Do you also suffer from heat and sweat? Let's talk about Cholinergic Urticaria!

Imagine you've just finished a good workout , or eaten some rice with a nice spicy chili sauce, or spent some time in the sun. Suddenly, small red blisters appear all over your body, especially on your chest and back, and you start itching unbearably. Have you ever had this experience? Although this may seem like a normal thing to many people, it is a specific medical condition. This is what we're talking about today.

What is Cholinergic Urticaria?

Simply put, this is a response that occurs when our body temperature increases for some reason. To be precise, it is an allergy-like condition associated with sweating. This is also known as "heat bumps."

Although the exact cause of this condition is still not 100% clear, it is believed to be caused by a hypersensitivity reaction of the nerve fibers in the sweat glands to sweat and heat. In other words, it is as if your body is allergic to sweat itself.

If you already have eczema , asthma , or other allergies, you are more likely to develop Cholinergic Urticaria .

What are the main reasons for the emergence of these problems?

These problems can occur anytime your body temperature increases and you sweat. For example:

• Exercise: Exercising to get a good sweat is a major reason.
• Bathing in hot water: Bathing in very hot water.
• Hot weather: When you are outside on extremely hot days.
• Spicy or hot food: When you eat a very spicy dish.
• Stress : This condition can occur when you are nervous, scared, angry, or under pressure from something like an exam.
• Tight clothing or bandages: Wearing tight clothing or a bandage that prevents air from reaching the skin.

What are the symptoms? How do we recognize this?

There are several specific symptoms of this condition. Also, some people may experience other symptoms as well. Let's see this clearly in a table.

Could this situation be dangerous?

Most of the time, Cholinergic Urticaria is an annoying but not dangerous condition. However, very rarely , it can develop into a severe allergic reaction that can be life-threatening. Therefore, it is very important for everyone to be aware of these serious symptoms.

If one or more of the following symptoms occur with a bite, it is an emergency. Go to a hospital's Emergency Department (ETU) immediately.

• Generalized Urticaria: If the entire body is covered in hives, not just one spot on the body.
• Swelling of the face and lips (Angioedema): Swelling of the deeper layers of the skin. Especially if the lips, around the eyes, tongue, or throat swell. If the tongue or throat swells, it can block the airway and be life-threatening.
• Difficulty breathing (Bronchospasm): Sudden difficulty breathing, a wheezing sound coming from the chest, or a severe cough.
• Hypotension: If you experience extreme dizziness, blue eyes, and fainting.

Exercise-induced Anaphylaxis

Although this is very rare, exercise can cause a severe allergic reaction called anaphylaxis in some people. This is also a condition that requires emergency medical treatment.

How does a doctor diagnose this?

If you have these symptoms, it's best to see a dermatologist. He or she can use several methods to diagnose the condition.

1. Asking about symptoms: They will ask you about the nature of your symptoms, when they occur, and how long they have been present, to rule out other causes (e.g., food allergies).

2. Physical examination: Your doctor may ask you to do some exercise (e.g., run on a treadmill) until you break a sweat to see if any signs of damage appear.

3. Special tests: Very rarely, a drug called methacholine may be injected to check for signs of toxicity.

Treatment and ways to avoid it

The best treatment for this is to avoid the causes as much as possible. But when you live in a hot country like ours, that's always hard to do.

Medical treatment:

Typically, the doctor will prescribe a type of allergy medication called antihistamines , such as Cetirizine (Zyrtec), Loratadine (Claritin), and Fexofenadine (Allegra) .

If these do not control the condition, your doctor may prescribe steroids or other specific medications for a short period of time. Never use these medications without medical advice.

Tips to avoid:

• If you feel pain while exercising, stop exercising for a while or slow down.
• As soon as you feel your body heat up, cool it down. Take a cool shower, wipe yourself with a damp cloth, or stay near a fan.
• Wear loose, sweat-absorbing clothing like cotton.
• Keep your room, especially your bedroom, cool.
• If this condition is exacerbated by stress, practice calming techniques (e.g. yoga, meditation).

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