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97615 tn?1212682189

cholinergic urticaria/hives

I have exercise induced urticaria.  I want to know if anyone else has this and if so what causes it and what can you do to control it without a prescription.  I am desperate.  I am a runner that does not want a prescription.  I suffer from asthma and the hives are worse when my asthma is worse.  I am not taking anything for asthma except for an inhaler at the moment.  I am tired of depending on drugs.  I know that may sound ignorant but I want to help myself to help itself if you know what I mean.
65 Responses
Avatar universal
I have the exact same problem, runner also, asthma too.  I don't like taking the meds either but the rash was so bad in the beginning that I slept most of the time on meds so as not to destroy my skin.  They don't even really know what causes this, allergic to your own sweat, food allergies, asthma...  if they don't know how can we?

As I sit here typing this, I have a breakout on my shoulder and my forearm.  After diagnosis, I searched and found some information.  Just type in 'exercise induced rash'  you'll find some stuff.

Right now I try not to eat anything an hour before my workout and I take a 10mg lortadine and hour prior to training.  It seems to help a bit but it isn't going away.  It's been happening since last February, I was preparing to run a 10K and I didn't get to thanks to the rash.  Now I am 16 pounds over my running weight because I locked myself in the house for 5 months covered in a rash every single day.

Keep in touch, I know no one in my area with this problem.
Avatar universal
I have the exact symptoms that flare up at the gym.  I am less of a runner more a weight lifter.  Red patches appear as I am lifting.  I am taking 10mg Zyrtec everyday.  Does seem to make any difference.  I also use anti itch cream / lotion from Eucerine.  Very frustrating!  Before this happened a couple of months ago, I had zero allergies to anything and I am 40 years old.
Avatar universal
I am very sympathetic, I have suffered from Cholinergic Urticaria (exercise allergies) for twelve years since developing them at the age of 15. The rash develop during or sometimes slightly after running or working out at the gym.

The symptoms persisted for four years, vanished for a year, returned more aggressively (I would break out in a rash after any exertion, eating hot food or emotional stress)  and persisted for a year, vanished for a further five years and then returned again just recently.

Initially, most anti-histamines were not effective at treating it but in later years I found Fexofenadine hydrochloride 180 mg (Allegra/Telfast) prevents attacks.  

There is plenty of good literature available online on Cholinergic Allergies (try searching in www.scholar.google.com). Basically, the average time you will suffer is 7 years, although people can suffer on and off for 30 years. I am sorry to tell you this but apparently there is NOTHING you can do to get rid of it. It is ironic, but that was the best advice I was ever given because I stopped searching in desperation for a cure.

I suggest you learn to manage the allergy. I take Fexofenadine hydrochloride 180 every morning. Most research I have read suggests this medicine should not damage your health if taken over a long period (although I give my body rest from it for a few days at a time when I don’t plan to do any exercise.  

