Cholinergic Urticaria (Chronic Heat Hives)-Cholinergic Urticaria.net I Get Itchy Heat Hives (Cholinergic Urticaria) When I Get Hot or Exercise

I think I may have found another thing some cholinergic urticaria sufferers have in common. I noticed today that I have a skin condition known as Keratosis Pilaris .

What is Keratosis Pilaris or “Chicken Skin?”

Keratosis Pilaris is a genetically inherited skin condition in which “bumps” can appear on certain parts of the skin. It looks very much like a patch of goosebumps, and sometimes even acne. People often refer to it as “Chicken Skin” due to its appearance.

It happens when the body produces too much Keratin (a protein found in the skin). The excess keratin can get entrapped in hair folicules/pores, and clog it up. It forms a plug in the pore, and becomes hard over time. The end result is a series of red dots, or sometimes flesh colored “goosebumps.”

This may be more severe in the winter or times of low humidity, which causes the skin to become dry. It will eventually resolve on its own.

Many KP bumps contain an ingrown hair that has coiled. This is a result of the keratinized skin’s “capping off” the hair follicle, preventing the hair from exiting. The hair, then, grows inside the follicle, often encapsulated. The hair can be removed, much like an ingrown hair, though removal can lead to scarring.

Keratosis pilaris may be hereditary. It is present in babies and continues into adulthood, but is uncommon in elderly people. It is most obvious during the teenage years. KP is prevalent in those who have atopic dermatitis, ichthyosis, or descend from Celtic backgrounds. Keratosis pilaris occurs in otherwise healthy people.

I have this on the back of my arms, and never really paid attention to it. Here is a picture of the back of my upper arms (where the tricep muscle is located):

Picture of Keratosis Pilaris on Back of Upper Arm:

This is a zoomed in picture of the back of my arm, and as you can see, I have these very faint little red “plugs” of skin protein that have taken over the pore of my skin.

How Did I Find Out About Keratosis Pilaris?

Believe it or not, I found it by searching for cholinergic urticaria. I stumbled on a guy’s blog , and the guy said this,

I am not a doctor, but here are some telltale signs if you have cholinergic urticaria (thanks to the dubdubdub):

–Do you get hives (itchy rashes surrounded by red patches of skin… i.e. pantal) after sudden strenous activities? After hot showers? (My former housmate noticed that I was getting all rashy every time I take a bath. For a while I thought I was allergic to soap.)
–Do you have signs of keratosis pilaris or chicken skin (non-itchy ones), usually on the back of your biceps and/or your buttocks? (Yes, I now have an excuse for having year round goosebumps in those areas!).
–What about constant rhinitis? (Nose that runs even without colds and flu.)

Then you might be a candidate! Consult your family doctors right away. Di naman kayo siguro mamatay jan. (I’m not sure about that so please do not take my word for it).

The post was very interesting. Why? Because I too am yet another CU guy, and I have all of the things he mentioned:

• I have Keratosis Pilaris (not officially diagnosed, just compared to the web images)
• I also have Rhinitis (inflamed nasal passages) all the time. In fact a few people have mentioned on the forum about how they always have a “Stuffy” nose. I have read this on other blogs as well.

So it definitely seems like there is a pattern that is starting to emerge here. Perhaps this keratosis pilaris thing is even more connected to CU than first look. Here is why:

Is It Possible Keratosis Pilaris Causes Cholinergic Urticaria? Or is it Just Associated With It?

First, I want you to think about these interesting things that almost every site I visited while researching this earlier said about this condition, and relate that to what we know about cholinergic urticaria (heat hives):

1. It tends to get worse in the winter months (sound familiar)
2. It tends to get worse in dry climates when humidity is down (sound familiar)
3. Excess Keratin is forming, and clogging pores (interesting, huh).
4. Some patients also have atopic dermatitis (eczema/allergies)
5. It tends to develop first in the late teens (hmmm…Just like CU)
6. It tends to come and go over the years, and sometimes goes away completely on its own (hmm…)
7. Sunlight exposure seems to help the condition.

Is it just me, or are all 7 things above also the exact same thing that we all experience with cholinergic urticaria?? Quite interesting I think.

Now with that being said, let me point some things out. Could CU be as simple as our bodies making too much keratin, which clogs our sweat pores. Since our sweat pores are clogged, it is really hard to sweat. So the body freaks out at this burst of chemical to release sweat, but the sweat can’t come out.

It could be all over our skin in a very fine layer, and only gets clumped up and red in areas where it happens a lot (like back of arms).

There is a condition that is very similar to ours that even causes similar symptoms called “Miliaria Rubra .” In this condition, the sweat pores get clogged with bacteria, and get infected. It causes big mosquito looking bumps to form, but that is because there is bacteria involved.

So how about if this is just our skin protein being over-produced. We get not big “mosquito” looking bites, since it isn’t a bacterial infection. But we get the really itchy/prickly type of heat since our sweat pores are indeed clogged with too much material (our own skin cells).

Could that be actually causing the Cholinergic Urticaria in us? It is interesting to think about.

Can Keratosis Pilaris Be Cured or Treated?

There is no cure for Keratosis pilaris, but treatment is available. One option is to use a loofa/stiff exfoliating sponge to remove the dead, dry skin. I actually picked one up today at the store. I plan on scrubbing my skin very good now while in the shower, and trying to clear it up. It is also good to use lotions.

Another option is to use a dermotologist-prescribed cream or lotion that should be applied daily. I found this posted on multiple sites. The best lotions for this condition would have urea, 15% alphahydroxy acids, or Retin A in them. Over-the-counter lotions work as well and should be applied after showering, as well as several times a day.

