Urticaria aka hives is an allergic skin reaction with characteristic red and itchy patches which usually subside within twenty-four hours without any pigmentation or scaling. When this condition persists for more than six weeks, it is known as chronic urticaria. While urticaria is usually not serious, a variant known as angioedema – involving the skin and mucous membranes, usually in the eyelids, lips, and tongue – is typically more serious and may prove to be life-threatening if not treated immediately.
A detailed medical history along with physical examination usually suffices to make a clinical diagnosis of chronic urticaria. Further investigations may be warranted with a concurrent history of parasitic infection, thyroid disorder, or autoimmune disorder. A skin biopsy may rarely be indicated with concurrent skin bleeds, autoimmune features, fever, arthritis, or if skin lesions persist for more than 24 hours at a time.
Chronic urticaria is usually idiopathic in nature; there is no definite cause which can be attributed to it, though it is now believed that an underlying autoimmune process may be one driving factor. A small subset is known as pressure urticaria, which may be caused or aggravated by pressure, vibrations, temperature changes, sweating, sun exposure and contact with water. Though rare, chronic urticaria may also be secondary to some underlying medical condition.
The modern (Allopathic) management of chronic urticaria is usually with the help of anti-histamine medications, which usually suffice to treat rash as well as itching in mild cases. For individuals with moderately severe symptoms, additional treatment with colchicine, dapsone, and steroids may be required for a limited duration. Immune modulating drugs may be required for patients who exhibit an autoimmune disease process, while a few may require thyroid medications.
In addition to a medication regime, it is also important to avoid triggers like stress, fatigue, tight-fitting clothes, alcohol, aspirin, and other non-steroid anti-inflammatory drugs. Soothing ointments can help relieve itching, while lukewarm baths can alleviate night-time itching. With a properly planned medication regime, nearly 50 percent patients undergo disease remission within a year, even though chronic urticaria is known to last from several months to several years. Though not serious or life threatening, this condition can adversely impact quality of life.
Ayurvedic herbal treatment is also very useful in treating chronic urticaria; this treatment can especially be put to good use in treating those patients who do not respond satisfactorily to modern medicines. While modern (Allopathic) medicines treat on a symptomatic basis, Ayurvedic medicines act to reverse the basis pathology of the disease. Ayurvedic herbs act on the skin, subcutaneous tissue, mucus membranes, capillaries, blood as well as the nervous system and thereby strengthen skin tissue, treat allergy, and prevent recurrence.
As per Ayurvedic pathophysiology, the diagnosis of chronic urticaria is further differentiated as follows: urticaria with predominantly ‘Vata’ dosha symptoms is known as ‘Sheeta-pitta’; with dominant ‘Pitta’ symptoms, it is known as “Utkotha”; while with dominant ‘Kapha’ symptoms, it is known as ‘Udarda’. Each of these types is treated in a different way and with different herbal medicines, thereby making the Ayurvedic treatment more specific and further amenable to results, even in refractory patients. For patients with highly refractory symptoms, purification Panchkarma procedures like induced emesis, induced purgation, and bloodletting are utilized, either as stand-alone procedures, or as combinations, or even as repeat combination-procedures, if indicated, along with oral medications. Since chronic urticaria may be related to hidden, underlying causes, it is equally important to look for and treat chronic gastro-intestinal symptoms, repeated worm infestations, thyroid disorders, chronic stress, latent infections, chronic inflammation, and autoimmune processes.
It is therefore very important to take a detailed medical history, do a thorough clinical examination and reach an accurate diagnosis before commencing treatment, in order to achieve a quick and complete remission. With proper and regular Ayurvedic herbal treatment, most patients having chronic urticaria can be fully treated in about 4-8 months. Depending upon the severity, patients with underlying autoimmune disease may require treatment for longer periods. It is equally important to adopt suitable lifestyle modifications and avoid know triggers.
Chronic urticaria, Ayurvedic treatment, herbal medicines, symptomatic dermatographism, cholinergic urticaria, pressure urticaria, chronic idiopathic urticaria, chronic spontaneous urticaria, Sheeta-pitta, Utkotha, Udarda.