Integrative management of urticaria in children - an ayurvedic and modern medicine review

Abstract

Urticaria represents a significant global health burden affecting approximately 65 million individuals worldwide, with increasing prevalence trends observed over the past three decades. This comprehensive review examines the integrative management of urticaria through the dual lens of modern evidence- based medicine and traditional Ayurvedic approaches. Modern pharmacological strategies, anchored by second-generation H1-antihistamines and progressing to biologic agents such as omalizumab and dupilumab, demonstrate substantial efficacy in symptom control. However, treatment-resistant cases and the chronic relapsing nature of the condition necessitate exploration of complementary therapeutic avenues. Ayurvedic medicine conceptualizes urticaria as Sheetapitta, a disorder of tridoshic imbalance amenable to Shodhana (purificatory) and Shamana (palliative) interventions. Key Ayurvedic herbs including Tinospora cordifolia (Guduchi), Curcuma longa (turmeric), and Azadirachta indica (neem) exhibit scientifically validated mast cell-stabilizing, immunomodulatory, and anti-inflammatory properties. This review synthesizes current evidence supporting an integrative paradigm that combines conventional pharmacotherapy with Ayurvedic interventions, addressing both the pathophysiological mechanisms and the holistic patient experience. The analysis reveals significant potential for synergistic therapeutic outcomes while identifying critical evidence gaps requiring rigorous clinical investigation.