Table 1. Treatments for Chronic Urticaria [89, 97, 98].

Step 1	➢ Establish a diagnosis. Reassurance, patient education, avoidance of known triggers	[10, 89, 97, 98]
	➢ Second-generation H1 antihistamines
Step 2	➢ Optimize dosages of second-generation H1 antihistamines ➢ Adding another second-generation H1 antihistamine, or a leukotriene receptor antagonist such as montelukast	[10, 11, 89, 97, 98]
Step 3	➢ Increase the dose of potent first-generation H1 antihistamines such as or doxepin and hydroxyzine and titrating the dose as tolerated ➢ Any medications that did not seem to work should be discontinued	[10, 11, 89, 97]
Step 4	➢ Omalizumab, cyclosporin, corticosteroid, etc.	[10, 28, 89, 97, 98]
	➢ Once CU is controlled, “step-down” in treatment is recommended ➢ Second-generation H1 antihistamines may be withdrawn periodically to identify spontaneous remission of the disease ➢ CU should be treated until spontaneous remission occurs

Current and future potential treatments for chronic urticaria.