[37M] With severe itching upon sweating or getting wet

Patient Description

A 37-year-old male reports experiencing severe itching localized to the upper body (back, sides, stomach, chest, and arms) whenever he sweats or gets wet. This issue has been present for as long as he can remember. The itching starts a few minutes after getting wet and typically lasts for about an hour or more. The patient finds relief from cold air. There are no associated rashes, hives, redness, dryness, or swelling in the affected areas. He has not experienced any shortness of breath or wheezing during these episodes. The patient has no family history of allergies, eczema, or other skin conditions, and he does not have any pre-existing conditions or chronic illnesses. He is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Cholinergic Urticaria: This is a type of hives that occurs in response to sweating, heat, or stress. It can cause severe itching without a visible rash. The itching usually starts a few minutes after sweating begins and can last for an hour or more.

    • Treatment: This condition is typically managed with antihistamines to reduce itching and prevent hives. Avoiding known triggers, such as hot showers or intense exercise, can also help.
  • Aquagenic Pruritus: This condition causes intense itching after contact with water, without any visible skin changes. It can be triggered by sweating, bathing, or swimming.

    • Treatment: Antihistamines and topical treatments may help alleviate symptoms. Moisturizing the skin and using lukewarm water instead of hot water can also be beneficial.
  • Eczema (Atopic Dermatitis): Although you mentioned no visible rash, eczema can sometimes present as severe itching without an obvious rash, especially in its early stages.

    • Treatment: Moisturizers, topical corticosteroids, and avoiding known irritants can help manage symptoms.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms in the meantime:

  1. Avoid Triggers: Try to avoid activities that cause you to sweat excessively or get wet. If you need to exercise, consider doing so in a cool environment.
  2. Use Cold Air: Since cold air helps relieve your itching, consider using a fan or air conditioning to cool down quickly after sweating.
  3. Moisturize: Apply a good quality moisturizer to your skin to help maintain its barrier function.
  4. Lukewarm Water: Use lukewarm water instead of hot water when bathing or showering to minimize itching.
  5. Over-the-Counter Antihistamines: You may find relief from over-the-counter antihistamines like cetirizine (Zyrtec) or loratadine (Claritin).

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Worsening Symptoms: If your itching becomes unbearable or starts to interfere significantly with your daily life.
  • New Symptoms: Development of a rash, hives, or any other new symptoms.
  • Signs of Infection: Redness, swelling, or warmth in the affected areas, which could indicate an infection.

Remember, while this information can help guide you, it is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What is cholinergic urticaria and how is it treated?

Cholinergic urticaria is a type of hives that occurs in response to sweating, heat, or stress, causing severe itching without a visible rash. It is typically managed with antihistamines to reduce itching and prevent hives, and by avoiding known triggers such as hot showers or intense exercise.


What is aquagenic pruritus and what can be done to alleviate its symptoms?

Aquagenic pruritus is a condition that causes intense itching after contact with water, without any visible skin changes. It can be triggered by sweating, bathing, or swimming. Antihistamines and topical treatments may help alleviate symptoms, and using lukewarm water instead of hot water can be beneficial.


Can eczema cause itching without a visible rash?

Yes, eczema, or atopic dermatitis, can sometimes present as severe itching without an obvious rash, especially in its early stages. Moisturizers, topical corticosteroids, and avoiding known irritants can help manage symptoms.


What are some general tips for managing severe itching triggered by sweating or water exposure?

To manage severe itching triggered by sweating or water exposure, avoid activities that cause excessive sweating, use cold air to cool down quickly, apply a good quality moisturizer, use lukewarm water for bathing, and consider over-the-counter antihistamines like cetirizine or loratadine.


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