How fast does prednisone work for hives

Note: Content may be edited for style and length. Science News. Hold the steroids. ScienceDaily, 3 May American College of Emergency Physicians. Got hives? Retrieved November 11, from www. The study was a pre-registered, placebo-controlled, double-blind E-mail: moc. Urticaria is a disease characterized by development of wheals hives , angioedema, or both. This needs to be differentiated from wheals caused by skin prick test, anaphylaxis autoinflammatory syndromes, and hereditary angioedema.

Acute urticaria is often treated with antihistamines, steroids, and topical anti pruritic lotions. The aim of our study was to evaluate the efficacy of an additional 5-day course of oral prednisolone when compared with levocetirizine alone in the management of acute urticaria.

Inclusion criteria were adults more than 17 years, present urticarial episode of less than 5 days duration, and active urticarial lesions at the time of presentation. Exclusion criteria were history of chronic urticaria or dermographism, children, wheezing or fever, pregnancy and lactation, use of antihistamines or oral corticosteroids within 5 days of first consultation, history of diabetes, hypertension or active peptic ulcer disease, and refusal of informed consent.

This was randomized single blind non-cross-over study at the teaching hospital. Patients were randomized into two groups. The first group received levocetirizine 5 mg twice a day and prednisolone mg twice a day for the first 5 days. Prednisolone was given in the dose of 0. The second group received only levocetirizine 5 mg twice a day.

Levocetirizine was continued for 6 weeks in both the groups. Detailed history with complete physical examination was done in all the patients. The UAS measures two symptoms — number of wheals and intensity of itching — each on a scale each day. The UAS was recorded by each patient daily and was obtained from the patients weekly.

Severity of itch was scored as 0 — none; 1 — mild; 2 — moderate; and 3 — severe. One has to add both of these scores, namely for both the number of wheals and the severity of itch, on a given day for each of the days in a given week to get the weekly UAS.

The average daily UAS thereby ranged from 0 to 6. Results were as follows [ Table 1 ]. Total 49 21 males and 28 females, mean age Hsu Blatman says that for patients with relatively mild cases of hives, the study underscores the option of simply taking antihistamines at home.

But if you continue to have symptoms or it doesn't seem like it's turning around, then you should be seeking medical advice. She called the study "nicely done," and further evidence that histamine is a key element in the hives allergic reaction, "so it makes sense that if you take an antihistamine, that that would help with blocking the histamine, which is what's really driving that itch.

But, I asked her, doesn't it make sense that if an allergic reaction like hives is an overreaction of the immune system, and steroids ratchet down the immune system, they should be helpful against hives? The steroid "is trying to help decrease that inflammation kind of slowly," she said. So for patients who may have a bigger presentation, the steroids can be helpful in that way. Vukmir said the study offers more fodder for a discussion between doctors and patients as they consider the options.

In the wake of the study, he said, his script might sound like this:. You know, normally we would prescribe steroids in this situation. It's been done for years. There's a good track record. Some people get a little concerned about steroids. So there is this other alternative: There's a new study that said maybe we don't need to give steroids, in that you don't get better that much more quickly.

And we can try that approach, and I might use a higher dose of the antihistamine. He might also suggest that the patient call him if there's a problem, and that he could still phone the steroid prescription in to the pharmacy.

And medicine is always trying to improve, in part by reexamining current medical dogma, as this French study did. I'm leaning toward skipping the steroid, at least at first, if I get another hives attack. But one lingering concern: The study did find that in one patient among the 50 who got a placebo rather than a steroid, the hives progressed to an anaphylactic allergic reaction.