Aquagenic pruritus or water induced itch is a typical pricking itch which appears after contact with water at any temperature, without any visible changes in the skin.
The itching in aquagenic pruritus or bathing itch can be so intense and prickly that some of the sufferers develop aversion to bathing. Aquagenic pruritus is very chronic and resistant to treatment in most patients. To compound the matter, it does not respond to conventional anti-itch medications, like antihistamines and getting rid of aquagenic pruritus is really a challenge.
The itching usually starts immediately or within minutes of contact with water. In some persons, itching is induced by sudden drop in temperature, as entering a cold room or freezer compartments, in humid weather conditions. Contact with rain water induces more itching than normal tap water in most affected individuals. Itching may continue for hours after bathing.
Because of the chronic nature, treatment resistance and lack of skin rashes, patients with the aquagenic pruritus are most often labeled as psychoneurotic and prescribed antidepressant or anxiolytic medications.
Causes of Aquagenic Pruritus
The exact cause is not known why some people develop allergy to the water. Various chemical mediators have been found in the affected skin, like histamine and acetyl choline. Though mast cells degranulate and secrete histamine as a response to contact with water, it is evident, from the ineffectiveness of antihistamines, that histamine is not the primary mediator in aquagenic pruritus (as opposed to aquagenic urticaria, where the histamine induced wheals appear along with itching on exposure to water).
Diseases Associated with Aquagenic Pruritus
In addition to the unknown (idiopathic) origin of aquagenic pruritus, more seriously, there are some diseases in which the bathing itch may be the presenting symptom.
Polycythemia vera, itching on exposure to water and sudden changes in temperatures may be the premonitory symptom in polycythemia vera.
Metastatic carcinoma of cervix in women
Hypereosinophilic syndrome
Juvenile xanthogranuloma
Myelodysplastic syndrome.
How to Get Rid of Aquagenic Pruritus
The most effective treatment of the aquagenic pruritus involves the desensitization of the skin through phototherapy. The following are a few tips on treating the bathing itch:
Though most antihistamines are ineffective in aquagenic pruritus, a combination of long acting antihistamines like Cetrizine 10 mg and short acting antihistamines like Cyproheptadine 4 mg is useful in reducing the intensity of the itching in the water induced pruritus.
Before bath, apply an oil based emollient lotion to your body, face, and limbs. This will reduce water coming in direct contact with the skin and will reduce the intensity of itching.
If itching occurs, in addition to the antihistamine combination above, apply Capsaicin cream to the skin, immediately after the bath.
Avoid forcible showers, hot water or prolonged stay in the pool. Use the pool and bath water when it is at body temperature. Those who have cold urticaria or itching following cold exposure will feel better with warm water bath and increased itching following contact with cold water.
Use only cotton dresses, cotton sheets and cotton quilts on your bed. Any contact with synthetic dresses, woolen blankets etc will increase the tendency to itch.
Avoid alcohol, coffee, hot, spicy, fried fast foods. Drink lots of fresh fruit juices (except mango) and eat more vegetables.
If the itching is intense and intractable, phototherapy with Psoralen-UVA or filtered UVB will provide excellent results in most patients. These are available in most dermatologists’ offices.
Thus, though very resistant to conventional treatments, patients with aquagenic pruritus can enjoy the occasional plunge with proper precautions and medications. It has also to be borne in mind that all itching after contact with water is not aquagenic pruritus, it could be contact dermatitis to the soap, solvents in the water, brush etc. If wheals are present, it is called aquagenic urticaria.
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
The copyright of the article How to Get Rid of Aquagenic Pruritus in Skin Disease is owned by Hanish Babu. Permission to republish How to Get Rid of Aquagenic Pruritus in print or online must be granted by the author in writing.
I have Aquagenic pruritis. The best thing for me has been heat. I avoid
cool pools and showers. I now take them as hot as I can stand it and no
longer itch afterwards. Showering at night also helps. I get dressed and
under covers as soon as I can. I do agree with that capsaicin and avoid
synthetic clothes help. Eating a clean diet, such as an anti-candida diet
helps my symptoms tremendously.
Jul 20, 2009 11:44 PM
Guest :
I, too, have aquagenic pruritus and have found that ending my shower with
the hottest water possible averts the post-shower itch. Aiming a hair dryer
at itchy places or putting a heating pad on them is likely to bring me
relief, as does electrical stimulation from a TENS unit when the itch is
mostly at my ankles or elbows. Using capsaicin, I believe, is effective
because of the heat generated. However, some of us develop a respiratory
sensitivity to the capsaicin and can no longer use it.
