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I think my child may have Aquagenic Urticaria.  Female 12 years old.  She started getting hives after taking a shower or bath in any temperature with or without soap, or changing soap about 6 months ago and it is steadily getting worse. (More hives and they went from non itchy to very itchy.)  

My question is, in true Aquagenic Urticaria can the temperature of the water change the amount of hives.  For example, hot water makes them much worse, cool water there are less but still there.  Also, is there a doctor who anyone knows that actually specializes in this exact disease?  (Onset of these was after a severe swelling episode - her first real swelling episode - related to below information. No source found, but it was so bad she has permanent stretch marks.)

Note about my child: Ongoing undiagnoses autoimmune issues (hx of pnuemonias, joint pains, etc.. lupus ruled out but she does get tons of rashes on her face and these are unrelated to the aquagenic issue.. this has been her entire life, swelling episodes,) Other new issue in recent months is her veins show through her skin like mottling and that too is getting worse.  She has a recent onset of headaches within the last 8 months or so.  Otherwise healthy.  

So again, my question.. sorry, two questions:

In REAL Aquagenic Urticaria:

Can temperature changes of the water used change the amount of hives?
Can different types of water (tap, sea, sterile) change the amount of hives?

I know there is not alot know about this but someone has to know something.  The internet has been useless in finding answers so far.  

Thank you to all who reply.
10 Responses
Avatar universal
These data suggest that patients with aquagenic urticaria react to a water-soluble antigen in the epidermal horny layer that diffuses into the dermis to cause histamine release from sensitized dermal mast cells.
Journal of the American Academy of Dermatology
Volume 15, Issue 4, Part 1, October 1986, Pages 623–627

Thus it looks to me that your child indeed has a aquagenic urticaria from the fact that she responds to water of any temperature with whealing and not just itching.(aquagenic pruritus).
Avatar universal
I forgot to include that these hives are only on her torso (back and front) and her shoulders and neck and sometimes under her chin.
Avatar universal
The present concept is that any type of water at any temperature carries an unknown allergen present in the skin across the skin barrier, causing the wheals.This can coexist with other forms of physical urticaria,though rarely.
In fact injecting water into dermis does not produce the rash! That means while water permeates the skin barrier, the allergen gets mixed.ok?
Avatar universal
Thank you for responding.  Are you a physician?  Also, do you know if the water temperature can change the amount of wheals?  If hot, there are more wheals, if cold then there are less wheals.  

Also, can the amount of wheals change based on different types of water?  (Tap, sea, etc...)  THANK YOU!
Avatar universal
As I mentioned to you earlier the very diagnosis of aquagenic urticaria, by definition hinges on the finding of urticaria produced byANY water at ANY temperature.The whealing is not dependent on other factors.
If temperature varies and that is the factor it it would be more of a cholinergic urticaria.
While I am indeed a physician, here my capacity is that of a community member!
Best wishes.
Avatar universal
Thank you :D
Avatar universal
Also Cyproheptidine (periactin)  is very effective here but do consult your doc. ok?
Avatar universal
Absolutely calling a Dermatologist in the morning.  I appreciate your help.  
Avatar universal
You were right.  :D   Thank you!
Avatar universal
do you have black mold in your home? i was reading about black mold and your daughters symptoms seem that the same, almost exact same as those of people suffering from exposure from  black mold and the information i was reading about said that there are MANY misdiagnosed diseases that black mold ingestion can actually be the cause of or trigger the onset of diseases...i dont know...i just thought i would share information i recently learned.
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