Does anyone know of a cream that actually works on Urticaria?

My poor sister has urticaria on her neck and arms and nothing ever seems to make it go away and stay away. Steroids work short term. Has anyone had any success with something different? She is only 25 and it really bothers her. Many thanks.

Avoid any obvious triggers or exacerbating factors and try these simple measures:

Keep the skin cool, avoid getting hot from exercise and take lukewarm baths. Resist the temptation to rub the itchy skin and apply copious amounts of moisturising creams to reduce dryness and itch. Avoid alcoholic drinks and foods containing additives (sodium benzoate, colourings and salicylate).

Apply 1% menthol in aqueous cream to soothe the affected skin.

Avoid all aspirin or codeine containing medication (including ibuprofen, diclofenac and mefenamic acid). Only use paracetamol as a painkiller.

Carefully read Side Effects list of any other medication you are currently taking and avoid medicines that are known to trigger urticaria or angioedema.

Pregnancy may specifically aggravate urticaria as Pruritic and Urticarial Papules and Plaques of Pregnancy (PUPPP syndrome).

The mainstay of treatment is high dose ANTIHISTAMINE medication which may be necessary for prolonged periods (in excess of 6 weeks). Double conventional doses of antihistamines such as Cetirizine, Loratidine and Fexofenadine may be needed for symptom relief. Occasionally we add "stomach-ulcer treatment" medication such as Cimetidine and Ranitidine which are known to also dampen down histamine release. New leukotriene receptor antagonists used for asthma such as Montelukast have produced some symptom relief in chronic urticaria. Oral Doxepin is a good antihistamine but induces drowsiness, while Doxepin cream may soothe the skin. Short courses of oral cortisone or steroids may be necessary to settle more severe symptoms. Cortisone should not be used for prolonged periods of time as they may lead to stunted growth in children and osteoporosis in adults.

Specialist investigations in Chronic Urticaria may be necessary to exclude other underlying illnesses or to confirm the presence of 鈥渁uto-antibodies鈥?in the blood stream (鈥淎nti IgE Receptor Autoantibodies" and "Basophil Histamine Release鈥?can be measured). The Autologous Serum Skin Test (ASST) raises a weal on re-injection of the patients serum and is a good indicator of Auto-antibodies.

Highly specialised treatments may include Immunosuppressive drugs (Cyclosporine, Methotrexate, and Azathioprine), Androgens and Warfarin. Colchicine is useful in treating Urticarial Vasculitis. If available, Immunoglobulin injections, Plasmaphoresis or the use of novel anti-IgE monoclonal antibodies such as Omalizumab (Xolair) may be necessary. The future holds many exciting new therapeutic modalities including DNA Plasmid Vaccines.

I have had Urticaria for many years and the best treatment bar none is Loratadine 10 mg, but you need 30 mg a day for the first 2 weeks and then down to 2 x 10 mg daily. There is no cream that works, but pile creams can stop the itch. But I find the tablets work VERY well.