Urticaria, commonly known as hives, is a skin reaction characterized by itchy, raised, red, or skin-colored welts (wheals) that can appear suddenly and vary in size and shape.
Ranked by community outcomes, then evidence grade, Health Voice mentions, and recency.
Why it may help Urticaria: Often low in chronic urticaria
Why it may help Urticaria: High-dose reduces histamine
A pungent root that has been studied for nausea and digestive comfort.
A succulent whose inner-leaf gel has been studied for burns, wound healing, and skin hydration.
Why it may help Urticaria: Holy Basil (Tulsi) may help alleviate urticaria symptoms by modulating immune responses and reducing inflammation, potentially by inhibiting mast cell degranulation and histamine release.
Why it may help Urticaria: Reduces allergic inflammation
Aerobic and resistance exercise have RCT-grade evidence for depression, comparable to SSRIs in mild-moderate cases.
Why it may help Urticaria: Modulates histamine response
Why it may help Urticaria: Reduces urticaria severity
Why it may help Urticaria: Modulates immune-allergic response
Why it may help Urticaria: Natural antihistamine and mast cell stabilizer
Why it may help Urticaria: N-Acetyl Cysteine (NAC) may help alleviate urticaria by acting as an antioxidant and modulating immune responses, potentially reducing oxidative stress and inflammation associated with the condition.
Why it may help Urticaria: Magnesium may help alleviate urticaria symptoms by stabilizing mast cells and reducing histamine release, thereby modulating the allergic inflammatory response in the skin.
Why it may help Urticaria: Nettle may help alleviate urticaria symptoms by inhibiting histamine release from mast cells and reducing inflammatory mediators involved in allergic skin reactions.
A daisy-like flower that has been studied for mild sedative and digestive effects.
Community outcomes
Self-reported by community members · not medical advice.
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Community Discussions
How global health authorities view Urticaria.
The Mayo Clinic suggests identifying and avoiding triggers, using anti-itch remedies, and managing stress. The NIH acknowledges that some natural products are used for allergic conditions but emphasizes the need for more research to confirm their effectiveness and safety. The Cochrane Library has reviewed some interventions for chronic urticaria, often focusing on conventional treatments, with limited strong evidence for specific natural approaches. Overall, international health bodies generally recommend conventional medical evaluation and treatment for urticaria, while acknowledging that some complementary approaches may offer symptomatic relief, often with a call for more robust scientific investigation.
Indexed studies for Urticaria, grouped by source type and quality.
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Pooled analyses across multiple human trials.
Vieira ACP, Ventura de Santana de Jesus AC, Cappellaro AP, Barbosa LM, de Farias Santos ACF, de Medeiros CMD · Clinical drug investigation · 2025 · n=2488
BACKGROUND AND OBJECTIVE: This meta-analysis aims to evaluate ligelizumab's efficacy and safety for chronic spontaneous urticaria (CSU) treatment by analyzing recent clinical trials and comparing it with placebo and omalizumab. PubMed, Embase, and Cochrane were searched up to October 2024. Eligible studies were randomized controlled trials (RCTs) comparing ligelizumab with placebo or omalizumab, reporting relevant outcomes. Nonrandomized studies, or those without control groups, were excluded. Risk of bias was assessed using the Cochrane RoB-2 tool, and the Grading of Recommendation, Assessment, Development, and Evaluations approach rated evidence certainty. Statistical analysis used R software (v.4.4.2), assessing heterogeneity by Cochran Q and I2 statistics. Four RCTs with 2488 patients were included. Ligelizumab (< 72 mg) significantly improved itch severity score over 7 days (ISS7) [risk ratio (RR) 5.07; 95% confidence interval (CI) 3.12-8.24; prediction
Zhao Z, Zheng Y, Song X, Peng C, Liao S, Zhang P · Clinical and translational allergy · 2025 · n=6933
