Patients should be instructed to strictly avoid any known triggers, and be provided with educational materials that help them to recognize trigger exposure and manage urticaria.[1]Zuberbier T, Abdul Latiff AH, Abuzakouk M, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022 Mar;77(3):734-66.
https://www.doi.org/10.1111/all.15090
http://www.ncbi.nlm.nih.gov/pubmed/34536239?tool=bestpractice.com
[37]Sabroe RA, Lawlor F, Grattan CEH, et al. British Association of Dermatologists guidelines for the management of people with chronic urticaria 2021. Br J Dermatol. 2022 Mar;186(3):398-413.
https://www.doi.org/10.1111/bjd.20892
http://www.ncbi.nlm.nih.gov/pubmed/34773650?tool=bestpractice.com
It is imperative to administer treatment, particularly antihistamines, prophylactically on a daily basis rather than reactively after the occurrence of lesions.
Patients with a history of urticaria associated with angioedema of the head and neck should be prescribed two self-injectable epinephrine (adrenaline) devices and instructed on their use.[27]Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis - a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020 Apr;145(4):1082-123.
https://www.doi.org/10.1016/j.jaci.2020.01.017
http://www.ncbi.nlm.nih.gov/pubmed/32001253?tool=bestpractice.com
Patients with hereditary angioedema (HAE) should be taught how to self-administer C1 esterase inhibitor at the first signs of an attack.
Patients with HAE should be advised to avoid methods of contraception that include estrogen. They should be advised to discuss plans for pregnancy with their doctor, because attenuated androgens should be stopped before conception and are contraindicated in pregnancy.[91]Caballero T, Farkas H, Bouillet L, et al. International consensus and practical guidelines on the gynecologic and obstetric management of female patients with hereditary angioedema caused by C1 inhibitor deficiency. J Allergy Clin Immunol. 2012 Feb;129(2):308-20.
https://www.jacionline.org/article/S0091-6749(11)01830-6/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/22197274?tool=bestpractice.com