Wow, some interesting news I just read that may affect some of us. According to an article I stumbled upon, it appears a company has acquired the rights to produce the generic form of Allegra (fexofenadine). As you all know, Allegra (fexofenadine) is an antihistamine often used in the treatment of cholinergic urticaria.

According to most people that have tried it on the forum, it seems to be the best in most cases, with Zyrtec being a close second. Allegra usually does not give as bad side effects (such as drowsiness) as other antihistamines, and seems to be slightly more effective.

In the past, even trying Allegra would require a prescription and visit to a doctor. This meant it was very expensive for most people to try. Luckily, if it comes over the counter (like Claritin and Zyrtec did), then we can all try it now without the added hassles and expenses of doctors visits.

I, for one, am excited to try this, as I still haven’t tried it yet. I have researched a lot of interesting studies on this, and it seems relatively safe. Of course, I would only take it when I thought I would need it, but I am excited to try it.

When Will Allegra Be Available Over the Counter?

According to the article and others like it, Allegra (fexofenadine) may be available over the counter (OTC) as soon as June 2011. So if things go as planned, we may be able to buy Allegra over the counter at our local stores. Yah. I am excited and I hope they produce it soon.

Hopefully this will be good news for any of you currently taking this medication. Just thought I’d share that info.

Hello Everyone,

I wanted to give a few quick updates, and also briefly discuss an interesting post on the forum as of recent.

My diet is still doing great, despite eating another pizza, and so forth. So I am very happy about that. As far as my Cholinergic Urticaria hives, they have been significantly better. If you recall from the last post, I had been trying to get more sun exposure, and I actually sweat some. This was an incredible feeling that I hadn’t felt in a while.

Since that time, my hives have still been great. I had a small reaction during a period of about 4-5 days when I couldn’t get sun exposure (due to rain & not having time). But when I got sun exposure again, not only did it make my hives better, I started to sweat even more. Afterward, I could do almost anything and I would not have an attack. I even did some push-ups outside which normally would have had me scratching like crazy.

And I know that it isn’t just from the acclimatization to the heat and humidity. When I turn on the AC in my apartment, I can get cold and then go back into the heat (or do physical activities) without a evoking a reaction for a few days. I tend to start getting more sensitive after a few days if I have not received adequate sun exposure.

I am becoming more and more convinced that the sun is the solution on how to keep cholinergic urticaria in check (at least for me). At this point, I am speculating that consistent daily safe sun exposure (except for rainy days) will not only get me sweating again, but will keep the hives gone as long as I keep it up. This may take a few months to achieve, but I think it can be done.

Granted, this isn’t always easy at this point in time. I realize I may have to suffer with the hives a little this winter since I won’t be able to get as much sun exposure as I would like right now. However, I am going to be hopefully getting a house within the next few months, and next year will be open game for daily sunshine.

I have already finally started to develop a very light brown base-line tan, and it feels great (and looks much better too). I am being very cautious, and I am preventing sunburns. I make sure that I don’t even get a little red, and so far I have been doing well with this (with the exception of 1 time I got barely red on the stomach, but it wasn’t what I would call a “burn”.

How Could UVB Rays Help Cholinergic Uritcaria?

A very interesting post on UVB was made by a new forum member a couple of days ago, outlining how UVB treatment (also called phototherapy), has helped them completely manage cholinergic urticaria. It has a lot of great information, and I highly recommend you check it out.

UVB is a type of ultraviolet radiation that occurs natually in the sun. It can also be produced with special bulbs that are manufactured to produce radiation in the UVB range. UVB is the radiation that causes your skin to tan (or burn), and you can get this from the sun most during the hours of 10-2.

This is really exciting to me because it proves a couple of things:

• That UVB does indeed have a direct effect on cholinergic urticaria (at least in this person’s case). This is evidenced by the fact that they experience no hives while getting treatment, but if they stop treatment, the hives can come back.
• They are able to live a normal life again, can sweat, and everything with no hives.
• It tells me that while Vitamin D may be beneficial, it isn’t the only factor involved. I think the actual radiation (from UVB), is also having a major effect, and not just the vitamin/hormone.
• It reinforces what is in my mind about the necessity to get regular “SAFE” levels of sunlight exposure. Or, if you cannot get UVB from the sun, you can get it artificially via the doctor or a safe tanning bed recommended by your dermatologist.

