r/CholinergicUrticaria

Hello, I’ve been doing a 40-minute workout (sweat therapy) for 26 days now. On the first day the rash was excessive and unbearable, but in the last few days, thank God, there has been very little of it visually.

As I understood it, the idea is that histamine gets “depleted” and there’s basically none left for about the next 24 hours.

However, sometimes during the day I go out in the sun and walk, and a small rash appears visually — how is that possible? Am I on the right track?

Hey everyone,

I’ve been dealing with what seems like cholinergic urticaria for the last couple years and wanted to see if anyone has had a similar experience or found anything that actually helps.

For some background, I grew up on the East Coast, went to college in Texas, then moved back to the East Coast for my master’s. I’ve always had seasonal allergies, but never hives or anything like that growing up.

Toward the end of grad school, I noticed that if I pushed myself insanely hard during soccer, I’d sometimes get these tiny red dots on my legs. They weren’t itchy and would disappear pretty quickly. It only happened a handful of times, and weirdly it never happened during lifting, climbing, or other workouts.

Then I moved to Washington State and within weeks things got way worse. I started getting really itchy hives on my forearms whenever I worked out or lifted. Over the last two years it’s progressively spread, and now I can break out basically head to toe anytime my body heats up. Exercise is the biggest trigger, especially hiking or tennis, but even stress/anxiety or sometimes just taking my dog on a short walk can set it off.

At its worst my whole body gets red, itchy, and puffy.

I’ve tried a few elimination diets with no success. I’ve had a bunch of blood tests done over the last two years and everything always comes back normal. Allergy testing showed I’m allergic to pretty much every tree and grass in the PNW but nothing specifically tied to this.

Xyzal has helped the most out of everything I’ve tried. Taking it daily used to reduce the itching a lot, although the hives would still appear. Lately though, even that seems less effective and the itchiness is coming through more and more.

The weird thing is it doesn’t seem connected to weather or seasons at all. Hot or cold, summer or winter, doesn’t matter. If my body temperature rises, I react. I’m also confused by the people that say to sweat or to exercise more. The more I exercise the worse I break out :(

At this point I’m mostly just frustrated and curious if anybody has found a fix. Ideally would be natural, non-medicine fix, but I know that’s easier than done.

Hello, today I finally managed to sweat a little, and the pain during exercise disappeared completely. I wanted to share my method for reaching that point, because many people cannot tolerate the pain. My advice is not to jump مباشرة into the sauna or start with an intense workout right away. Instead, begin with a moderate warm-up until you get through the first flare-up. After that, the pain usually decreases and you can tolerate more. You can also take an antihistamine before starting. In addition, based on my experience, I recommend avoiding hydrogenated fats and excessive sugar, and trying to get a little sunlight exposure

Honestly, I couldn’t decide whether to post this or not but as someone who has gone through CU, I felt like it would be selfish if I didn’t. This post will be long because I have researched the hell out of this and I intend to do my due diligence in explaining everything. Now a little heads up, when I was researching, there were specific scientific and medical name of some thing I read, I will not be able to name them verbatim but be rest assured that I fully understand this due to the fact that I retained all the knowledge and also you are free to do your own research.

DISCLAIMER: I am not a medical practitioner or anything or that nature. I am merely sharing my experience on how I have been able to cure myself. Reach out to for any medical support to clarify anything I have written here and do your own due diligence.

BACKGROUND:
A little background before I explain what you need to do: I am a person who was born in the UK and lived/was bred in Nigeria most of my life (from maybe 2 years old to 17 years old) and then I came back to the UK when I was 17/18 years old. Now, all my life I have NEVER had CU, I was extremely active and I would sweat daily (this was necessary and completely natural especially if you live in Nigeria — sweating was like breathing. Now fast forward, I came to the UK and things CHANGED. At first, things were good but things were completely different. I didn’t sweat daily mostly due to the fact that it was cold and honestly, the life abroad is just too easy, it’s baffling. For the first time in my entire life at 18, I was fat. And this is someone who convinced himself that I could “never” get fat (lol, I didn’t even know what “calories” meant when I was in Nigeria, talk less of tracking them). A few months passed and I just had CU. I couldn’t tell you exactly when it came but it just came. My life was HELL. Imagine being new in a country where you are trying to make friends in school and you have CU — I was the most awkward and most miserable person I’d ever been. I was fat and I couldn’t lose it because it required I sweat which I couldn’t/ didn’t want to do because of CU and I couldn’t explain what was going on with me because I didn’t even know what it was. To not make this post too long, I have gone through multiple cycles of remission and CU cycles (first time I hit remission — what I did was eat clean, use dandelion herbal tea and I sprinted at midnight through the itch cause I didn’t want anyone to see me itching like a maniac). I thought it would be the end of it and it was so for months but it came back and stayed for months and then I kept doing the same thing. At remission, I did door to door sales and I was in remission for well over a year. Then I quit and then the CU came back again. Basically right now, I have have 4 CU cycles and I’m in my 4th remission phase (18 years old to 21 years old) and I have finally cracked it, at least for my CU type.

