What is the treatment for physical urticaria by heat, physical effort and tension?

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You told me about your problem with physical urticaria. Tests advised are CBC (complete blood count), ESR (erythrocyte sedimentation rate), ANA (antinuclear antibody), cryoglobulin, HBsAg (hepatitis B virus antigen), and anti-HCV Ab (hepatitis C antibody).

The first thing you should keep in mind is that there is no cure for cholinergic urticaria, and the treatment options are often limited. It is a chronic condition and will need long-term treatment. You can have two or more different types of urticaria at the same time. Physical urticarias by heat and sun exposure are mainly due to cholinergic urticarias. They are responsive to the most common antihistamines like Levocetirizine, Desloratadine, and Cetirizine. The first line of treatment and most important is to avoid the triggers and physical agents like chemicals, latex, cosmetics, plants, ointments, and stress. Also try to avoid exercise, heat, high temperature (fever), emotion, or eating spicy food. You need to modify your diet and try to avoid hot drinks, hot foods, and spiced foods. This gives a lot of relief in symptoms. Even the tablet Danazol 200 mg twice daily is helpful in many cases.

A dose of an antihistamine just before you exercise may help to prevent or limit a flare-up of the rash. The use of cooling sprays, ice packs, or other materials may help to quickly resolve oncoming reactions. Tablet Cyclosporin may be worth trying for antihistamine-resistant DU (demographic urticaria), especially in those patient cases characterized by severe itching. Unlike most other types of urticaria, physical urticaria is not usually helped by steroids. So better you avoid steroids in any form. It is not possible to predict how long the problem will last. In some cases, the condition may last for many years. In most cases, by avoiding the trigger and by taking antihistamines, the condition can be controlled. So a lot of patience is required before you get full relief. Meditation, prayer, or using mental relaxation techniques may help individuals to cope with attacks or the stress of living with the condition.