I grew up living in Hong Kong, spending every summer there for 19 years – until this summer which I spent in the UK and where my symptoms of Cholinergic Urticaria started developing. I am a big sweater so the hot and humid weather in Hong Kong used to make me sweat a lot.
However, since I spent most of my time working as an intern and with the less hot weather in UK, I had not sweat much and I wonder if that had been a trigger to my urticaria – simply my body “forgetting” how to sweat properly.
I read about sweat therapy somewhere on this website, and I wonder would that be a solution to me?
Sweat Therapy Overview
Sweat therapy is a method that some people use to decrease their symptoms of cholinergic urticaria. The concept of sweat therapy is that sweating regularly (via exercise or a sauna) could do two things:
- It can help the body “remember” how to sweat (and maintain that state), which could decrease symptoms.
- Forcing an attack via planned exercise or heat exposure might result in a widespread histamine release, which, although very painful or uncomfortable, could provide a “refractory” period that could decrease hives symptoms for a day or so until the histamine stores rebuild.
For those who practice sweat therapy successfully, it is usually a daily process. Their hives are usually minimized so long as they force an attack, but they may have to endure pain each day before they experience the temporary relief.
Sweat therapy is certainly NOT safe, practical, or effective for everyone with cholinergic urticaria, but some people on this forum experience a greater quality of life by using it. Some people may have associated anaphylaxis, which makes sweat therapy dangerous or even life-threatening. Others may have medical problems (even other hives or allergic disorders) that prevent exposure to hot saunas or strenuous exercise. For individuals with extreme cases of cholinergic urticaria, sweat therapy provides such little relief that it isn’t even worth the pain or struggle.
Is sweat therapy safe for you?
That’s something you need to discuss with your doctor. Here are a few of the disadvantages and risks:
- Sweat therapy (also called “sweating it out”) isn’t beneficial for everyone with cholinergic urticaria. Some individuals still suffer from attacks throughout the day, regardless of how much they exercise or sweat.
- Some individuals may be intolerant to excessive heat caused by saunas, or they may be at risk for heat stroke after prolonged use (especially for individuals with associated anhidrosis–the inability to sweat).
- Sweat therapy can be very painful to endure, especially the first few times.
- Sweat therapy might not be ideal for individuals with more than one physical urticaria type (ie, cold and cholinergic urticaria).
- Sweat therapy could potentially lead to life-threatening symptoms such as anaphylactic shock, shortness of breath, and other serious complications, especially in individuals with severe cases of cholinergic urticaria or concurrent allergic conditions.
- Other medical conditions such as “exercise-induced anaphylaxis” can mimic cholinergic urticaria, leading to a misdiagnosis, especially among self-diagnosed individuals. Individuals with exercise-induced anaphylaxis could be at an even great risk of life-threatening symptoms during exercise, and they should avoid sweat therapy unless their doctor suggests otherwise.
Having said that, here are some advantages:
- For individuals with mild cases of cholinergic urticaria, sweat therapy might provide a reduction in symptoms or temporary relief, which does lead to a higher quality of life. In some cases, individuals have reported that they can keep their symptoms to a minimum by using sweat therapy daily.
- If exercise is used as the sweat therapy method (as opposed to a sauna), there are obvious benefits of increased health and self-esteem, as well as reduced risks of other obesity-related diseases.
If your doctor agrees that sweat therapy is safe for you to try, please use extreme caution. At the very minimum, I’d recommend having an Epi-Pen on standby, as well as a person to assist you in case of an emergency.