CU TYPE:
My CU type is that of “sweat allergy”. Basically I’m allergic to my sweat (most people hear this and they completely misunderstand what this means — I will explain it below). I also have this condition where sweating was difficult even after doing work that would suggest I should be sweating (Hypohidrosis). Another thing I noticed, strong emotions and feelings would cause “the itch”. Spicy foods would cause the itch which I hated so much because I eat and enjoy spicy foods a lot.And here is the thing and I should expect most of you to relate: the most time you spend in your CU cycle, your nervous system starts to adapt around it — you can anticipate WHEN the itch is about to come, you have “mastered” how to stay calm, you may have even created a life to box yourself in because of your CU. One peculiar thing I noticed though, if I am with friends I felt safe with, my rate at which I could have a CU episode could be longer than if I was alone (this is because of your anticipatory and threat response continuously tracking for when the episode will arising which creates the strong emotion that causes the CU, it’s an awful conundrum but with friends, your threat response is down). In terms of hives, mine was at the wrist, forearms and back of my palms mostly, I rarely get them all over my body except it is a massive episode and they were tiny. If your CU fits this profile then you are golden.

DUMBED DOWN EXPLANATION (READ):
Basically, what is happening is this: YOUR PORES ARE BLOCKED. That is it. This is actually what is going on with people with sweat allergy and I know it sounds so “meh” but like I said I have done my research. When I was in Nigeria, the heat and humidity was strong enough that it was impossible for my pores to be blocked, but when I came to the UK, it changed. The cold meant I couldn’t sweat which meant keratin and dead skin cells would stick into my pores as sweating is reduced. Think of your pores like pipes, your sweat is the power wash that is supposed to clear out the keratin and dead skin cells from the pores (the pores also slightly open up when you need to sweat which helps). Due to the blocked pores, when you are supposed to sweat, instead of the sweat leaking out of your skin freely, they can’t get out due to the blockage so they leak back into your body. Your mast cells see this “sweat protein” leaking back into your body and they consider them as a threat so they fire histamine at it which then leads to this itch (CU). This is why you have Hypohidrosis and the CU. This is the dumbed down explanation.

THE CURE:
You need to SWEAT (I know this isn’t what most people want to hear and I know most people will look at this and say “I have already tried that” but hear me out). Basically, you need to sweat DAILY, EVERY SINGLE DAY and it must be multiple times per day (basically it shouldn’t even be that your objective is to sweat, it needs to become the new constant). In Nigeria, the environment was good enough to do the work for me, in the UK, I am the one doing the work.

HOW TO START:
Firstly you need to gauge how harsh your CU episodes are right now. Are you in the “if I have an episode I am in perpetual hell” phase or are you in the “if I have an episode, I wouldn’t need to scratch aggressively as touching with my palms and staying calm would be enough to end it” phase? You need to know your phase. Good news is, I have been in both so I will tell you how to go from wherever you are to remission AND MOST IMPORTANTLY, HOW TO STAY IN REMISSION.

PERPETUAL HELL PHASE:
If you’re in the perpetual hell phase, you need to start sweating. The bad and “good-ish” news is that, for this particular CU type, the only way to unclog those pores is to sweat. There is no Plan B (or atleast I don’t know of any). But your goal isn’t to go straight to remission, it is to reach the “TOUCHING WITH PALMS AND STAYING CALM WOULD BE ENOUGH” phase. This took me about 1.5-2 months to get there.

