Advice to lessen my dermatographic urticaria aka "skin writing"

March 5, 2013 8:48 PM

I have dermatographic urticaria, also known as "skin writing." It's really problematic because I will scratch an itch on my forehead or rub my chin while I am working and then, without even realizing it, I will look like I am breaking out with an illness or I got into a fight. Even though my skin is going haywire, getting puffy and red from being scratched or rubbed, I don't feel anything bothersome at all so I don't know until I check in a mirror. Does anyone have any experience with this and possibly reducing the symptoms?

I just saw a dermatologist who didn't know any of treatments. I saw an allergist a few years ago who said there's nothing I can do but hope it goes away on its own. Well, it hasn't, and I've had it at least five years. I also have grave's disease and my allergist said there seems to be a correlation between dermatographic urticaria and thyroid disorders.

Anyone tried to get rid of this or found something that helped? I checked a few stores and didn't see any sort of antihistamine creams so I couldn't try that, but I figured it was worth a shot if I could buy some. I use lotion to make my skin less dry and itchy, but that doesn't stop the problems I get when I do scratch an itch.

Thanks in advance.

posted by AppleTurnover to health & fitness (16 answers total)

Keep your nails short... train yourself to relieve itches with pressure instead of scratching/rubbing?
posted by ecsh at 9:04 PM on March 5

Benadryl and Allegra both make antihistamine creams.

I am not a doctor but as far as I know, sometimes urticaria is treated with prednisone or anti-cancer drugs to reduce the auto-immunce response but your case doesn't sound that extreme since you only mentioned how it looks, not how it feels.
posted by Dansaman at 9:16 PM on March 5

Oh man. I have this too, though mine was noticeable, making me extremely itchy and covered in hives last year, to the point that I was then covered in bruises from scratching before we got it under control. I went to a dermatologist and then an allergist to figure it out. What helped me: Taking OTC ranitidine (Zantac) and fexofenadine (Allegra) every morning (no fruit juice with the Allegra) and, as needed at night, a stronger prescription antihistamine, hydroxizine (Atarax). The combo of the first two drugs targets both kinds of histamine receptors for a more effective block. I also use Jason hemp lotion all over my body daily, especially during dry winter months. All of that (and avoiding one thing I actually was found to be allergic to during my dermatologist's patch test) almost completely knocked out my dermatographic urticaria last year and ever since. I don't even have to take the antihistamines or the ranitidine much anymore, now that I have it under control; the key for me was figuring out what was starting the itching in the first place (dry skin, an allergy), then fixing that while also blocking as much of my histamine receptors as possible! As you probably know, the whole thing with dermatographic urticaria is avoiding itches in the first place, since scratching just causes more itches/hives/redness.

I hope that helps! There definitely are ways to combat it, and they're pretty cheap.
posted by limeonaire at 9:25 PM on March 5

Also, from what I've heard, using antihistamine creams when you have conditions like this can actually make them worse, sensitizing the skin. I would go for a pill-form antihistamine.
posted by limeonaire at 9:30 PM on March 5

I'm assuming you do, but do you have the Graves disease under control? As in, in treatment with an endocrinologist? If there's a link with the urticaria and thyroid function, the first step would be to prove that both TSH and thyroid antibodies levels are ok.

On the "creams" side of treatment, I'm thinking that whatever works for treating rosacea could be worth a shot with trying for your skin. I tried an earlier version of this once and it worked so well on my face that I only ever bought one bottle.
posted by CrazyLemonade at 9:40 PM on March 5

I have this too. Taking a daily Zyrtec (cetirizine) in the morning clears it right up. If I miss a day, though, my skin reminds me.
posted by topophilia at 9:52 PM on March 5

I have this! Like topophilia, a Zyrtec a day keeps the welts away. Costco sells 365 zyrtec (under their own brand, AllerTec) for something like $16.
posted by KathrynT at 10:07 PM on March 5

I have this, but only when I haven't been taking my daily Zyrtec that keeps my other allergies under control.
posted by MadamM at 5:40 AM on March 6

I have cholinergic urticaria which is slightly different (mine is triggered by heat, not touch). What helped me were two things: 1) a course of prednisone to knock it back (and this really, really, helped by the way); and then 2) exercise and hot showers. The exercise might be specific to my urticaria, not yours, but the exercise does three things for me -- it "expresses" the hives, it raises the heat tolerance of when the hives are expressed, and it reduces stress, which was the original trigger for my condition.

