Exercise can be an integral component of healthy living; however, for some it can cause life threatening anaphylactic reactions a condition known as exercise induced Urticaria or EIU.
Exercise Induced Urticaria is characterized by symptoms including flushing, pruritus and hives when exercising physically. Sometimes symptoms may progress to include gastrointestinal symptoms and even hypotension.
What is ( Exercise Induced Urticaria ) EIU?
Imagine being passionately enthusiastic about working out, whether running with friends or doing it solo, only to experience sudden itchy hives all over your body this is what exercise induced urticaria (EIU) sufferers experience. Exercise Induced Urticaria may be difficult to live with; however, with proper management and precautions taken when exercising can still be an enjoyable part of life for those diagnosed.
Hives can be caused by allergies to substances like dust, pollen, air pollutants or certain foods; however, allergens may also trigger an immune reaction during or shortly after physical activity this condition is known as exercise induced urticaria and usually takes the form of large raised bumps or blotches on any part of the skin, with itching, swelling or burning sensation.
EIU remains poorly understood, though several theories have been proposed as potential explanations. One theory suggests that exercise induced increases in body temperature result in mast cell releases of histamine a chemical responsible for creating characteristic itches and hives associated with urticaria. Another theory suggests that increased blood flow during exercise could put pressure on small blood vessels, triggering localized swelling resembling angioedema. Furthermore, there may be links between Exercise Induced Urticaria and Cholinergic Urticaria (CU), an emotional stress response and sweating condition which results in multiple papules surrounding by redness on the trunk and neck (4).
Before and during exercise, it’s crucial that you stay well hydrated to avoid dehydration something which can aggravate symptoms in some individuals with Exercise Induced Urticaria. Furthermore, keeping a diary can be useful for tracking patterns or triggers. Furthermore, being aware of foods which make symptoms worse may also help. Acupuncture has also been known to decrease symptoms for some, along with specific herbs like quercetin and bromelain supplements.
Exercise Induced Urticaria – Causes
Imagine being excited for an exhilarating workout or run, only to suddenly be met by a sudden outbreak of hives or rashes all over your body – this condition is known as exercise induced urticaria (EIU).
EIU occurs when physical activity causes allergy like reactions on the skin, such as itching and red spots that resemble blisters to appear, usually manifested as itchy, red or pink patches of blister-like blisters that look similar to itching rashes on any part of the body, either raised bumps or more typically flat itchy spots rashes which typically appear following increased body temperature or an allergic response to sweat; most commonly due to either elevated body temperatures and/or sweat allergies; most commonly this form of physical urticaria which also includes various other forms such as cold, pressure or certain foods and medications among others.
EIU remains unknown with no single cause identified; however, many theories exist as to its causes.
One popular theory holds that an increase in body temperature causes mast cells to release histamines that cause hives; these chemicals then travel through blood and skin circulation to form a rash, leading to itchy and painful skin as well as headaches, salivation, palpitations or shortness of breath symptoms in extreme cases it may even result in reduced blood pressure which could potentially prove life threatening.
As well as sweat, exercise can cause an allergic reaction in some individuals; this condition is called Cholinergic Urticaria and similar to EIU. Triggering factors include heat-generating activities like jogging or aerobic workouts as well as hot baths/showers/eating spicy foods/emotional stress;
Many factors can help prevent EIU, including avoiding triggers and drinking plenty of water before and after exercising. Maintaining an exercise diary as well as practicing stress management techniques may also prove helpful in keeping symptoms at bay, such as early morning or late evening workouts. It can also be helpful to try working out at cooler times of the day such as early morning or late evening workouts. In some instances, using medications like antihistamines, epinephrine (an EpiPen) and leukotriene modifiers combined with avoidance can help control symptoms effectively; alternatively immunotherapy (an approach that targets specific allergies) may provide relief from EIU symptoms.
Exercise Induced Urticaria – Symptoms
Physical activity can sometimes trigger an allergic response known as exercise-induced hives or urticaria that is both uncomfortable and potentially serious in its severity. If this is something you’re experiencing after exercise, seek medical assistance immediately!
Itchy welts or hives may manifest themselves in small bumps or large red blotches on your skin, often caused by heat or sweat. Their cause varies between individuals; so it is essential that you identify and avoid your own individual triggers as soon as possible.
Hives may cause generalized warmth as well as itching, flushing or sneezing, headaches, drop in blood pressure, nausea or vomiting as well as respiratory symptoms like wheezing or stridor accompanied by gastrointestinal distress. Rarely an anaphylactic reaction may occur with sudden loss of consciousness and sudden drop in blood pressure requiring emergency care services to manage.
Though the cause of hives after exercise remains poorly understood, researchers have hypothesized that thermal sensitivity, cholinergic urticaria and mast cell degranulation play an integral part.
This results in histamine release as well as other vasoactive substances which may contribute to allergy like symptoms.
Food can trigger adverse reactions during exercise when done shortly after eating; infections or illnesses that increase susceptibility to developing rashes during physical activity; or other underlying conditions. To decrease your chances of an allergic reaction during physical activity, start slowly by walking daily before gradually progressing up to more intensive aerobic exercises such as swimming or cycling.
Those at risk for exercise-induced hives should keep an adrenaline pen in their pocket to be prepared in the event that an allergic reaction arises during outdoor activities or public places. It would also be prudent to discuss this condition with their physician and ensure you’re prepared in case an allergy appears during workouts.
Exercise Induced Urticaria – Treatment
Research on exercise-induced urticaria is still relatively new and its causes remain elusive; however, some steps that may help include avoiding certain foods before exercising, staying properly hydrated, and staying current with vaccinations. Furthermore, keeping a journal detailing symptoms and exercise patterns may prove helpful in finding patterns; other individuals have reported relief through acupuncture treatments as well as herbal remedies like quercetin and bromelain.
Doctors published in March 2022 a case study about an Asian man aged 22 who developed an widespread rash after going running. Previous studies had suggested exercise-induced urticaria is most likely to arise after eating certain food; yet this patient developed pruritus with raised erythematous wheals on both arms within minutes of beginning his workout, lasting two hours.
Some medical experts attribute the rash caused by physical activity to blood pressure spikes, heat build-up and sweating; while other researchers believe that other factors might also play a part; perhaps an immune response or reaction to medication consumed prior to exercise or by an underlying disease or allergy could also play a part.
Antihistamines are often the go-to treatment for this condition; second-generation antihistamines like cetirizine or fexofenadine may be especially helpful. Patients experiencing severe allergic reactions may require an injection of epinephrine to manage symptoms such as angioedema and breathing difficulty. Though this condition can be distressful, with proper management plans most people can still live full lives. As with any disorder, monitoring diet and exercising regularly are effective measures against EIU; if you already suffer from it however, speaking to your physician before initiating any new routine or taking medications will ensure the most suitable management plan for you. If physical activity levels are inadequately high then start slowly while gradually increasing intensity; include walking as part of daily life routine then gradually add low impact aerobic activities like swimming or cycling into daily regimen.