WHAT TO DO:
WALK.
Get a treadmill (I promise this will be one of the best investment you can make). You don’t want to walk in public because if you walk and start sweating you will itch and you will be embarrassed which will cause more itch and it will just be a disaster. Get a treadmill from Amazon (small, cheap, affordable. Nothing too crazy) and then your routine is this and IT IS STRICT: 15mins on the treadmill at a pace of 2.8, twice per day. YOU MUST STICK TO THIS.
Additional rules, when the itch comes and it will/may, DO NOT GET OFF THE TREADMILL. You can scratch but delay scratching for just a minute before you scratch (this is to inform your nervous system that “behavioural continuity is the norm, instead of choosing the threat response of scratching and stopping”). If you have had this condition for a while, your nervous system has multiple instances where the itch came and you decided to stop an activity, which has lead to your nervous system being very good at triggering that anticipatory and threat response over time.

SO RULES:

1. 15 mins, twice daily, 2.8 pace. This is non-negotiable. First one ideally should be at around noon. The second should be around 6pm evening. Place them apart. Don’t do them closely together.

2. If itch comes, don’t scratch immediately, stay there for just 30seconds to 1 minute first. If you can’t, try using your palms to touch the area before scratching. But if you must scratch, scratch but don’t get off the treadmill. And please don’t do this in a hot room, open a window. I did mine during Spring so the weather was cool and I had the window open.

If for any reason you get off the treadmill, don’t feel down. Leave and then just continue the routine. Personally, in this phase, I cried on the treadmill (YES, IT WAS HELL) but I promise if you get over this phase, it will be downhill from here. Also, the number of times I got off the treadmill before the 15mins was up was 4 times in the span of the 1.5-2months (so that’s 4 times out of almost 90 to 120 sessions which is negligible so try as much as you can to not get off). When you do this for 1.5months - 2months, you should be in the next phase already. YOU WILL FEEL IT, YOU WILL KNOW IT. And honestly, it’s easier from here.

“THE TOUCHING WITH PALMS AND STAYING CALM IS ENOUGH” phase:
Whether you got to this phase after going through the “PERPETUAL HELL” phase or you were already in this phase from the start, it is a good idea to TEST whether you are actually in this phase or not.

THE TEST: (Do any ONE of the following to qualify)
1.Pull ups: if you can do a maximum of 10 pull ups, do 6 pull ups and the get off the bar. The itch may come from the first rep, but the test is this: can you keep going till the 6th rep in the first set? And when you get off the bar, and the itch is ongoing, can you touch the area with your palm while staying calm to recover? (Please stand at a window so it is cool — I DID MINE DURING THE SPRING so the weather was cool. Don’t do this in a hot room). If you can recover under 3 mins, you are golden.

2. WALK OUTSIDE IN A PARK WHERE THERE AREN’T PEOPLE AROUND or NOT ENOUGH PEOPLE THAT COULD CAUSE YOU TO BE WEARY IF YOU GET THE ITCH OUTSIDE
   Walk outside for 25minutes MAX. When the itch comes while you are outside, can you stop walking, stay calm and recover? If you can do this under 3-5minutes and continue walking home, you are golden. Ideally, you want to time the distance, walking to a checkpoint and back to your home should take the “25minutes” timeline so you should ideally get the itch when you are just close to home.

If you pass the test, you are in this phase. And I was in this phase for 2 -3 weeks before I hit remission.

WHAT TO DO:

1. Flash Boil: First thing in the morning, non-negotiable. You wake up, wear a hoodie and a winter jacket on top. You need to trap heat and pressure. Layer as much as possible and then while inside your house, do burpees and/or run around the dining table till you sweat. This will be hard at first (not due to the itch, but because sweating will take so much time especially the first time you do this), but you don’t stop till you feel a sweat trickle down your forehead, chest, arms and back. Do whatever you must: jog, burpees, sprint on a spot and keep doing that till you sweat. I also use to drink hot water/ tea before I start to increase my temperature “internally”. Do this for 14 days. At day 14, this should be cake. If this isn’t cake at day 14, do it for one more week and vague again. The point of this, is to drain your mast calls of histamine. Think of your mast cells like security guards with guns with a lot of ammunition and magazines, their ammo is the histamine. Eventually they run out of ammunition (this is why some people will CU say if they sweat once per day, they may not itch for the rest of the day). Although this wasn’t the case for me, it would only last for about 6 hours. After doing this first thing in the morning, then the next immediate thing you must do is STEP 2.

