Nighttime Urticaria: Causes and Treatment Options - Dermatology

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Urticaria


Hello, Dr.
Jiang.
I've been experiencing symptoms of urticaria since around August.
At first, it occurred almost every other day, and it seems to be quite frequent.
The most concerning part is that it only happens at night while I'm sleeping.
I'm really troubled as to why it only occurs at night.
The treatment methods I found online seem to be quite passive; is there a more proactive treatment available? Should I see a doctor? I've heard that taking antihistamines can be harmful to the body; is that true? I also prefer not to take steroids.
Are there other treatment options? By the way, my diet hasn't changed and is the same as usual.

Shali, 20~29 year old female. Ask Date: 2006/10/19

Dr. Jiang Zheen reply Dermatology


The side effects of the new generation of antihistamines are low, allowing for safe use.
However, the most important aspect is to identify the cause of the allergy.
Most cases of urticaria are related to food, and you may need to temporarily avoid certain foods such as seafood (both freshwater and saltwater), eggs, fermented dairy products, bamboo shoots, mushrooms, tomatoes, and peanuts.
Additionally, it is advisable to keep a daily food diary to track any correlation between the foods consumed and the days when rashes occur.
If you can identify the trigger, avoiding it will prevent the recurrence of urticaria.
You should consult a dermatologist for treatment.
Wishing you peace, and remember that Jesus loves you.

Reply Date: 2006/10/19

More Info


Nighttime urticaria, also known as nocturnal urticaria, is a condition characterized by the appearance of hives or welts on the skin during the night. This can be particularly distressing as it often disrupts sleep and can lead to anxiety about going to bed. Understanding the causes and treatment options for nighttime urticaria is crucial for managing this condition effectively.


Causes of Nighttime Urticaria
The exact cause of nighttime urticaria can vary from person to person. Some potential triggers include:
1. Allergens: Exposure to allergens such as dust mites, pet dander, or certain foods can lead to hives. If your symptoms are worse at night, it may be worth investigating your sleeping environment for potential allergens.

2. Temperature Changes: Some individuals may experience hives in response to changes in temperature, such as sweating while sleeping or exposure to cold air.

3. Stress: Emotional stress can exacerbate urticaria. If you are experiencing increased stress levels, this could be a contributing factor.

4. Infections: Viral infections or other illnesses can sometimes trigger urticaria.

5. Chronic Conditions: Conditions such as chronic urticaria or autoimmune disorders may lead to nighttime symptoms.


Treatment Options
When it comes to treating nighttime urticaria, there are several approaches you can consider:
1. Antihistamines: While you mentioned concerns about antihistamines being harmful, they are often the first line of treatment for urticaria. Non-sedating antihistamines (like cetirizine or loratadine) can help reduce itching and hives without causing significant drowsiness. However, if you are experiencing nighttime symptoms, your doctor may recommend a sedating antihistamine (like diphenhydramine) to help you sleep better.

2. Avoiding Triggers: Keeping a diary of your symptoms and potential triggers can help identify what might be causing your nighttime hives. This could include dietary changes, environmental factors, or stress management techniques.

3. Lifestyle Modifications: Maintaining a cool sleeping environment, using hypoallergenic bedding, and practicing relaxation techniques before bed can help reduce symptoms.

4. Prescription Medications: If over-the-counter antihistamines are not effective, your doctor may prescribe stronger medications or a combination of treatments. This could include corticosteroids for short-term use or other immunomodulatory drugs.

5. Alternative Therapies: Some individuals find relief through acupuncture, herbal remedies, or dietary supplements. However, it's essential to discuss these options with your healthcare provider to ensure they are safe and appropriate for your situation.

6. Consulting a Specialist: If your symptoms persist or worsen, it may be beneficial to see an allergist or dermatologist. They can perform tests to identify specific triggers and recommend a tailored treatment plan.


Conclusion
While nighttime urticaria can be frustrating and disruptive, there are various treatment options available. It is essential to work closely with your healthcare provider to find the most effective approach for your specific situation. Avoiding triggers, considering antihistamines, and exploring lifestyle changes can all contribute to better management of your symptoms. If you have concerns about the safety of certain medications, discussing these with your doctor can help alleviate fears and lead to a more informed treatment plan. Remember, you don’t have to suffer in silence; seeking medical advice is a proactive step towards finding relief.

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