Don't feel lonely, it occurs in about 15 % of people at some point, and about 0.5 % of people will have on going problems, so there are plenty of us around.
Avatar universal
Hi, I have this awful itch when I run or walk long distances.  My thighs mostly, but sometimes it will spread to my butt and sides.  It is the weirdest thing.  I have suffered from it for years, but no I want to run and it is limiting me.  I can do other cardio no problem, it is just the running motion that gets me for some reason.  
Avatar universal
I too have had this problem, cholinergic urticaria or mitochondrial urticaria, for over 14 years.  They told me it would only last 10 but guess they were wrong.  I take Reactine (Citrizine sp?) 10 mg during the summer and whenever I think I may break out.  Walking around the mall, someone yelling at me, any exercise can trigger it.  It basically comes with an increase in heart rate.  The Dr. who diagnosed me (4 doctors later) explained it like this... when you temperature goes up, the message gets sent to your mast cells to sweat except your mast cells mess up the message and release histamine instead causing the hives.  
Avatar universal
I am 45 and have had this since I was 18.  I am not a runner but if I just want to walk briskly anytime between 10 and 30 minutes I will start to itch at my ankles and it moves up to my thighs until I can't stand it anymore.  I get little red raised bumps and start to scratch like a crazy woman.  I am able to get on an olyptical but not a treadmill which seems really weird.  I can't even walk on my lunchhour for fear that I will get a breakout.  It's hard to even walk the rest of the way home once it starts to itch.  My doctors all think I am crazy but at least now thanks to the internet I see i am not alone.  I have tried antihistimines but they make me so tired it kind of defeats the purpose of wanting to exercise to get more energy.  it is very frustrating.  
Avatar universal
Cholinergic urticaria is a subcategory of physical urticaria (aka hives) that is a skin rash brought on by a hypersensitive reaction to body heat. Symptoms follow any stimulus to sweat such as exercise (sometimes called exercise-induced urticaria), heat from the sun (which could also indicate solar urticaria), saunas, hot showers (reaction to water can also indicate water urticaria), spicy foods which may cause an increase in body temperature or even stress due to blushing or anger. Some people only have symptoms during the winter months where their body temperature rises when it is unacclimatized to heat.
The rash typically develops within a few minutes of a rise in body temperature but can take longer to appear visibly on the skin. The visible rash is often preceded by a general warming of the skin or itchiness. The hives last from a half an hour to several hours with a mean time of 80 minutes, with the duration often contingent on the severity of the outbreak.
Cholinergic urticaria can be very difficult to treat. Most treatment plans for cholinergic urticaria involve being aware of one's triggers.
Drug treatment is typically in the form of antihistamines,H2-receptor antagonists such as cimetidine.
As the disease may be physiological in origin, psychological treatments such as stress management can sometimes lessen severity and occurrence.
540397 tn?1213891378
Hello My Fellow Itchers,

Lately I have had a lot going on.  We just moved from Colorado to Ohio to be with my husbands family, I am an RN and it took 2 months to even get my nursing license here, I still can't find a job that will hire me right away... So I've got a lot of stressors here.  I started to break out about 2 weeks ago after being attacked by bugs when we went camping.  I thought that the new hives were from mosquitos that were getting me in our house and when I let the dogs out - but I started covering myself up and using "Off" and kept getting them.  Then they started in huge clusters underneath my clothing and started to merge together to form COLOSSIAL sized ones.  I always thought that "nerves" causing things were kind of a cop-out for symptoms, but now I know better.  Trying to control it with Hydrocortisone 1% (ineffective), triaminaclone (effective for 10-30 seconds), daily doses of Zyrtec 10mg + Benadryl 25-50mg (effective but makes me too sleepy - at least I get some good rest and the hives are totally resolved when I wake).  I am just sick of medicine and itching already.  Totally frightened that it will still plague me after I start working.  Can't believe there isn't an easier solution.  No sense in even going to a doc.
Avatar universal
I also have it. I got it when i was nine i've had it for seven years.I'm not sure if i'ts a more severe disease or not, every time i run or exercise my eyes swell, it takes two days for it to go down,i also break out in a rash, which lasts a couple of hours. i have tried zyrtec and claritin,and other meds, but nothing seems to be working.
Avatar universal
Hey everyone. I've had these rashes for about three years and I only recently started taking medications but reading these comments is making me wonder if theres a point because I've been extremelly exausted from the hydroxyz hcl. I really want this to end, it' has interfered with my life in so many different ways. I use to run and work out a lot, as I see most of you have as well, but I completely stopped because I noticed that the more I sweat, the more spots come out.

I've read somewhere that UV light might be a solution? Is that possible? Does anyone have any experience with that?

