Each lesion persists for 2 to 10 days and may leave behind pigmentation. Fleas may cause papular urticaria where two to three lesions are seen in a row. The lesions are often excoriated and recurrent impetigo may be a troublesome complication. 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.