The lotions are often soothing and can help improve the appearance of the skin. Dermotologists also recommend mild peeling agents, or alpha hydroxy acids, that may open up the plugged follicles. Antibiotics may also help in some cases where the bumps are red and badly inflamed. To temporarily reduce redness but not roughness, pulse dye laser treatment or intense pulsed light (IPL) can be done.

Although it may clear up with treatment, reccurance of KP is very likely. Therefore, treatment should be continued regularly. It may take several months to years for the condition to completely clear up.

Do You Have Keratosis Pilaris?

Time for a self exam! Do you have a similar patch like my picture above? This is where it most frequently occurs:

• Back of Upper Arms
• Lower Buttocks (toward the crease)
• On the cheeks
• On the back (may look like acne or something)
• On the thighs
• And other areas (it does not occur in areas of no oil glands (palms, etc.)

I have opened a thread in the forum (Click here ). Please feel free to let us know if you have this or not, and also your thoughts on it.

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Well the temperature has just dropped where I live to in the 40’s for the high. Believe it or not, we actually had a few snow flurries this morning! It was pretty unexpected, and is signaling that winter is almost here!

But one thing this cold weather has shown me is that cholinergic urticaria definitely gets worse in the winter-at least for me. I have also read in several other articles online that people with Cholinergic Urticaria tend to get worse during the winter. I have been much more reactive now, to the point that I truly fear having to go out in public at all. I hate the intense sensation that a cholinergic urticaria outbreak can cause.

I can only speculate that what is making it worse is the extreme dryness and coldness of my apartment. During the winter, I do not generally turn the heat on. My wife and I try to tough it out by wearing extra layers during the day and blankets during the night to keep ourselves warm. Plus, since it is an actual apartment, it never gets too cold since there are neighbors above and to the sides of our unit and that helps keep in insulated. However, it can still get as low as 55 on the thermostat during the dead of winter. So it definitely gets chilly.

One thing I have noticed that is a big “NO NO” is taking hot showers during this cold weather. It seems as if the hot showers really rob my skin of moisture or something, and make the breakouts even more severe. I experienced this just the other day. Right after I got out of the shower and dried off, I noticed that I was really way more reactive.

I used to love just standing in the hot water of a shower before I got cholinergic urticaria. I would get the water as hot as I could stand it, and just sit there and relax. But now I have to watch out for that. I don’t really break out in the shower, though.

When I first got CU, I did break out in the shower if the water was too hot. But now that doesn’t happen too often. I try to keep the water luke-warm, and I try to be quick so that I do not stay in it long. As I have mentioned before, I have extremely HARD water where I live, and the water even dries out my wife’s skin.

That brings me to a few tips I thought I would share with you to help manage your skin during these up and coming winter months:

Tips for Keeping Your Skin Moisturized During Winter Months:

• Try to take “warm” showers instead of “HOT” showers. This prevents your skin from getting so dry during the winter months. Plus, it cuts down on hives reactions in the shower for those of you that still experience this.
• Try to spend less time in the shower- in other words- try for a 5-10 minute shower instead of a 15 minute shower. Get in, get clean, and get out.
• Use Moisturizing Soap- Try to find a soap with a lot of moisturizers in it. Soap brands such as Dove, etc. often have brands with extra moisturized soap that leaves your skin less dry and more moisturized.
• Don’t Scrub Your Skin Too Hard- Wash gently and don’t scrub too hard on your skin. Scrubbing too hard can irritate your skin and make it more dry or uncomfortable.
• Take showers less often. You may want to consider taking showers less often during the cold months. This is something I have already started doing these past few days. Instead of taking a shower every day, try every other day. Or even every two days. You can always “spot” wash any dirty areas if necessary in between showers. Taking showers or baths less often helps the natural oils of your skin come out.
• Get a good moisturizing lotion, emollients, or oils. There are several things you can use to help keep your skin more moist. You can use standard moisturizing lotion. I have also heard of some people using a thin layer of Vaseline during the winter months to prevent dry skin (although I really haven’t used it as I feel it makes me feel too greasy). Oils are also good at preventing your skin from drying out excessively. I have mentioned before in other posts that I sometimes use a very thin layer of extra virgin olive oil during these winter months. It doesn’t really prevent a hives breakout (I wish!), but it does keep my skin more oily which does help prevent dryness. Most experts say it is best to apply any lotions or oils within the first few minutes of getting out of the shower so your skin can quickly absorb it. So I usually get out, dry off with a towel, apply the thin layer of lotion or oil, and then get dressed.
• Consider a vaporizer or humidifier- These can help add moisture to your living space. This helps a lot by keeping a more humid atmosphere, and preventing everything from getting too dry. Just make sure it doesn’t get too moist, or you might find walls developing a mold problem.
• Crank Up the Heater if Necessary-It may help to use both a heater and humidifier (or vaporizer) to make it even more humid. Of course, I am a cheapskate and I try to avoid turning up the heat as much as possible right now. But as I mentioned in another post, one person said they fully manage their CU by simply keeping it hot and muggy while they sleep. I have yet to try this, but I bet it does at least help keep the skin more moist.
• Try to Limit Extreme Cold Exposure- The cold winter months can be hard on your skin. If you find yourself outside, try to avoid long periods of cold exposure to your skin. This can make your skin more dry, chapped, and uncomfortable. Instead, try to limit direct cold air from hitting your skin as much as possible by wearing protective clothing and using lots of moisturizers.

Keeping your skin moisturized won’t necessarily prevent outbreaks of hives. However, I have found that it at least makes your skin feel better, and it may help 5-15% or so in protecting against an attack. When my skin is excessively dry, my attacks seem worse.

I hope these tips will help you keep your skin smooth and silky during the cold winter months!

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Posted under winter hives tips