Also, if you have had this condition and it did go away, tell how, if it slowly disappeared or it just all together just never came back?  It seems like such a leisure to never have this ever again.
535822 tn?1443980380
Can I join the itch club? I first got the Itch after Dental treatment I thought something like the Numbing agent caused it ,it lasted the first time for a year mostly neck area and some on the arms, went away, came back 4 weeks ago again with Dental work, the Dentist says No not anything he did or gave me , put me on antibiotics!! I have noticed a definate pattern to it, I dont exercise like you guys, OK I am lazy nowadays! but even if I get warm like tying now it flares up, I also think mine is Solar induced as I live in a pretty warm area of CA and it is worse now.Yup I have tried all you have every cream ,pill, potion on the Planet, the drug companys should award me for buying all their products,nothing has helped in fact their drugs sometimes make it worse.I guess I will have to put up with it for another 7 years.if I   place a cold wet cloth on the site for relief,that helps.
Avatar universal
I have had this for approximately 8 years.  Very debilitating as when I get warm, just sitting outside, running errands, going in and out of a/c.  It gets so bad that my throat, eyes, lips, tongue & ears even swell.  The throat swelling started about 4 years ago and my epi pen definately helps halt the progression.

I take Zyrtec every day for the itch and a couple of benedryls before my workout but still manage to scare everyone in the gym.

MY SAVING GRACE - Last year, for totally unrelated reasons, I was prescribed 10 mg progesteron.  From some of the things I've seen on the internet, it can re-set the mast cells.  I was red-free, itch-free, rash-free for about 6 months.  My doctor and I are repeating the treatment as we speak to see if it works again.  I'll let you know.  I felt truly liberated for those 6 months!
robin/kansas city
Avatar universal
I have been active all my life, including playing college football.  My rash started about a year after graduation and is induced by just about anything: heat, anxiety, definately exercise, and I sometimes even just wake up with them on my arms.  I have taken claritin, clarinex, zyrtec, and benadryl, none really do much.  I have to take crowded public transit to work every day, and it gets real bad.  The strangest thing happened to make them go away (although they are now back).  I got married on 8/8/08 and they dissapeared for half of my honeymoon for no reason.  i was obviously very active during that time (oh yeah) and not a single itch or bump.  the rash and itch came back the day before we came back from the honeymoon.  too weird.
Avatar universal
Yesterday I was diagnosed with Cholinergic urticaria. I was so relieved to have a name I could research as I have been badly itching for 3 months. It started with small white rash like bumps on my forearms and morphed into what i was convinced were spider bites and eventually thought must be cancer.
It went from my ankles (the worst) to my legs (burning sensation on shins) and to my arms, back, stomach, and chest. I was exhausted by trying to figure out what triggered it (clothing? detergent? soaps?) and was reduced to tears when taking hot showers. Falling asleep was difficult at times because I itched so badly.
My mom, with a similar condition, was diagnosed with neurodermitis, which I now think was a mis-diagnosis. I have been reading a lot this morning and there might be a genetic connection with CU. This would make sense as my sister has a mild allergy to the sun.
I found this website particularly helpful-
Avatar universal
Thank god i'm not alone.

I'm 18 years old and about 6 months ago I developed Cholinergic Uticaria. At first I subconsciously ignored it as a temporary thing and slowly started avoided exercise and cardio type work. Until it got so bad that I couldn't work my job I began to seek the help of doctors. With the slightest activity I would develop a fiery intensely itching rash (or red bumps) over my entire body. It would start at my legs and I knew it was coming then would spread to my neck, chest, arms and eventually everywhere. I'd find myself dancing around the house like a mad man itching and whining rolling around on the carpet trying to itch. I'd even be laughing in pain sometimes at the ridiculousness of it. I found that slashing myself with water (manual sweating I call it) would really help. As long as I kept a water bottle with me and clothes i could get wet i'd be ok. This is hard to do at work though. My dermatologist couldn't diagnose it and 4 doctors later (at the Allergist clinic) She told me what it was. She prescribed more antihistamines of which I have yet to start taking tomorrow. I really hope it will fix this and after reading all of your posts I can believe I might have to deal with this for up to 30 - 40 years possibly. I imagine myself getting really fat because I cant do work. This really is the "lazy" condition. You have to keep telling people why your not working or helping them work with things because of this skin problem your trying to prevent and some people just think your lazy.