2. Hot water wash:
   Immediately after sweating from the flash boil in step 1. Get into a hot shower. Ideally, you want to “pre heat” the shower. So before your flash boil in step 1, turn on the hot shower so the shower already has the “humidity” in there before stepping in. If you are not using a shower, you can use a bath, fill it up and immerse yourself inside. Here is the key. This shower MUST BE HOT. Hot enough that you aren’t burning yourself obviously but hot enough that it is almost at your limit. You must stay here for 12-15minutes. If you did your flash boil, this should be cake plus right after this, you will know your mast cells have run out of ammo because you will literally feel like Superman/Superwoman after you step out — because you will be filled with endorphins and you will have this “glow”. I don’t know how to explain it but you will feel “semi-high”. You will feel like Superman is the best explanation I could come up with (lol). I also like to immediately do 6 reps of pull ups to confirm that the mast cells are completely drained. It is possible that at day 1, you may still feel a slight itch (a prickle) but at day 3-4, you shouldn’t feel anything if you are doing this right (at least from my own experience). Now move to step 3.

3. This is where you need dedication and discipline. You need to start walking. Walk outside daily. In my experience, my back was the part that was stubborn to unclog but I walked through the back itch. I was doing 7K - 10K steps daily and I live around hills so you know I sweat. Make sure you are moving and make sure your environment indoors is hot and warm to keep those pores breathing. You could also get the treadmill too to help with sweating if you don’t want to sweat indoors. But outdoor is KING.

4. STEP 4 should be done immediately when you have gotten to the point where the Flash Boil and the Hot shower bath are basically a cake walk. For me, this was day 4 of starting this. Be honest with yourself. When you are here, start exercising. I favour pull ups because they are one of the most demanding exercise for me, so I do them for reps, the itch will come (mostly my lower back) I touch with palms, walk to window, breathe and start calm. I recover and then I do another set. I also added multiple exercises as I got more comfortable.

Do this entire 4 steps daily for 14-21 days. Honestly, I was already in remission at like day 10 but don’t let that fool you. Keep doing it.

STAYING IN REMISSION
This is the most important step. If you have had this condition for a while, you are familiar with the “CU cycle to remission” cycles phases, so the idea of staying in remission is taken with a pinch of salt. But it is possible (at least to me). Staying active and sweating daily is basically the answer. Most people will never understand us, they think we are sedentary and lazy from face value but they never know what we are going through. This is torture and this condition made me realise never to fat shame anyone EVER. Because most people may be fat or sedentary but you never know why they are. CU made me sedentary and fat, not laziness. But the more we stay in the CU cycle, we may start to become lazy, we start to lose ourselves. Things become so hard. The answer to all your problems if you have this condition is to make sure your pores never get clogged again and the only way to do that is sweating hard, every day. My current daily routine does it for me easily. This also explains why I was in remission during my door to door sales days for over a year until I quit.

HOW I STAY IN REMISSION:

1. I exercise immediately I wake up 6x/day (this is my version of the Flash Boil). I do Kettlebells and Calisthenics so you know I sweat a lot in this bracket. Basically, my entire body is “crying” and dripping after I am done. I exercise for 50mins. Sundays is mobility and skill work.

2. I still do my hot shower bath. Even though I don’t get the “glow and Superman” feeling anymore as I am deep into remission, I still do them but I end them with the coldest temperature for about 2-5mins.

3. I walk every single day. I walk MINIMUM 10K. On a good day, I am walking 20K steps. Walking hasn’t been any hassle for me as I used to walk 30K steps daily during door to door sales but now I work from home so I walk ALOT. Don’t choose the path of least resistance. Take the stairs. WALK, WALK, WALK.

4. I play sports. I play multiple sports that demand I sweat (basketball during the weekends, boxing and I am even thinking of getting back into track athletics as I did this back in Nigeria and there’s a track nearby.