Most biological and synthetic target-specific drugs for antihistamine-refractory chronic spontaneous urticaria (CSU) have not been compared head-to-head. This systematic review and network meta-analysis evaluated their relative efficacy and safety. Searches were conducted on PubMed, Embase, Web of Science and Cochrane library databases to March 25, 2024 for randomized trials. A random-effects model was used to calculate the network estimates reported as mean differences (MD) and odds ratios (OR) with corresponding 95% CIs. Main outcomes included the weekly urticaria activity score (UAS7), adverse events (AEs) and serious adverse events (SAEs). 23 randomized clinical trials with 6933 participants that compared 26 different interventions or dosages and placebos were included. Omalizumab 300 mg [MD -10.07, 95% CI (-11.35; -8.82)] continues to demonstrate superior efficacy compared with placebo. Remibrutinib, at doses of 35 mg once daily [MD -7.80, 95% CI (-12.76; -2.51)], 25&#
Xiong G, Rayner DG, Kim L, Mahmood S, Yu T, Abu-Hilal M · The Journal of dermatological treatment · 2025 · n=913
Chronic spontaneous urticaria (CSU) is a skin condition that significantly impairs quality of life. While omalizumab remains the standard treatment for patients who have failed antihistamines, emerging therapies show promise in randomized control trials (RCTs). This study aims to compare the relative efficacy of omalizumab, dupilumab, and remibrutinib in CSU. Four databases were searched for RCTs evaluating omalizumab (75/150/300 mg Q4W), dupilumab (300 mg Q2W), or remibrutinib (25 mg BID) in CSU. Urticaria Activity Score (UAS7), Itch Severity Score (ISS7), Dermatology Life Quality Index (DLQI; DLQI 0/1), disease control (UAS7 ≤ 6), and symptom remission (UAS7 = 0) were assessed at weeks 12/24. Frequentist random-effects network meta-analysis were conducted in R. Fifteen studies (4,913 patients) were included. Omalizumab 300 mg demonstrated the greatest efficacy in UAS7, ISS7, symptom remission, and disease control at bot
Structured reviews of the full body of evidence (incl. Cochrane).
Sánchez J, Pite H, Gómez RM, Ansotegui IJ, Canonica GW, Dávila I · The Journal of allergy and clinical immunology · 2025
There is no global agreement on the definition of chronic spontaneous urticaria (CSU) remission. Our aim was to generate a consensus for clinical definitions of CSU-related terms focused on remission. The World Allergy Organization Urticaria Committee systematically reviewed current available longitudinal articles. On the basis of this review, a consensus agreement was reached for the definition of the term CSU remission. In addition, a scheme specifying when and how therapeutic de-escalation should be performed was constructed. Almost all of the groups that have carried out longitudinal studies to evaluate the frequency of CSU remission agreed to use the term CSU remission if the patient remains without urticaria signs and symptoms without pharmacologic treatment (omalizumab, cyclosporine, antihistamines, or systemic corticosteroids). According to our systematic review, the available evidence does not specify the best time to consider CSU remission. However, current evidence sugges
A systematic review and Bayesian analysis of the adverse effects of dienogest.
Li RR, Xi Q, Tao L, Sheng W, Zhao CC, Wu YJ · BMC pharmacology & toxicology · 2024
Endometriosis and adenomyosis are two common diseases that impair women's health, and dienogest is one of the pharmacologic treatments which is the first-line therapeutic option for patients with pelvic pain and individuals who have no desire for immediate pregnancy. The goal of this study was to summarize the current evidence of adverse events associated with dienogest as well as the prevalence of these adverse events during treatment with dienogest. Several databases (PubMed, Embase, Cochrane Central and Clinicaltrials.gov, etc.) and the US FDA Adverse Event Reporting System (FAERS) Public Dashboard were searched on May 31, 2023, using the topic words alongside free words of dienogest and "adverse reaction". Studies were incorporated into this research if they reported or assessed safety issues or adverse reactions of dienogest during the period of endometriosis treatment or adenomyosis therapy. The extracted information comprised trial design, dienogest and control group demographi
Dupilumab in Inflammatory Skin Diseases: A Systematic Review.
