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Wednesday, Mar. 23, 2005 | ||
Antihistamine may help exercise-induced hivesBy Allen Douma, M.D. Q. Whenever I exercise for 20 minutes or more, I get itchy all over my body. Round bumps start swelling up all over my body. As I cool down, the bumps start going away, but then I get weak, dizzy and sometimes feel like vomiting. The bumps get worse when I scratch it. J.G., Soledad, Calif. A. It sounds like you have a medical condition called urticaria. This is commonly referred to as hives. Urticaria is characterized by itchy, red swellings (called wheals or hives) of various sizes on the skin. Its usually a short-term allergic or immune reaction to external chemicals. It also may be part of an abnormal immune response of the body against itself. Ill write about the many varied causes of urticaria before responding specifically to your case. These external chemicals can be found in foods, drugs, preservatives, food additives, insect venoms and other chemically treated products. The cause of acute or short-term urticaria is often easy to pinpoint e.g., an allergy to strawberries or peanuts. This form of urticaria usually goes away by itself once the cause is removed, and symptoms are usually easy to treat. Chronic or long-term urticaria (episodes lasting more than six weeks) is quite another matter. In half the people who have an episode of urticaria lasting that long, the condition will recur for years. Although identifying the cause is key to treatment, thats often hard to do. Health care professionals are often frustrated attempting to identify the cause of, or aggravating factors for, chronic urticaria. A dermatologist or allergist can do what is called a RAST test to look for common chemicals that frequently cause allergic reactions in others. A simple allergic reaction is not usually the cause of chronic urticaria unless the person continues, without knowing it, to use a food additive, drug or other chemical that may be responsible. All too often, the reaction is caused by taking a prescription drug. Drugs are often overlooked as the cause, however, because theyre expected to be taken for your own good, and only a small percentage of people are allergic to them. Psychological factors may aggravate urticaria even if they are not the cause. Avoiding stressful situations can help reduce the frequency and severity of attacks. When and where the episodes of hives occur is important. So I often recommend that people start a hives journal. Immediately following the beginning of an episode, or the worsening of one, try to remember anything you started doing differently a few hours, days or even weeks prior the hives showing up. Its important to pay close attention to any new prescription or over-the-counter medication. Basically, you have already done this in associating your problem with exercising. I also suspect that your weak, dizzy and nauseated feelings are caused by the same release of internal chemicals causing you skin reaction. A similar problem to yours is called exercise-induced asthma, in which exercise causes the release of chemicals in the body that cause the breathing tubes to get smaller. Obviously the simple solution to your hives is to stop exercising or to at least do so with less intensity to see if you get the same results. You can also try pre-medicating yourself (about 30 minutes before exercising) with an allergy medication that contains an antihistamine. Nonprescription medications should work as well as prescription ones. Also, its very important, but sometimes not easy, to refrain from scratching the lesions that occur in urticaria. Doing so may turn them into infected pustules that can be much worse than the hives themselves. The worsening you describe with scratching is called dermatographia. It is a skin condition in which you develop red, swollen ridges in the skin when its stroked with a blunt instrument such as a fingernail. Although dermatographia is associated with other types of allergic responses, such as in your case, it can exist alone. | ||
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