Urticaria, also known as hives, is a skin condition characterized by itchy, raised welts on the skin. Long-term urticaria treatment focuses on symptom management, identifying and avoiding triggers, and addressing underlying causes. Here are some specific long-term treatments for urticaria:

1. Antihistamines: Antihistamines are the mainstay of treatment for urticaria. They help block the effects of histamine, a chemical released during an allergic reaction that causes itching and inflammation. Non-sedating antihistamines like cetirizine, loratadine, and fexofenadine are commonly used.

2. H2 blockers: In some cases, combining an H1 antihistamine with an H2 blocker like ranitidine or cimetidine can provide additional relief, especially for individuals who experience both urticaria and acid reflux.

3. Leukotriene receptor antagonists: These medications, such as montelukast, help block the effects of leukotrienes, which are inflammatory molecules involved in urticaria and other allergic reactions.

4. Corticosteroids: Oral corticosteroids like prednisone may be prescribed for short periods in severe cases of urticaria. However, long-term use of systemic corticosteroids is generally avoided due to the risk of side effects.

5. Omalizumab: Omalizumab is a monoclonal antibody that can be used for chronic spontaneous urticaria that doesn't respond to antihistamines. It works by reducing the levels of IgE antibodies, which play a role in allergic reactions.

6. Avoiding triggers: Identifying and avoiding triggers that worsen urticaria is essential for long-term management. Common triggers include certain foods, medications, insect bites, stress, temperature changes, and allergens.

7. Stress management techniques: Stress can exacerbate urticaria symptoms, so stress reduction techniques such as relaxation exercises, meditation, and therapy may be beneficial.

8. Allergy testing: If there is a suspicion of an underlying allergy triggering the urticaria, allergy testing can help identify the specific allergens. Avoiding exposure to these allergens can reduce the frequency and severity of urticaria episodes.

9. Immunosuppressants: In severe cases of chronic urticaria that are unresponsive to other treatments, immunosuppressive medications such as cyclosporine or methotrexate may be considered. These drugs suppress the immune system and help control the symptoms.

It is important to note that treatment methods may differ depending on the type and severity of urticaria. A dermatologist or allergist should be consulted for an accurate diagnosis and personalized treatment plan.