Olbrich H, Sadik CD, Ludwig RJ, Thaçi D, Boch K · Biomolecules · 2023
Dupilumab was first approved for the treatment of atopic dermatitis (AD) and blocks the signaling of interleukin (IL)-4 and -13. Several other chronic skin conditions share mechanistic overlaps with AD in their pathophysiology, i.e., are linked to type 2 inflammation. Most recently, dupilumab was approved by the U.S. Food and Drug Administration for prurigo nodularis (PN). Given its relatively good safety profile, effective off-label use of dupilumab has been reported for a multitude of dermatologic diseases and several clinical trials for dermatologic skin conditions are currently ongoing. We conducted a systematic review of applications of dupilumab in dermatology other than AD and PN by searching the databases PubMed/Medline, Scopus, Web of Science and Cochrane Library as well as the clinical trial registry ClinicalTrials.gov. We found several reports for effective treatment of bullous autoimmune diseases, eczema, prurigo, alopecia areata, chronic spontaneous urticaria, Netherton sy
Recommendations from medical societies (NICE, AHA, ADA, ACG, Endocrine Society…).
Urticaria (hives): assessment and management
NICE
This guideline covers the assessment, diagnosis, and management of urticaria in children, young people, and adults. It aims to improve outcomes by recommending effective treatments and strategies.
Controlled human studies with random assignment.
Remibrutinib in chronic spontaneous urticaria: 52-week results from two phase 3 studies.
Giménez-Arnau AM, Szalewski R, Hide M, Jain V, Khemis A, Lebwohl M · The Journal of allergy and clinical immunology · 2026 · n=313
Remibrutinib, an oral, highly selective Bruton tyrosine kinase inhibitor, demonstrated significant improvements in disease activity over placebo in the 24-week phase 3 REMIX studies in patients with chronic spontaneous urticaria (CSU) remaining symptomatic despite second-generation H1-antihistamines. We sought to evaluate the long-term efficacy and safety of remibrutinib in patients with CSU. REMIX-1 (NCT05030311) and REMIX-2 (NCT05032157) were two randomized placebo-controlled studies evaluating the efficacy, safety, and tolerability of remibrutinib in patients with CSU. Patients were randomized 2:1 to receive oral remibrutinib 25 mg twice daily or placebo during a 24-week double-blind placebo-controlled period, followed by a 28-week open-label treatment period (up to 52 weeks). The primary end point was change from baseline in weekly Urticaria Activity Score at week 12. A total of 470 patients in REMIX-1 and 455 in REMIX-2 were randomly assigned to receive remibrutinib (n = 313 an
Saini SS, Maurer M, Dytyatkovska Y, Springer E, Ratkova M, Krusheva B · Allergy · 2025 · n=619
This study compared the therapeutic equivalence of CT-P39 (an omalizumab biosimilar) and EU-approved reference omalizumab (ref-OMA) in patients with chronic spontaneous urticaria. This double-blind, randomized, active-controlled Phase 3 study (NCT04426890) included two 12-week treatment periods (TPs). In TP1, patients received CT-P39 300 mg, ref-OMA 300 mg, CT-P39 150 mg, or ref-OMA 150 mg. In TP2, patients treated with ref-OMA 300 mg were rerandomized to CT-P39 300 mg or ref-OMA 300 mg; patients initially randomized to CT-P39 300 mg continued this regimen; and patients initially randomized to CT-P39 or ref-OMA 150 mg received 300 mg dosing with the same drug. The primary endpoint for the assessment of therapeutic equivalence of CT-P39 300 mg and ref-OMA 300 mg was change from baseline in weekly itch severity score (ISS7) at week 12. In TP1, 619 patients were randomized (CT-P39 300 mg, n&#
Parks KR, Moodie Z, Allen MA, Yen C, Furch BD, MacPhee KJ · Science translational medicine · 2025
mRNA technology might accelerate development of an urgently needed preventive human immunodeficiency virus (HIV) vaccine. We evaluated the safety and immunogenicity of three mRNA-encoded envelope trimers, including two doses of soluble and membrane-anchored forms, in a randomized, open-label, phase 1 clinical trial. Vaccines were generally well tolerated, although 6.5% (7 of 108) of participants developed urticaria, a higher proportion than seen with other mRNA vaccines. mRNA-encoded trimers induced strong envelope-specific B and T cell responses. Immunization with membrane-anchored trimers, intended to obscure epitopes at the trimer base targeted by nonneutralizing antibodies, reduced the frequency of base-binding serum antibodies in comparison with soluble trimers. Three immunizations elicited autologous tier 2 serum neutralizing antibodies in 80% of vaccinees receiving the membrane-anchored trimers, in contrast to only 4% receiving the soluble trimer. Thus, with demonstration of mor
Cohort, case-control, and cross-sectional human studies.
