From the Research
The primary treatment for dermatographism includes antihistamines to control symptoms, with second-generation antihistamines such as cetirizine (10 mg daily), loratadine (10 mg daily), or fexofenadine (180 mg daily) being often preferred due to their efficacy and lower sedation rates 1. For patients who do not respond to standard doses of antihistamines, increasing the dosage up to 4 times may be recommended, and in some cases, off-label use of omalizumab can be considered 1. In addition to antihistamines, avoiding triggers such as tight clothing, hot showers, emotional stress, or certain medications is also important, as well as applying cold compresses to reduce itching and inflammation during flare-ups, and moisturizing regularly with fragrance-free lotions to maintain skin barrier function. Narrowband UVB phototherapy has also been shown to be effective in treating symptomatic dermatographism, particularly in patients who are resistant to antihistamines, with studies demonstrating significant improvements in itching and whealing symptoms 2, 3. It is essential to note that the treatment of dermatographism should be individualized, taking into account the severity of symptoms, response to treatment, and patient preferences. Some patients may require long-term management, and regular follow-up with a healthcare provider is necessary to adjust treatment plans as needed and to monitor for any potential side effects of medications. The use of H1 antihistamines, such as fexofenadine (180 mg daily), has been shown to be effective in reducing symptoms of dermatographism, and can be used in combination with other treatments, such as narrowband UVB phototherapy, for optimal results 2.