When I was newly pregnant with my first child, the areas of adult and perinatal health were not new realms. As an obstetrical nurse for several years, I also had training and experience in the health of pregnant women. Though I embraced a spirit of continual learning, I did not expect my body to become my own teacher. However, that is exactly what happened when a couple months into pregnancy, my body developed mysterious symptoms: widespread reddened hives and itching after each shower.
Upon discussing my concerns with my provider, I learned that pregnancy had brought out an underlying skin diagnosis called “dermatographia.” In fact, I may have lived with this disorder much of my life without knowing it. Dermatographia is not pregnancy-related for most people; in fact, it may be present in 2-5% of the general population. My provider explained that my dermatographism was likely exacerbated by pregnancy hormones. This diagnosis led me to explore more details of this unique disorder.
What Is Dermatographia?
Despite being a fairly common condition, many have never heard of dermatographia. It refers to a benign skin condition where people experience temporary raised lines or welts on their body from a variety of stimuli.
Other terms for dermatographia include:
Dermatographism
Dermatographic urticaria (or dermographism urticaria)
Inducible urticaria
“Skin writing”
Dermatographia often presents with the following symptoms:
Red or discolored lines on the skin
Swelling/inflammation
Hive-like welts
In less common cases, itching, stinging, or prickling
What Causes Dermatographia?
The above symptoms may appear in response to a number of tactile stimuli, such as touch, pressure, scratching, rubbing, or tight clothing. Dermatographia is the most common of a group of hives-related disorders called “physical urticaria.”
Some additional causes or aggravating factors of urticaria (hives) include:
Exercise
Stress
Temperature extremes
Allergies
Certain medications or infections
Pregnancy or menopause
The medical community believes a release of histamine from mast cells causes dermatographia’s skin reaction. Experts do not know for certain why this allergic reaction-like response occurs, despite the absence of a specific allergen.
Some researchers and healthcare providers believe dermatographia may even be an autoimmune disorder. In addition, people with other skin conditions such as eczema, dry skin, and dermatitis may be more prone to dermatographia. The disorder may also exist more frequently in young adults and females.
How Is Dermatographia Diagnosed?
A healthcare provider can easily diagnose dermatographia by using pressure from a blunt, firm object to simulate “writing” on the skin. The arm or back is a common place for this test. Within 30 seconds to several minutes, people with dermatographia usually develop raised or reddened lines in the original pressure pattern. The NIH describes this physiological response as an aggravated form of the body’s “triple response of Lewis.” This tri-fold response refers to the body’s formation of raised, reddened wheals.
Taken from: https://skintherapy.com/dermatographia/
How Is Dermatographia Treated?
The symptoms of dermatographia typically go away on their own within 15-30 minutes, though sometimes longer. People usually do not need any special treatment and the condition is not harmful or contagious. Many find that the condition disappears after 1-2 years, though some experience chronic symptoms.
Most dermatographia cases have a mild presentation. However, with more significant symptoms lasting longer than 30 minutes, or accompanied by bothersome pruritus (itching), the following remedies may help:
H-1 antihistamine medications (such as cetirizine, loratadine, hydroxyzine, or diphenhydramine)
Cromolyn
Light therapy
Steroids
Moisturizers
People should usually focus on decreasing the triggers of their urticarial symptoms. For example, it may help to avoid harsh tactile stimulation, temperature extremes, allergens, or stress.
A primary doctor or dermatologist can help identify different treatments based on the kind of urticaria present. Consult a healthcare provider for guidance when taking medications, especially with children or if pregnant or breastfeeding.
Back to the Beginning
Returning to the anecdotal story at the beginning of this article, I found the diagnosis of my dermatographia helpful in multiple ways. First, it alleviated my anxieties that some other serious condition, such as an allergic reaction, was causing my hives.
Second, my provider encouraged me to decrease symptoms by avoiding key stressors. I found some relief by taking cooler, shorter showers. This lessened the temperature extremes that likely aggravated my body’s histamine response. Using gentle towel drying also decreased tactile stimulation. In addition, the hives tended to dissipate after 30 to 60 minutes. Reminding myself of the temporary and self-limiting nature of my symptoms also felt reassuring.
However, the primary factor that resolved my dermatographia symptoms was giving birth to my child. This post-pregnancy state seemed to stabilize whatever hormones heightened my histamine response. This left the dermatographia symptoms almost unnoticeable after giving birth.
While I do still consider myself as having more sensitive skin, I no longer experience hives and itching. Perhaps dermatographia or other urticarial responses may appear again. However, I would now feel more prepared to explore the causes and treatments with a trusted provider. Hopefully this article helps others who have experienced similar symptoms, or healthcare workers coaching patients through various histamine-related conditions.
Sources
Dermatographia (Dermatographism).
Dermographism. www.ncbi.nlm.nih.gov/books/NBK531496/
What Is Dermatographia? www.webmd.com/skin-problems-and-treatments/what-is-dermatographia
What Is Dermatographia?
Urticaria: chronic inducible urticaria (eg pressure, cholinergic, contact, aquagenic). www.pcds.org.uk/clinical-guidance/urticaria-physical-urticaria Assessed and Endorsed by the MedReport Medical Review Board