Infections such as sinusitis should be treated if present. Thyroid hormone replacement may be useful in cases where antithyroid antibodies are present. The specific triggers should be avoided in cases of physical urticaria. Patients with solar urticaria should wear protective clothing and use sunscreens. If the cause cannot be identified, then antihistamines are prescribed to suppress hives.
Hydroxyzine is one of the most effective but often causes drowsiness.
Newer antihistamines such as loratidine, cetirizine, fexofenadine and astemizole are less likely to do so. If these are not effective, then corticosteroids may be added. In severe cases with respiratory difficulty, adrenaline injection may be used.