Chai HX, Wang F, Liu H, Xie YQ, Zhou ZH · Asia Pacific journal of clinical nutrition · 2025 · n=120
Vitamin D deficiency has been linked to urticaria, but causality remains uncer-tain. We used Mendelian randomization (MR) to investigate potential causal effects of vitamin D and its me-tabolites on urticaria risk. Summary statistics from genome-wide association studies (GWAS) of total 25-hydroxyvitamin D [25(OH)D] (n=120,618), 25-hydroxyvitamin D3 [25(OH)D3] (n=40,562), and C3-epimer-25-hydroxyvitamin D3 [C3-epi-25(OH)D3] (n=40,562) in Europeans were used, along with data on urticaria and its subtypes from FinnGen consortium (R10 release). For validation, we performed additional MR analyses using a larger dataset that meta-analyzed data from the UK Biobank and GWAS results from the SUNLIGHT consortium (n=496,946) as exposure variables. We performed compre-hensive sensitivity analyses, including heterogeneity tests, pleiotropy assessments, and leave-one-out analyses to evaluate result robustness. Statistical power calculations were conducted to validate the reliability of our findings
Khan AA, Riaz AA, Naseer F, Fatima N, Abrar Z, Malik L · The journal of allergy and clinical immunology. In practice · 2025 · n=997
Chronic spontaneous urticaria (CSU) is a mast cell-mediated condition affecting approximately 1% of the population and is often refractory to antihistamines and omalizumab. Remibrutinib, a Bruton's tyrosine kinase inhibitor, prevents mast cell activation independent of the IgE pathway. To assess the efficacy, safety, and quality-of-life outcomes of remibrutinib compared with placebo in adults with refractory CSU. A systematic review was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three randomized controlled trials (RCTs) (n = 997) and 2 single-arm studies (n = 280) evaluating remibrutinib in CSU were included. Specific disease activity end points assessed included changes in Urticaria Activity Score over 7 days (UAS7), Hives Severity Score over 7 days, Itch Severity Score over 7 days, Angioedema Activity Score over 7 days, and Dermatology Life Quality Index. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool for RC
Chu AWL, Oykhman P, Chu X, Rayner DG, Bhangal S, Dam A · The Journal of allergy and clinical immunology · 2025 · n=11
Chronic urticaria is a common skin condition characterized by itchy wheals (hives), angioedema, or both, lasting for 6 weeks or more. Beyond antihistamines, multiple systemic treatments are available, but there is uncertainty regarding their comparative effects on chronic urticaria outcomes. We systematically synthesized the comparative benefits and harms of systemic treatments for chronic urticaria. As part of updating the AAAAI/ACAAI JTFPP chronic urticaria guidelines, we searched Medline, Embase, Central, Chinese Biomedical Databases (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang from inception to February 4, 2025, for randomized trials addressing systemic immunomodulatory treatments, including phototherapy, for chronic urticaria. Paired reviewers screened records, extracted data, and assessed risk of bias. Random effects Bayesian network meta-analyses addressed urticaria activity (comprising itch and wheal scores), an
Registered ongoing or completed trials (ClinicalTrials.gov).
n=52 · NCT05822999 · COMPLETED · COMPLETED
The purpose of the study was to determine safety and efficacy of WELT-IP in adult insomnia patients. WELT-IP is a cognitive behavioral therapy for insomnia (CBT-I) based digital therapeutics.
n=44 · NCT03712228 · COMPLETED · COMPLETED
This is a multicenter, randomized, placebo-controlled, parallel-arm, phase 2 study to investigate the clinical efficacy, pharmacokinetics, and safety of CSL312 as prophylaxis to prevent attacks in subjects with HAE.
n=12 · NCT03183024 · COMPLETED · COMPLETED
Study to determine the efficacy of benralizumab when compared to placebo in patients with chronic hives that do not respond to antihistamine treatment
Conventional medical care for urticaria typically involves antihistamines as a first-line treatment to relieve itching and reduce hives. For chronic or severe cases, other medications such as corticosteroids, leukotriene receptor antagonists, or immunosuppressants may be prescribed. Identifying and avoiding triggers is also a key component of conventional management. In some instances, a specialis
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