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Exercise Induced Hives

Exercise and Hives

Urticaria is thought to affect 10 to 20% of the population at some point in time. Urticaria is commonly referred to as hives. It appears as raised, well-circumscribed areas of erythema and edema involving the dermis and epidermis that are very itchy or pruritic.

Exercise-induced urticaria is much less common. In this case, the hives or urticaria occurs during or after exercise. The hives favor the stomach, back, or chest but can occur anywhere.

The diagnosis of exercise-induced urticaria can often made on the basis of the history. A history of exercise-induced cutaneous warmth, erythema and pruritus with or without urticaria is highly suggestive.

If you’re exercising and you develop an itchy red rash, then stop exercising. If the hives don’t go away within 15 minutes, then stop your workout and take an antihistamine like Benedryl. If you develop swelling of your mouth or throat, or difficulty breathing or swallowing, then seek immediate medical help.

If you have a history of exercise-induced urticaria, there are things you can do to reduce the episodes. These include:

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1. Avoid eating cheese, celery, seafood, or wheat for 4 hours before your workout.

2. Avoid aspirin or ibuprophen for 4 to 6 hours before exercising.

3. Take antihistamines such as Benedryl or Zyrtec an hour before exercising may help block an outbreak.

4. Run or exercise with a partner and cell phone for safety.

5. Patients with high-risk allergic reactions should carry an epi-pen at all times and should never exercise alone.

Exercise-induced Anaphylaxis and Urticaria; Am Fam Physician. 2001 Oct 15;64(8):1367-72; Hosey RG, Carek PJ, Goo A.