolkit. They can track when hives occur, how severe they are, and what their symptoms are, including whether they experience local or systemic symptoms. 

They can also note any relevance of the common types of triggers, such as:

  • animal dander 
  • clothing
  • foods or drinks
  • medications
  • physical or emotional stress
  • pollen

Including the remedies they try and whether they bring relief is helpful, as well. This will allow them to refine the items they need or do not need in their toolkit.

There is one app designed for people with urticaria that can help patients track symptoms and other aspects of treatment. CRUSE (ChRonic Urticaria Self-Evaluation) Control is an app provided by Urticaria Centers for Reference and Excellence (UCARE).

2. Medications

Your urticaria patients are likely taking a second-generation antihistamine, such as loratadine (Claritin) or cetirizine (Zyrtec) as a first-line Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  treatment. They may also be taking the biologic omalizumab (Xolair) or the immunomodulator, cyclosporine (Gengraf, Neoral, Sandimmune).

Remind them about having an appropriate supply of medications on hand. Using an automatic refill or mail order program can help make sure their prescriptions do not run out.

When they are out and about, suggest products that can ease itching should it begin while they are away from home. This could include topical creams or lotions, such as calamine.

Some people may benefit from having an epinephrine auto-injector. For these patients, make sure to explain how and when to use the auto-injector and verify that caregivers or others close to the patient are aware of the instructions. 

Also, remind patients to check expiration dates regularly — expired medications may not work as well to relieve itching or systemic symptoms of urticaria.

3. Home remedies

Patients can keep several tools on hand at home to help soothe the itch of hives. Home remedy items to include in a toolkit include:

  • colloidal oatmeal baths 
  • cool compresses
  • fiddle toys to keep hands occupied when itching is at its worst
  • nail clippers to keep nails short, which can reduce the harm of scratching
  • natural fiber gloves to wear during sleep to protect from scratching

Takeaway

Check in with your patients during their appointments about the strategies they use to manage itching and other symptoms of urticaria. Offer educational materials and checklist reminders about potential triggers and lifestyle changes they can use in their care routine.

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  1. CRUSE control. https://cruse-control.com
  2. Dabija D, et al. (2023). Chronic urticaria. https://www.ncbi.nlm.nih.gov/books/NBK555910/
  3. Hives. (2018). https://acaai.org/allergies/allergic-conditions/skin-allergy/hives/
  4. Managing chronic urticaria. (n.d.). https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
  5. Yosipovitch G, et al. (2023). Current and emerging therapies for chronic spontaneous urticaria: A narrative review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10366054/

Medical Reviewer: Debra Sullivan, Ph.D., MSN, R.N., CNE, COI
Last Review Date: 2024 Mar 12
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