Does this only affect specific parts of your body? Your torso, waist, feet, etc. aren't constantly covered in hives from rubbing against your clothes?
posted by (Arsenio) Hall and (Warren) Oates at 5:48 AM on March 6

I also have this -- except mine is invariably itchy, and will pop up where my clothing rubs my body, or my thighs rub together, or the side of my foot rubs my shoe, or where my purse smacks me as I walk, etc. And I also agree that only daily antihistamines have made a dent.

I've kind of accepted it as one of my body's hiccups, and don't worry anymore about how it looks. But the antihistamines have reduced the awful appearance, as well as the itchiness.
posted by Coatlicue at 8:25 AM on March 6

I get it too. I will second hydroxizine. I take 1 10mg pill per day and I'm set, although in the last 8 years or so my DU has gotten much less drastic.
posted by Strass at 9:27 AM on March 6

+1 for daily antihistamines
posted by misanthropicsarah at 10:41 AM on March 6

Taking a daily Zyrtec (cetirizine) in the morning clears it right up. If I miss a day, though, my skin reminds me.

Oh! I forgot about this. I would strongly caution you against starting cetirizine, actually. Everyone's different, but I had a bad experience with it. My primary-care physician had me start taking it when my big episode of hives hit last year, and within a couple of weeks, I found exactly this: Less than 24 hours after taking a dose, I would start to get itchy again, and if I went beyond 24 hours without taking it again, I'd immediately develop the worst itching of my life—worse than before I started taking it in the first place!

After reading about many others' experiences with cetirizine, I decided to go through the itchy hell of withdrawal, and after several days went by without relief, that was when I made my initial appointment with the dermatologist, who administered a patch test and discovered my formaldehyde allergy, then referred me to the allergist, who did a different patch test, diagnosed me with dermatographic urticaria, and had me start taking the Allegra/Zantac combo plus hydroxyzine as needed at night.

As my allergist noted, cetirizine is a major metabolite of hydroxyzine, so they're related molecules. But I don't get any sort of withdrawal-type "rebound itching" after I take hydroxyzine for one night, whereas I would start getting itchy even before a full day had passed since I took my last dose of cetirizine.

I would definitely suggest that you try Allegra first. Taking that and the Zantac for just a month pretty much cleared up my symptoms, and now the only antihistamine I take is hydroxyzine at night on occasion, when I'm feeling particularly itchy.
posted by limeonaire at 1:08 PM on March 6

I also have this. I saw an allergist for a while when it first started and she basically had me try antihistamine after antihistamine to see if any of them helped. Most DID help, but didn't completely solve the problem. The one that worked the best for me was Zyrtec.

So I'd suggest (as others have above) picking an antihistamine and trying it. But if it doesn't help enough, try a different one. People really do react differently to these drugs. Good luck!
posted by christie at 1:21 PM on March 6

I don't have your type of urticaria; I have delayed pressure hives and regular old hives. Without meds I develop constant hives -- sometimes as long as 12 inches.

My med combo is hydroxyzine (2 at night, one in am), famatodine 2x per day, cetirizine 2x per day, 6 sulfasalazine, one singulair. (Plus Vit D and Calcium). I think that's everything.

But I am under a dermatologist's care, and she orders labs regularly. She also biopsied my hive before putting that cocktail together.

It took weeks to kick in. If I miss a refill for a day, I start to itch again.
posted by vitabellosi at 2:05 PM on March 6

OK, I will try some oral antihistamines first. I had tried Benadryl and didn't notice any difference. But I guess maybe I should try some meds and then scratch myself at specific times throughout the day for comparison to see if my skin reaction is getting less intense. Sounds like I should also see a different allergist or dermatologist since you people were able to get some advice from your doctors.

Sounds like some of you have it a lot worse. I don't really get hives. Usually, my skin just turns red and if I really scratch, it'll puff up. It's mostly a nuisance because it seems when I do have it on my face, I don't realize it. And when I don't, I'm self-conscious and trying to find a mirror. And yes, my thyroid disorder is under control but the simple fact is, I will have a thyroid disorder for the rest of my life, so I can't worry about that.

Thanks fellow skin-writers!
posted by AppleTurnover at 7:57 PM on March 6