Bradley E. Chipps, MD, FCCP


August 28, 2003


I have intense generalized itching after each bath. What could be the reason?

Filmon Haile, MD

Response from Bradley E. Chipps, MD, FCCP

The physical form of urticaria described in this question is cholinergic urticaria. This occurs in approximately 15% of people at some time during their lives. Cholinergic urticaria is a physical urticaria. It is most common in teenagers and young adults. It carries a very good prognosis for eventual improvement. About half of the patients who experience this have other allergic illnesses. There are characteristically itchy, small, red papules that occur when heat stimulus is applied to the skin. It is caused by activation of cholinergic sympathetic intervention to the sweat glands and it often subsides in minutes after the patient cools. The occasional patient may also have chest symptoms associated with this condition.