Occasionally, the condition persists into adolescence or adulthood. The treatment of papular urticaria is supportive. Therapy includes relieving pruritus, prevention or of secondary infection. For the relief of pruritis, topical application of calamine lotion may suffice. Topical antihistamines are inadvisable as they are relatively inactive and the risk of allergic sensitization is high.
Topical steroids are often helpful in refractory cases or if secondary eczematization has occurred.
Good skin care is essential for prevention of secondary infection. For isolated or minor infected lesions, topical application of an antiseptic e.g. betadine usually suffices. Systemic antibiotics must be given for severe or extensive infection of if clinically evident secondary infection and adenitis are present. Erythromycin should be the first choice oral antibiotic. Examination of bedding and the children's play areas for insects may provide a clue to the cause.