5. Most importantly, sleep. You need to fix your sleep architecture. Make sure you are getting 7-8 hours of sleep daily. In fact, add this to every single phase you are in because this is one of those things I did. Most people compromise on this a lot but it is necessary.

This has been a long read and they are probably some typographical errors somewhere (lol). Anyway, I am open to answer any questions in the comments if I can be of any help.

Thank you.

Ok so basically I got diagnosed with CU a month back and the dermatologist gave me an ayurvedic syrup, X-zine tablets and a calamine lotion. I've been using it for a month and TRUST ME it's 90% gone already. Now, it might be because I caught onto the symptoms early and took medications asap (cus this was the first time ever I got CU). But I just wanted to share that it can be cured don't lost hope and maybe what I told might help.

Also, u have to do some physical activity everyday even if it's just going for a walk or sports. It's recommended to sweat a bit everyday.

Stay in there everybody I pray to God everyone reading this shall overcome this problem and prosper.

Peace.

A question about delayed onset hives (only before bed or shortly after waking) a year after starting use of hair loss drugs topically applied to the scalp.

Is topical dutasteride / finasteride known to potentially start causing hives a year after starting treatment?

Strange thing is not only is the hives not on my head where I'm applying dutasteride topically, but it didn't start until nearly a year after starting use. (Is this because topical dutasteride takes longer to build up systemically in the bloodstream than oral? Still a long time.)

But, I had never experienced hives in my life before and I'm in my mid 40s, so I'm apt to think dutasteride is a cause. It goes away quickly and generally has a trigger that's considered common like heat from a heated blanket, pressure from a bunched up sleeve or intense stress. This ONLY happens shortly before bed or after waking; it never happens mid-day.

I'm aware dutasteride and finasteride can cause hives, but not sure what I described sounds definitely drug induced due to the triggers and the fleeting symptoms.

It seems possible that after I tried Rosemary on my scalp, a natural remedy presumably more gentle, it came back again after going away from stopping dutasteride use. Anyone have experience or thoughts on this?

Thanks.

Guys please check your zinc levels if you suffer from cu cause I’ve been struggling for months with extremely bad cu to the point I’d start breaking out just from talking to people, but I randomly decided to start taking zinc without a proper reason (Ik it was stupid but that’s not my point) my cu improved almost immediately and I started sweating again for the first time in months. This is not saying that zinc is a solution but cu is like 30 times worse if your deficient in zinc for some apparent reason, well for me atleast and I just wanted to share my experience as it may help someone else. Also my cu is not gone it’s just not as bad as it used to be . Also dry skin is a factor pls be aware of it

It may be common sense to some people but it wasn’t for me. I take levocetrizine (Xyzal) and I usually wait until I feel symptoms to take them. I have been taking them for probably 4 years straight and it adds up. So in my mind I take as needed to save some coin, right. The problem is I would flare up so bad that I was taking 2 even 3 a day sometimes, and the flare up could last a few days to a couple weeks so that’s a lot of pills. Well, a while ago I started taking them before bed after waking in the middle of the night a few days in a row with severe itching. I started with 2 because I was heavily inflamed and itchy. Then I did 1 a night. Ever since doing this I have not had any symptoms whatsoever during the day. No hot flashes, flushness, inflammation in my extremities or itchiness. It’s warm in Arizona and that hasn’t bothered me one bit. Sharing in hopes it helps 👍

Let me break it down a bit
I tried 4 types of antihistamins
1-Telfast (fexofenadine) 180
It didnt work at all even on higher doses
2- Histazine-1 (cetirizine)
basically zyrtic and i didnt get any relief at all
3-bilastigic (bilastine)
It finally gave me relief,it really did,but after some time like 2 weeks probably it stopped working completely AND it worsen my hives (???????) it now burns me and it on my legs too which i never had
i always had them on my upper body only
4-Evastine (Ebastine)
well i had high hopes but it didnt work and i noticed that my skin became too sensitive like i dont need my triggers anymore to flare up,even walking for a bit makes me flare up now or having a cold air
I eventually decided to stop all antihistamins at once becuase before actually taking it my urticaria was mangable,little annoying but manegable
now its stopping whatever i do in my life because its literally everywhere and now it BURNS,it became annoying AND painful
hopefully it goes away on its own