What dermatographism treatments are available?

Prevention

The best treatment is always practicing some sort of prevention. Avoiding the physical stimuli that precipitates the condition is important. However, the cause is not always known. For a look at the possible causes for dermatographism, please visit the dermatographism causes page.

Reduce the Itch

The logical step in a treatment strategy for dermatographism is to stop the scratching. Scratching is often the trigger that leads to the release of histamine and the formation of welts and red skin. The use of a dry skin lotion to moisturize the skin can be very effective in reducing the itch caused by dry skin, thereby eliminating the need to scratch. Lotions for itchy skin can also be used to relieve the itchy dermatographism symptom.

Antihistamines

When discussing dermatographism treatments, antihistamines are by far the most common group of products used to control the dermatographism symptoms. Their use does not cure the disease or alter the course of the disease, but they can be very effective in providing relief.

Non-sedating H1 antihistamines are normally used. H1 antihistamines are drugs that selectively bind to but do not activate histamine H1 receptors, thereby blocking the actions of histamine. By blocking the actions of the histamine, the dermatographism symptoms of itching and welt or hive formation are relieved. However, in many cases the red skin marks associated with the condition remain.

For dermatographism treatments, several different antihistamines may be used and sometimes a combination of two at the same time may be required. Antihistamine treatments may need to be continued for several months.

H1 antihistamines that may be used in dermatographism treatments are:

• Cetirizine hydrochloride (Zyrtec)
• Loratadine (Claritin)
• Desloratadine (Clarinex)
• Acrivastine (Semprex)
• Fexofenadine (Allegra)
• Hydroxyzine hydrochloride (Atarax, Vistaril, Vistazine)
• Diphenhydramine hydrochloride (Benadryl)
• Terfenadine (Seldane)
• Astemizole (Hismanal)
• Cyproheptadine hydrochloride (Periactin)
• Chlorpheniramine (Chlor-Trimeton)

Hydroxyzine hydrochloride (Atarax, Vistaril, Vistazine) is believed to be one of the most effective agents in combating dermatographism symptoms.

For patients that do not respond adequately to H1 antihistamines, then H2 antihistamines may be prescribed. These are similar to H1 antihistamines except that they selectively bind to histamine H2 receptors and therefore block the actions of histamine. These drugs may show a further small reduction in dermatographism symptoms. They are often used in combination with the H1 drugs.

H2 antihistamines that may be used as dermatographism treatments are:

• Cimetidine (Tagamet)
• Rantidine hydrochloride (Zantac)
• Terbutaline (Brethine, Bricanyl)

The selection of which drug and what dose to use by a dermatologist depends on the severity of symptoms, possible interaction with other drugs the patient may be taking, age and weight of the patient, whether the patient is pregnant, and degree of daily alertness required by the patient.

Because the use of antihistamines as dermatographism treatments are used for several months, there is always concern among patients with regards to the side effects and long term effects of these drugs on the body. For sedating antihistamines, drowsiness is a concern and would prohibit individuals from driving a vehicle or operating machinery. Sedating antihistamines are also particularly risky for older adults due to central nervous system side effects. Non-sedating antihistamines can act as stimulants and produce hyperactivity and sleeplessness, especially in children. For long-term side effects, a less responsive immune system is a possibility when antihistamines are used for many months.

There are also certain medical conditions that may prohibit the use of antihistamines or at least limit their use as dermatographism treatments. These conditions are:

• glaucoma
• hyperthyroidism (overactive thyroid)
• high blood pressure
• heart disease
• ulcers or other stomach problems
• intestinal blockage
• liver or kidney disease
• bladder obstruction
• enlarged prostate
• diabetes

Other Dermatographism Treatments

When antihistamines do not produce a satisfactory relief of symptoms, then some other less common dermatographism treatments may be used.

Oral Steroids

Oral steroids such as prednisone are used on rare occasions when the urticaria or dermatographism is very resistant to antihistamines. However, steroids are not a good long-term treatment solution because of the many side effects that accompany steroid use.

UV Light Therapy

UVB light therapy or UVA light therapy plus the use of psoralen (a medicine that makes the skin more sensitive to UVA rays) have shown some improvement in dermatographism or urticaria symptoms in the short term. However, generally this dermatographism treatment does not lead to a significant reduction in the welts.

Antibiotics and Antifungal Agents

Antibiotics and antifungal agents are used to clear an assumed underlying infection or for non-specific anti-inflammatory action. These agents are acting to cure what may be causing the dermatographism symptoms. Although this can work, many times the cause is unknown and such agents will not have any effect.

Tricyclics

Amitriptyline, nortriptyline, and doxepin hydrochloride (Adapin, Sinequan) are tricyclic medications that are sometimes used to control stubborn forms of urticaria or dermographism. These drugs are typically used to combat depression, but they also posses certain antihistaminic properties.

Topical

The topical application of certain substances such as Capsaicin (Zostrix) or local anesthetic can be used as dermatographism treatments. These substances can suppress the flare-up of the dermatographism symptoms such as the welts and/or the discomfort produced by the symptoms.

Immunosuppression

For severe cases of urticaria or dermatographism, immunosuppression therapy (ciclosporin, plasmapheresis) can be used. This type of therapy involves decreasing the responsiveness of the body’s immune system so that it does not react to various triggers that may cause the outbreak of the symptoms.

All Natural Organic Treatments

Please visit the all natural dermatographism treatments page if you would like to learn about an all natural treatment for dermatographism.

More information on natural remedies for skin hives can be found here.

Other Treatments

Visit the dermatographism hives remedies page for treatment suggestions from actual dermatographism sufferers.

Visit the dermatographism antihistamines page to read about the experiences of individuals taking antihistamines in order to treat their dermatographism skin problem. More stories can be found at the antihistamine drug treatment page or the over the counter antihistamines page.

The antihistamine side effects page provides reader submissions from those concerned about the use of antihistamines to treat dermatographism.

Visit the tanning beds dermatographism treatments page for submissions from readers on how ultra violet light has help them with their dermatographism skin condition.

Prevent, control, and cure your hives or urticaria (including dermatographism or physical urticaria) NATURALLY - Click Here for more information.

NATURAL DERMOGRAPHISM and HIVES CURE - Click Here.

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