Many of
us with aquagenic pruritus can have the itch triggered by humidity, sweat,
or simply blowing air. Keeping the entire body (except face and hands)
covered with 100% cotton, from long sleeves to cotton socks, makes the itch
less likely in these situations.
I agree with the previous
person's comment that showering at night is much better than showering in
the morning, which makes me wonder whether a temperature difference between
my skin and my deeper body tissues is a factor in triggering the itch. I
have not heard of anyone researching this possibility.
Thank you
for posting this information. Please keep updating this page as more is
learned.
Jul 21, 2009 4:48 AM
Guest :
I have had Aquagenic pruritis since 1989 and cool water is the worst method
of avoiding the itch. Hot pool water (Hot Tub or sauna) and a final very
hot rinse in the shower is much better than cool water. For some people, a
strenuous exercise program or a long run before a shower lessens the itch
and the duration.
Jul 21, 2009 4:57 AM
topper72 :
Showering at night and finishing with a very hot rinse is much better than
using cool water. Swimming in a heated pool or using a hot tub or sauna
also lessens the itch. Some people find that a strenuous exercise program
or a long run before a shower lessens the itch and shortens the duration.
Consider a change in diet if you get too much sugar or starches. There are
many degrees of AP and you need to experiment with different methods,
because what works for one person may not work for you. There are hundreds
of us that have this condition and you are not alone.
Jul 22, 2009 2:51 AM
Guest :
I have Aquagenic Pruritis as well. I have a hard time keeping it under
control. Even now, it's 3 in the morning and I can't sleep because my
husband changed the sheets, and they are unfortunately synthetic. I,
like everyone else who has commented have found that hot water is best when
showering. I have also found that if I swim in cold water, as long as I
stay in long enough to get pruny that it doesn't bother me as much. I
am just now discovering that I had this skin disease, and for the longest
time I was constantly frustrated. I felt alone, and no one believed me when
I said that water really bothers my skin. It's great to know that there are
other people out there who have the same issues as I do, and know how to
treat it.
Jul 22, 2009 4:13 AM
Guest :
I agree, I went through hell for years because I was incorrectly informed
cold water was best for me. I appreciate that it may work for some people
but in general the very hottest water you can stand works best.
Jul 22, 2009 5:45 AM
Guest :
Agree with the majority here ... showers have to be finished with an
extremely hot spray, all over, to minimise any itch afterwards.
Personally, sweating after playing sport doesn't cause a problem in that
I can shower with the water not being too hot. However, sweating after a
long walk can bring a severe itch on which even a really hot shower doesn't
remove.
It makes me think that perhaps body temperature plays a
part in my particular version of the condition.
Aug 7, 2009 8:27 PM
Guest :
I have being struggling with this condition for as long as I can remember.I
am 33 yrs old. I only recently put a name to this unbearable itching that
everyone just chalked up to being "in my head".I have tried
every thing,every soup but nothing would help. I would itch so bad after a
bath or shower so I don't go to the pool or take baths.Any contact with
water is always very short.A course hair brush would be waiting for me when
I get out of the shower...some days are worst than others but it is still
frustrating. Growing up in Jamaica, it was typical to take a shower outside
in the rain. I would cry for hours after that event. Now I try to study it
and do the things that reduces the itching. The house is always cool,cotton
sheets and underware. Mild soaps and lotions and a good course brush.I wish
this "thing" would just go away.