I have made several posts in the past about my theories of sunlight somehow being connected to this. I have speculated it could be something with Vitamin D (and I still suspect there may be some involvement), the photoperiod effect, and more.

But one interesting new piece of the puzzle that I discovered in the post was how UVB actually reduces the  number of inflammatory immune response cells in the skin. It reduces T-cells, and can alter the binding on mast cells and other things. It does this because the natural radiation that we absorb from the sun naturally has this affect on our bodies. We were created to get normal exposure to the sun, not live in a cave slathered up in sun screen all day.

This is something that had never occurred to me before, and now makes this whole cholinergic urticaria puzzle make a whole lot more sense. In my speculation, there is a cumulative collection of these immune inflammatory cells that accumulate during long periods of very little sunlight exposure (months or perhaps years).

This occurs due to the fact that during regular sun exposure periods, the immune system would be normally be regulated and the build-up of excessive cells in our skin would never happen. UVB on a regular basis would suppress this build-up, and break down the excessive immune cells, and also prevent excessive skin cells from clogging pores.

However, since there is an absence of appropriate UVB/sunlight exposure radiation for long periods, it causes the immune system to keep manufacturing these cells (which otherwise would be broken down by the radiation from the sun). They get deposited in our skin in ‘higher than normal” numbers. At this point, we are fine until our bodies heat up. When our bodies go to sweat, our brain sends a signal down to activate our sweat pores.

The brain sends these signals via chemical receptor responses (such as the neurotransmitter acetylcholine). When this chemical is released to activate our pores to sweat, it seems to degranulate the excessive mast cells/immune cells in our skin, and cause a rapid reaction of stinging and itching all over our bodies as the sweat attempts to get released.

I still speculate that there could also be an actual build-up of excessive skin cells as well, which may also inhibit the release of sweat and also contribute to cholinergic urticaria sensation. UVB even affects this, as it not only reduces immune cells, but it also helps to keep the actual skin cells from over-producing (which can lead to skin conditions such as Keratosis Pilaris, Psoriasis, and more).

Again the sunlight or UVB rays seems to potentially help CU in the following ways:

• It produces natural Vitamin D, which helps regulate over 2,000 genes. It also is vital to immune response.
• It produces UVB radiation which is shown to inhibit excessive skin cell production (which can lead to conditions like Keratosis Pilaris, Psoriasis, and more). It may also affect sweat pores and clog them.
• The UVB also inhibits excessive immune response cells from collecting in the skin (t-cells for example have been shown to reduce in numbers after UVB exposure in the skin).
• It gives you a nice tan!

That being said, obviously you need to watch out for sunburns, skin cancer, heat exhaustion, premature aging, etc. Those are all very serious risks that go along with getting any kind of regular sun exposure.

If you cannot get sun exposure where you live, then you do have other options. The post on the forum discusses the use of phototherapy at a dermatologists’ office. This is similar to a tanning bed, but with a much safer and controlled dose of the appropriate UVB rays.

So this is definitely interesting, and I think we should all be considering these things, and potentially even discussing them with doctors and dermatologists to hear what they have to say.

I know that I am going to try and get most of my exposure from the sun (which is more natural, and free!). But if I could not get it from the sun, I would absolutely consider a SAFE tanning bed that is specially made for UVB rays (by the recommendation of a local dermatologist or doctor), or I would get UVB treatment directly from a doctor. You can also buy equipment to give yourself UVB phototherapy, but I would strongly recommend you discuss this with a dermatologist.

Wow, if this turns out to be a safe way to manage cholinergic urticaria for life, that is going to be so awesome! I am already so optimistic and excited about one day being able to completely control the hives, and never having to let them interfere with my life again.

I am still going to be experimenting with sun exposure, and I hope to be able to discuss more about this soon. If anyone else tries phototherapy, or gets safe sun exposure, I would love to know if it helps your hives. So please drop me a line on the forum or in the comment section. I may also try and write more information on the theory above, and also discuss some more about UVB soon.