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what to do when your immune system hates you



dermographism is not cute
Dermatographic urticaria, or dermographism, is a form of physical urticaria (hives), usually due to underlying allergies. At its most basic level, dermographism is an allergic response to a stimulus. Dermographism means "skin writing" -- so named because most people with this condition think it's cute to "write" on their skin with a fingernail; they suffer nothing worse than a short-term raised marking from their "writing".

For a small percentage of those afflicted however, it isn't cute because it triggers painful, itchy rashes that can take hours if not days to subside completely. Even a brief, firm pressure on a particular area can trigger a response. For example, I have had an itchy spot below my right shoulder blade for years simply from leaning back when sitting.

What causes dermographism?

Recent research seems to point to a person's allergies as being a major factor. If someone is "allergic to everything", it is highly likely that person has, or will develop, dermographism. In many ways, it seems to be a manifestation of an over-stressed immune system.

Symptoms of dermographism

In 25% to 50% of normal people, firmly stroking the skin produces first a white line, then a red line, then slight swelling down the line of the stroke, and finally a mild red flare in the surrounding skin. Most people won't even notice unless they meet someone with this condition or read about it and test it for themselves.

About 5% of the population suffers from noticeable dermographism. In only a minority of these people does it cause any major symptoms. It is more common in allergy-prone people, but is by no means restricted to them.

Is dermographism contagious?

No! There may be a genetic component to it (you get it from your parents, and it passes to your children). You cannot however be infected by random dermographism suffers on the street.

The difference between 'normal' hives and dermographism

Isn't all urticaria (hives) a dermographic reaction?

Hives are a standard feature of allergic reactions. If you are getting hives, this means that there is a histamine reaction going on. How and when they appear is what determines exactly what you are suffering from. For example, if you have a violent allergic reaction to strawberries, you might pop up with spontaneous hives all over your body, or a rash, or your throat might swell up due to internal hives. (If you have trouble breathing to an allergic reaction, by the way, go directly to Emergency.)

A physical urticaria means that the reaction is caused by a physical trigger such as touch, to which then your body reacts in that particular spot. If you had cold urticaria, drawing an cube down your skin might produce a line, and falling in a cold pool might cause most of your body to swell up.

Random hives and rashes means that the problem is something else entirely.

Options to reduce the symptoms of dermographism

Some people are lucky that it doesn't hurt. Good for them. However, for some of us, it does hurt. It may disappear after a few months or a couple of years, but in the meantime we have to live with it. It is a challenge to get through the day when we just want to tear our skin off.

  1. Don't scratch! Scratching will only make it worse by prolonging the suffering.
  2. Take anti-histamines every day. This will provide at least some limited relief from the itching. You can talk to your doctor about a prescription strength anti-histamine if necessary.
  3. Find the source of the allergen and avoid it.
  4. Avoiding known allergens. This involves identifying what you are actually allergic to (or if it is an allergic reaction). If you can't do that, then you can't avoid them. Some people have reported tremendous success with avoiding dairy or gluten, for example, once they determine that a reaction each time they have bread or cheese.
  5. Avoid inflammatory substances. This may result in your immune system "calming down" such that you no longer react to everything.

The main thing to remember about dermographism is that it's so easy to diagnose, can't be anything else, and is rare and non-fatal in addition to being idiopathic -- that is, the cause is different for everyone and usually unknown, the actual reason it happens is unknown, how long it will last is unknown, and who will develop symptoms is often unknown. It is anecdotally linked to allergies, immune disorders and food intolerances -- all issues with the immune system reacting too strongly, or reacting to the wrong thing, but there's no common feature of all of the stories. It doesn't help that sometimes allergies and food sensitivities can be hard to identify!

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