Urticaria

Description

General measures

Medicine treatment

Referral

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L50.0-6/L50.8-9

DESCRIPTION

• Urticaria is a skin disorder characterised by itchy wheals (hives)
• There are many causes, including allergic, toxic or physical:
  • Allergic urticaria may be caused by drugs, plant pollen, insect bites or foodstuffs, e.g. fish, eggs, fruit, milk and meat
  • Commonly caused by medicines e.g. aspirin, NSAIDs, or codeine

GENERAL MEASURES

• Take detailed history to determine trigger factors
• Lifestyle adjustment

MEDICINE TREATMENT

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Note:
Avoid the use of oral corticosteroids.

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LoE: IVb

Children

• Chlorphenamine, oral, 0.1 mg/kg/dose at night. See: dosing table

LoE:IVb²⁴

Adults

• Chlorphenamine, oral, 4 mg, 6–8 hourly

For long term use in adults and school going children:

Children: 2–6 years of age

• Cetirizine, oral, 5 mg once daily. See: dosing table

Children > 6 years of age and adults

• Cetirizine, oral, 10 mg once daily
• Calamine lotion, applied on the skin

REFERRAL

• No improvement or response after 24 hours

Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Review-Version-2.0-November-2025

Chapter 5: Skin Conditions_5.10.1 Urticaria