Cholinergic urticaria, a form of hives, is characterized by red, raised wheals on the skin’s surface. The welts typically appear rapidly, usually within a few minutes after the onset of sweating or stress. They can disappear as early as 60 minutes but can last up to 24 hours.

Exercise is the most common precipitating event for cholinergic urticaria, but any stimulus that causes sweating, including hot temperature, spicy food, hot water, and emotional stress can bring on an attack.

Symptoms

Itching, burning, tingling, warmth, or irritation may precede the onset of many small (1-4mm in diameter), itchy red bumps that can coalesce into

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bright red wheals (hives). (See the example below)

Cholinergic urticaria may appear anywhere on the body, except on the palms or the soles and rarely in the axillae.

Patients who are more severely affected with cholinergic urticaria may experience systemic symptoms including the following:

  • Fainting
  • Abdominal cramping
  • Diarrhea
  • Salivation
  • Headaches

Duration

Usually symptoms last 60 to 80 minutes but can last as long as 24 hours. Many patients have a tendency to develop the intermittent rash for several years (average of 7 years) before the condition resolves itself.

Treatment

An antihistamine such as Benadryl can rapidly resolve the symptoms. For frequent, repeated urticarial symptoms, see a general dermatologist (recommendation link below) or an allergist. For some chronic, repeated attacks, Dr. Chilukuri successfully treats you with a neruomodulator (Botox, Dysport, Xeomin) in the axilla (underarms).

Stress avoidance also helps (ask your spouse to go on vacation with you).

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For further information, call our recommended Houston dermatologists: http://www.villagedermatologyhouston.com/