Goodluck :(
Avatar universal
What a horrible condition we all have!  I've been dealing with this for 15 years!  However it's gotten worse over the past 5.  I've seen lots of doctors and finally an allergist told me what it was!  I itch like crazy if I get slightly warm when I am having an outbreak.  Mine comes and goes.  I will have it for 2 weeks then feel great for 2.  Then bam it's back!  I tried benadryl and claritin and those didn't work.  Last summer I was on Allegra and it was wonderful for 6 months then stopped working.  I just recently started doubling the allergra dose, but it is not working.  I am sooo sick of not being able to excercise.  I will get in great shape and then I can't work out for weeks and have to start all over again!  My doctor told me that certain people react to antihistmines differently than others, so maybe try all.  I am about to start cetirizine (Zyrtec).  I can only hope it will give me another 6 months.  Here's a new twist....I drink decaffinated coffee and when I do it's worse.  Anyone notice this?  I know that there are chemicals in it so maybe???  I have just cut it out, can only hope it would be that easy!  Good luck to everyone!
Avatar universal
I''ve had the same type of heat/stress/sweat induced itching for 9 years and have been on every medication imaginable.  I also went through 6+ weeks of UV Light treatments and no effect at all.  So save your time if you or anyone else is thing of doing it. Even the Cleveland Clinic Dermatology doctors could only find that I am allergic to nickel and somewhat to cobalt. But were unable to give me any definitive diagnosis.  Just histamines.  I even moved to the mountains of Colorado from Cleveland to be in the drier and cooler temps.  Helps as long as I am calm and my body temperature stays normal.  Good luck.
Avatar universal
I too have been diagnosed with Cholinergic Urticaria.  I am glad that I am not the only one out there with the embarrassment of an uncontrollable itching spell while trying to work, getting nervous, or walking into a warm environment. However, I am very sympathetic to all of you because this is something that none of us could ever predict. My spells last 5 minutes before I break out into a cold sweat and then I am all set for the rest of the day.  However, it's the worst 5 minutes that I can ever imagine and sometimes not even predictable unless I am going for a run.  This winter has been the roughest for me out of the 3 years that I have suffered from this, to the point I have had to run to many public restrooms to hide myself from what was going on.  I do not believe in taking drugs for this because I love to run and remain active and am just frankly afraid of being dependent on a drug no matter how safe someone says it is.  I am going to subscribe to stay on this watch list with the hope that there is a cure out there or a diagnosis of an allergy that we all have in common that can be eliminated...like too many carbs or sugars...who knows!  Good luck!!
Avatar universal
I have had this problem, mine induced solely by running or brisk walking, for over 5 years and just today decided to do some internet searching on the issue. I've found some great information and was happy to find this forum. I feel for those of you who have this occur all the time, not just related to exercise - I can't even imagine that.

For anyone like me, who was boggled by the specific-ness of the itchy skin related to running versus other activities, it's good to know we're not going crazy in thinking we're suddenly "allergic to running". For me, this started after running religiously - cross country and track all through high school & college, 10Ks, 5Ks on weekends, and then after my 5th marathon at age 28 I took a few months off from running. When I started up again for runs the hives & itchiness started – every time I ran. (Mine starts on my thighs and moves up my stomach & back.) I'd heard about how capillaries can constrict after inactivity and that the burning sensation would go away once I started running regularly again. I tried to run through it, thinking my capillaries just needed to "get with the program", but that never happened.
I never saw a doctor, thinking I would sound crazy. The oddest thing is that I can go mountain biking, do workout videos, hot yoga, skiing, hiking...you name it...ANYTHING but running, and I'll be fine. (Similar to an earlier post where the elliptical machine would be OK but not running.) I've assumed it has something to do with the impact and vibration of running. I think I'll just try a short jog every now and then and see if I still have this condition or if it has run its course and left me as mysteriously as it showed up. I plan to also do some experiments with antihistimines (I've even read about Pepcid working), running in hot vs cold weather, and running on an empty stomach - to help determine triggers.
Anyhow, I wanted to share my story for those with similar running-related itching, and also share the best links I found. For anyone with exercise-related hives, it seems important for you to distinguish between Cholinergic Urticaria and Exercise-Induced Anaphylaxis (EIA). The latter is less common but can be very dangerous, and may require carrying an Epi-Pen. For those of you who get light-headed or restricted breathing along with your rash you should check this out.

