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Is it possible to be allergic to water? Also known as aquagenic urticaria, the extremely rare water allergy can cause pain and skin issues for the unfortunate person inflicted with it. Given the fact that over half of our bodies are made up of water, how does this allergy work?
We are going to take a look at aquagenic urticaria in detail, from the cause of this allergy to the associated symptoms and treatment.
Be assured, aquagenic urticaria is a very real allergy. And by the time you are finished reading this piece, you will know all about it.
What Is Aquagenic Urticaria (Allergic to Water)?
What is aquagenic urticaria, and what does it mean to have an allergy to water? Urticaria is the medical term for hives, an outbreak of raised red bumps or lesions on the body usually in response to an allergen. In the case of aquagenic urticaria, the allergy is a physical urticaria, meaning that its effects are seen externally (on your skin) as opposed to internally in your body. As mentioned, it is a very rare condition; therefore, statistics and detailed information about it tends to be scarce.
We do know that there are records of aquagenic urticaria occurring in people as far back as around 1,000 to 2,000 BC in an ancient Chinese medical reference book called The Yellow Emperor’s Inner Classic. However, it would not be until Paul Ehrlich discovered mast cells in 1879 that aquagenic urticaria would be classified as an allergy. Women also appear to be more susceptible to the allergy, with symptoms often appearing around the age of puberty.
Aquagenic Urticaria Symptoms
What are the symptoms of a water allergy? As we have noted, it is an allergic reaction that affects your skin when it is exposed to water. This could be rainwater or the treated municipal water in your shower. Once the skin has made contact with water, there will be a reaction such as redness, rashes, and hives.
This reaction usually takes place within 15 minutes of the exposure. The rash and hives can become itchy, painful, and occasionally the skin will blister. If the water is removed from the skin, the symptoms usually dissipate within 30 to 60 minutes.
Causes of Water Allergy
An allergy to water is very unusual, which makes the process of figuring out the cause of aquagenic urticaria challenging. As it currently stands, exactly what causes a person to be allergic to water is unknown.
However, experts know that those who are allergic to water can have a reaction from swimming, showering or bathing, and even accidental water spills. Furthermore, sweat and/or tears may trigger physical reactions. We also know that the allergic reaction to water occurs in the sufferer regardless of the temperature of the water.
Scientists have produced a number of theories, which include connections to lactose intolerance as well as diseases like atopy, polymorphous, light eruption, cholinergic urticarial, Bernard-Soulier syndrome and HIV infection. The lactose intolerant appear to have the highest risk due to the disease’s association with chromosome 2q21.
There is also the suggestion that the allergy, at least in some sufferers, might not actually be one to water. Instead, it could be an allergic reaction to a substance found in the water itself. But, as with the other theories, while there does seem to be a correlation, there is not enough evidence to confirm causation.
Diagnosis of Aquagenic Urticaria
Despite the lack of a concrete cause of aquagenic urticaria, there are very simple ways of diagnosing the allergy. The first step is for the doctor to dive into your medical history. He or she will look at any skin issues you have had in the past and whether they might be connected to aquagenic urticaria. This is often followed by an actual physical test using water, which includes direct contact or contact with the use of a wet cloth or paper towel.
The water used is often distilled (so that other allergens will not be involved), applied to an area of skin, and left on for approximately 30 minutes. After 30 minutes, the water is removed and the doctor will wait for another 10 to 15 minutes to see if a reaction occurs. If there is a reaction, an allergy is more than likely.
Water Allergy Treatment
Once a water allergy has been confirmed, the next logical step would be treatment. Unfortunately, there is no direct treatment for aquagenic urticaria. But, there are general allergy treatments you can use that could potentially help relieve the pain, itch, and blisters that you may be suffering from. Treatments that may help with aquagenic urticaria include:
Antihistamines
Antihistamines that you would use for other common allergies may also effectively stop the histamines in your body from activating their defenses against an allergen. This response is what causes the allergic reactions like itching, redness, etc.
Ultraviolet Light Treatments
These UV light treatments are meant to thicken the outer layer of skin so that the water cannot interact with the mast cells underneath, which would cause redness and blistering.
Corticosteroids
Topical corticosteroids may be able to alleviate some of the symptoms of aquagenic urticaria, and have been used as a treatment in the past. That being said, the amount it may be able to help is up for debate and yet to be quantified.
Epinephrine/Adrenaline
Epinephrine or adrenaline may be used to treat severe cases of aquagenic urticaria. Epinephrine helps stop severe allergic reactions quickly through injection into the thigh, halting the allergic reaction before it starts.
Bath with Baking Soda
Sodium bicarbonate, also known more commonly as baking soda, has long been used to help to relieve the itching that comes with other allergies. Baking soda helps with itchiness due to its anti-inflammatory properties. Try a running a warm bath and then mix in a half cup to one cup of baking soda. Then soak. This should only be done by those who suffer from a mild water allergy.
How to Prevent Water Allergy
For most allergies, the first recommendation for prevention is avoidance. Water is hard to avoid. We all shower and bathe, but there are a few things you can do to limit that exposure. First, take short showers instead of long baths, if possible. Also, if it looks like rain when leaving the house, always bring an umbrella.
You can also use creams and other topical treatments to make a barrier on your skin that will prevent water from fully penetrating it. Coating the skin with a petroleum-based gel, for example, may be an effective way of doing this.
You Can Manage Aquagenic Urticaria
Can people be allergic to water? As weird or preposterous as the idea may seem, it is a real allergy that can occur in some people. Given that water is difficult to avoid and a part of our daily lives, it may seem hopeless to someone who suffers from aquagenic urticaria. There is hope.
There are some basic allergy treatments you can try and some prevention methods that can be used to help these people through the allergy. Hopefully, this article has given you some ideas on what aquagenic urticaria is and how it can be treated.
Sources
“Aquagenic Urticaria – Allergy to Water,” Medical Bag, February 03, 2015; http://www.medicalbag.com/profile-in-rare-diseases/aquagenic-urticaria-allergy-to-water/article/472915/, last accessed August 7, 2017.
“Aquagenic Urticaria or Water Allergy: Causes, Symptoms, Treatment, Risk Factors,” ePain Assist; https://www.epainassist.com/skin/aquagenic-urticaria-or-water-allergy, last accessed August 7, 2017.
“Aquagenic Urticaria,” Wikipedia; https://en.wikipedia.org/wiki/Aquagenic_urticaria, last accessed August 7, 2017.
“Aquagenic Urticaria,” Rare Diseases; https://rarediseases.info.nih.gov/diseases/10901/aquagenic-urticaria, last accessed August 7, 2017.
Sharma, H., “How Does Epinephrine Turn Off an Allergic Reaction?” Allergic Living, April 10, 2013; https://allergicliving.com/experts/how-does-epinephrine-turn-off-an-allergic-reaction/, last accessed August 7, 2017
Wong, H., MD, “Urticaria,” Medscape, June 13, 2017; http://emedicine.medscape.com/article/762917-overview?pa=KYUnYaoB3HeOmTGezkF7b2UyWYq0%2BjqRG7083K2sK%2FJnfLPTlL2bK0VWZ89ZzaFAfSaUQtnMESjaSuBKWlmsMSchrzF%2F7vlnSF6AEX%2F09M8%3D, last accesed August 7, 2017.