Itching in Active Patients

Abstract

The cause of pruritus can be as benign as dry skin or as serious as liver disease. A variety of other conditions may trigger itching in active people, including eczema, heat rash, Grover's disease, sunburn, cholinergic urticaria, exercise-induced anaphylaxis, contact and systemic allergic reactions, infections, parasites, and several systemic diseases. Most of these conditions can be effectively managed with treatments that range from avoidance of environmental irritants to the use of topical agents, antihistamines, systemic corticosteroids, or antibiotics.

Skin manifestations of running

“…40 Systemic symptoms may include abdominal cramps, diarrhea, nausea, vomiting, salivation, headache, syncope, and hypotension. 8,15,20,39,40 Antihistamines, specifically hydroxyzine, especially if taken before exposure to the offending agent, may be helpful. 4,19,20,26,40 Vibratory angioedema is a rare form of physical urticaria that seems to occur with increased frequency in people who also have cholinergic urticaria.…”

“…4,26 Cholinergic urticaria, commonly reported in runners, is characterized by 2-to 4-mm, well-defined, erythematous, pruritic wheals that develop within 2 to 30 minutes after a general overheating of the body from environmental temperature, exertion, exercise, or stress. 4,20,26,39,40 This type of urticaria has a predilection for the upper thorax and neck, but may spread to the rest of the body. 40 Systemic symptoms may include abdominal cramps, diarrhea, nausea, vomiting, salivation, headache, syncope, and hypotension.…”

“…5,19,36,37,40,48 The symptoms typically begin within the first 5 minutes of exercise but may begin after exercise is complete. 39,41 Runners should stop immediately if they suspect the onset of EIA. 19,27,40,45,48 The acute treatment of EIA focuses on vascular support and airway patency.…”

“…26 Topical steroids and systemic antihistamines may be used for relief from the pruritic eruption if necessary, although avoidance of the offending substance is the best treatment. 4,5,8,20,26,32,39 Short courses of systemic steroids may be used for severe reactions. 8,20,23,24,39 Although some authors suggest that wearing heavy cotton absorbent socks and changing socks more frequently to decrease moisture are the best ways to prevent contact dermatitis, 19,23,24,31 others believe that sweating and subsequent allergen leaching usually will overcome these measures and that nonallergenic shoes are the best option.…”