Sep 6, 2009 3:14 PM
Guest :
I am 37 years old, I have had this hellish ich after showers since
highschool. I just found this condition today!! I have asked one doctor
about the ich and they suggested taking Benedril, which didn't help. I
thought I was just weird. I am going to have to figure out what works for
me, but sweating after rough housing with my son and husband brings it on,
humidity (reason why I knew it wasn't dry skin), hotel showers aren't bad
(very little ich if any). Sometimes I don't ich bad but sometimes I am
reduced to bawling, heat is iffy, there is really no pattern but now that I
know what I am suffering from I am going to watch for small signs, maybe
what I ate, time of day, activity before shower, ect. I feel vindicated, I
know what I have been suffering from and feel excited about the fact I am
not crazy! Thank you so much! I have searched and searched before and WebMD
doesn't list this, I have never found any information on this before. I am
not even sure how I found it today. I have spent over an hour just
searching and iching. I am really amazed at how it listed everything that I
thought was "causing" the ich, sweat, water, pools, humidity,
blowing air, that was why I thought I was so crazy! When I was younger I
would change soaps every two weeks, I didn't know the material connection,
but I can see now if I would sweat wearing something other than cotton, I
would begin to ich. I don't suffer from iching at night but my sheets are
cotten or flannel so I am good there, and most of my pj are cotton. I am so
relieved!! Now I know what to ask a doctor. 20 years of hating showers is
maybe over now. I would procratinate so bad, I would be late for work,
church, school. I am some ideas to help me till I can get in to see a
doctor. I thought I was alone in this, I don't wish this on anyone but it
is nice to hear what others have gone through and what they have done about
it! Thank you!
Sep 10, 2009 4:22 PM
Guest :
I have been living with this particular skin disease for 7 years now,I am
only 19yrs. I now have depression because of it,before now i felt like i
was the only one with this skin condition. thankfully, now I find help.
Sep 14, 2009 8:47 AM
Guest :
I am 44 years old, and have been suffering from agonizingly itchy skin
since I was 11 or 12. For years I thought it was from excessively dry skin
as I live in a desert climate. However, several years ago, I purchased a
water treatment system for my home, and the itching seems to have subsided,
although not completely eliminated. I did notice that when I would itch,
I'd check the salt container & find it was empty. I spent almost 2
years in Iraq, and I don't remember itching once after showering. Like
most of the other sufferers who have commented, I have developed an
aversion to showering. They are painful! The itch is like a stinging
itch, and about 99% of the time only affects my arms & legs. I am
currently spending time on a Caribbean island, and am now itching even when
not showering. I've started more "research" on this, and have
just discovered - today - there is a name, and that it is also triggered by
humidity. For years I have joked with people that I am allergic to water
(I don't drink it, either!), but now am realizing that that might not be an
inaccurate statement. I will be purchasing some Capsaicin cream when I get
home, and hopefully that will help for the times when I am away from
soft(er) water or in a very humid climate. I'll also try the very hot
water rinse. Thank you to everybody for commenting - it's wonderful to
hear this is a relatively common problem, and to read everyone's fairly
unanimous remedies.
Sep 15, 2009 1:54 AM
Guest :
Hi, I have aquagenic pruritus and have just undergone nearly three months
of UVB therapy, three times a week. It worked for a while but I am now back
to having that unbearable itch after having a bath. I do find that adding
bicard of soda to the bath decreases the itch. I am also on medication from
ny GP whichdoes help reduce the itch..but it still happens and is sometimes
worse than others. The strange thing is that I can go swimming in the sea
with no after effects. Does anyone else find that sea water doesn't trigger
the itch?
Sep 15, 2009 8:32 AM
Guest :
i have been suffering this hellfire since 1990 and i thougth it waas the
spoonge i was using, so did my parents, siiblings and friends think. it was evn morre than hell when i got to high school:itch if i did not
bath, and have the worrse if i took the riisk. i have changed almost
every thing in my life ranging from clothing to drugs and soaps and water
but to no avail. i have seen the dermatologists i can lay hands on. as
i am writing now i had a very bad episode this morning and only heaven
knows what will happen this evenning. i will try every suggested
method but in case anybody geeets the definite or permanent antidote to
this calamity, send me a mail and i will be very glad. my mail
address:seidu2k@yahoo.com
Sep 19, 2009 6:54 PM
Guest :
I am 36 years old, and have been suffering with this for the past year or
two. It really is very hard to live with. I have been avoiding a shower for
6 weeks. I can't even believe I haven't showered in that long! I am seeing
a doctor in two days and hopefully, I can get some help. If anything new
comes my way as far as relief, I will post it right away; Looking forward
to trying all of these suggestions. It is nice to know I am not alone.
Ocean water for whatever reason does not seem to bother as much as pool
water. My poor kids dont understand why I do not swim with them anymore. If
anyone finds anything else out, please post. Thanks
Sep 20, 2009 1:07 PM
Guest :
I think I am suffering from Aquagenic Pruritis also and before I heard of
this condition my doctor said it was nerves and the water hitting my legs
would stimulate the nerves and cause itching. The doctor prescribed Xanex
and I take .5 mg 15 mins before showering and it has totally helped me!
