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18 years
Why does my body gets itchy after a bath? I changed my shampoo and the water temperature but in vain.
Sep 27, 2014

Dr. Zakia Dimassi Pediatrics
Cholinergic urticaria is a common physical urticaria (type of skin rash or reaction) that is caused by sweating. It is sometimes referred to as heat bumps due to the appearance of the rash, which usually looks like very small (1-4mm) weals surrounded by bright red flares.
An elevation in core body temperature resulting in sweating causes the rash in cholinergic urticaria. Common triggers include:
Hot baths/showers
Occlusive dressings
Eating spicy foods
Emotional stress
Patients with cholinergic urticaria often have another associated physical urticaria, such as dermographism, cold urticaria or pressure urticaria.

The rash occurs within a few minutes of sweating, and can take between 30 minutes to more than one hour to resolve. Typical signs and symptoms of the rash include:
Itching, burning, tingling, warm sensation, followed by the appearance of many small weals with surrounding bright red flares.

The rash may involve any part of the body, but is more conspicuous on the upper trunk and arms. It does not affect the palms or soles and rarely the armpits.
Sometimes the tiny weals coalesce together into a large plaque.
Rarely, patients with cholinergic urticaria can experience more severe reactions such as anaphylaxis.
People with allergic type conditions, such as asthma, rhinitis, atopic dermatitis (eczema), have a greater tendency to develop cholinergic urticaria. This condition is more common in men than women and seems to first appear in people aged between 10 and 30 years and persists for a number of years before becoming less severe or completely resolving.

Once the causative agent of the rash is identified, it may be possible to avoid situations that trigger it. In your case, you should obviously avoid hot baths and only use warm water while bathing. However, stopping sweating may not always be possible, mainly in warm climates and during exercising. Sometimes rapid cooling can prevent an attack. For most cases, oral antihistamine such as cetirizine can be helpful in preventing the condition from arising. Beta-blockers such as propranolol have also been reported to be useful.