Great running article on EIA & CU: http://runningtimes.com/Article.aspx?ArticleID=7006
Also see running issues 5 & 6 on this site: http://running.about.com/od/illnessesandrunning/ss/embarrassing_6.htm
Avatar universal
I've always hated taking medication but had to start a prescription to manage my cholinergic urticaria. I take 5mg of xyzal (pill form) a night when I know I'm going to exercise or be active the next day. It prevents me from getting that itchy feeling all over (especially on my scalp) and the hives I used to get. I still get patches of redness all over my arms, legs and mid section but I don't care as long as I don't get itchy hives. It's really changed my life for the better as now I can actually go outdoors and be active. The redness can be unsightly but I was more debilitated by the itchy, irritated feeling which deterred me from being active. I hate this condition but I've learned to manage it.
Avatar universal
I have gotten hives only a couple of times.  My main problem is when I get warm from showers, running, walking, etc. I have tingling and numbness in my feet, hands and face.  It all started this spring and now that the weather is warmer it's worse.  Does anyone else have the tingling?
Avatar universal
I am having this symptoms from past 8 years, in monsoon when my body gets warmed by anything(exercise, running, anger, sex) my trunk covered by these water filled bumps & etching starts.  
Avatar universal
I get this too but mine is from my own body temp. Its not always when I work out but it used to be. Now I am constantly on antihistamines (Zyrtec D by day, xyzal by night). But I am soo tired of the meds. I am irritable sometimes and tired and fuzzy. I am trying to find an alternative. Besides the regular red bumpy hives I have been getting weird splotches in random spots on my hands and arms. Its bizarre and itchy. It makes no sense. They are in no real pattern. Its beyond baffling. I can't help but wonder if there isn't something else to this. I too am athletic but I am not a runner. I just work out alot. There is so little research out there on this, according to my phd./md allergy doc.
Avatar universal
For me, severe itching probably started during the winter of 07( I was then 18yrs old). It used to get very itchy esp. on my back whenever I used to enter a heater building or a room. After 3 frustrating months of feeling helpless( I was on no meds at that time), I knew this problem did not seem transient. Infact, being an avid sportslover, I was fearing that I would never be able to play anything again. Thanks to the internet, i came to realize that this problem was known by the name of Cholinergic Urticarea. It was again confirmed when I met with a dermatologist during March 2008. He told me that this problem could last upto 7 years. He prescribed me Xyzal tablets. Since then I have been on Xyzal every single night and I have got to say the condition has improved dramatically. During my recent summer hols this year, I experimented by stopping the meds.It used to pain like hell when I used to workout. But after working out for 2 or more days, I felt more comfortable. Every single day I tried sweating myself out. Suprisingly, I went all throught the summer( 3 months) having just taken a single tablet of Xyzal. Now I am back on my meds since school has started and I do not have enough time for workouts. I do believe working out everyday and crossing the pain barrier is very helpful is relieving ourselves of this problem. I know how utterly hopeless people can feel when confronted with an unknown painful problem but please never lose hope. That is what I have learnt all through this.
Hope everyone is cured of this as soon as possible.
Sid/ Kansas City
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