If you are suffering from this skin disorder I recommend asking a doctor to
let you try Xanex to pre-medicate before showering and it has made a huge
differnce for me! Thanks for all your other suggestions and I am going to
see a dermatologist to look into other treatments.
Sep 26, 2009 4:06 PM
Guest :
I also suffer with this condition. I live in Antigua (caribbean) and even
if I travel to the US I still itch. It can be very frustrating. I was told
to bathe in salt water and it did help me, but the problem is always
finding loose salt to bathe with. I don't know if bath salts will do the
trick (i had used regular kitchen salt). My hairbrush is my weapon of
choice because fingernails just don't cut it. I have had this condition for
at least 20 years.
Sep 27, 2009 7:05 AM
Guest :
hi everyone, i have had this condition probably since i was 11 i am now 29
and i have tried so many remedies but it does not work.bathing with
extremely hot water that yur body can take helps. I was sick recently for
another reason and i was prescribed diclofenac 100mg twice daily and to my
surprise i did not feel the itch again but i had to reduce the intake
because i did not want to get hooked to it. but it helps.
Oct 18, 2009 12:21 PM
Guest :
Wow I am not alone. I am currently taking prednosone & xyzal. I have
found at times when heat will resolve the itch and when cold blowing air
from a vent has done the same. I don't know which one will work at times
but whatever I have access too is what I will use. Prayer and meditation
has been added to my regime. I am hoping for cure and not just relief.
Oct 19, 2009 10:59 AM
Guest :
So I am highly allergic to water, and I thought it was just me, kind of
neat to know I am not the only one. And other people have it. However, I am
noticing most people only itch and rash out. I also swell up, when I drink
water my throat swells shut, if I take a bath I vomit, my eyes and ears
drain out this clear liquid as a result of having water in my system, and
if I go swimming, it is twice as intense, and my whole face especially my
sinus area burns (this happens even when I am not swimming if I drank water
that day). I have done scans and mris and stuff and don't have a sinus
infection or anything similar. Doctors here are at a loss, anyone have more
suggestions?
Oct 20, 2009 10:43 PM
Guest :
OMG!! I also have Aquagenic pruritis and it has been hell! Sometimes i wish
i could literally peel my skin off. Ive found that i itch less when i
shower @ nights but its still very painful it feels like 100 bee stinging
me all over my body at the same time. Ive tried hot water but it worked for
awhile until my skin got used to it. Even sweat irritates my skin. My
parents usually tell me it was all in my mind and i was beginning to think
i was crazy. I need a remedy that will stop this once and for all.lol im
glad that im not alone!;(
Oct 21, 2009 11:53 AM
Guest :
All of this info is very helpful. I agree with most all of the symptoms
mentioned. However I am curious if anyone else experiences these problems
more in the non-summer months? I have had this skin problem for over 15
years and know for sure that it is aggravated by cooler environments. Which
really, I think it is because my skin is more sensitive in the non summer
months. I know that when I am in the sun in the summer and consistently
wearing shorts, my skin becomes desensitized. Hence, the more sun exposure,
the less problems, but then of course you have the dangers of skin cancer.
Also, does stress aggravate anyone’s itching? Also, just changing
clothes, or removing pants, shirt etc??? I absolutely cannot wear
short sleeves or shorts in the fall or winter (on vacations/around the
house). Thanks for all the help. I certainly feel everyone’s pain…..
Even the “it’s all in your head”
Oct 21, 2009 7:21 PM
Guest :
I'm with you on that one. I have a really hard time changing clothes, and I
also trigger the aggravation after I've sat on a toilet seat. I was just
diagnosed with this condition in February and informed that it would only
last a year or two. Now that I've been reading these comments I realize
that I'll struggle with this indefinitely. I will try this hot water shower
trick, like you guys I was trying to take cooler showers and it has been
touch and go. I find that if I get stressed out while my skin is itching,
the symptoms intensify. Sometimes I feel like I'm having a break down. I am
very thankful that this site is here so that I don't feel so alone about
it. Thanks for posting all the good ideas.
Nov 1, 2009 4:53 AM
Guest :
OMG i,m not alone i thought i had dry skin and have tried every cream for
dry skin known to man, But i noticed it always happens after i take a
shower - even using cream, lotions, oils or nothing (in the shower) did not
help the intense itching after. thank you for all the ideas and
suggestions which i will begin tried today.:)
