Help! I Get Hives When I Exercise!

Help! I Get Hives When I Exercise!

August 14, 2019

It’s hard to stay motivated especially when you’re thinking about losing weight or just being fit and healthy. But it’s more difficult to keep focused when you know that a single trickle of sweat could lead to red itchy hives. What’s worse is that getting hives in a public place can be embarrassing. 

Cholinergic Urticaria 

Cholinergic urticaria is a type of skin rash that commonly occurs in some people when their body gets warm and sweats. The hives often develops fast, but they clear up on their own with no lasting effect. This condition directly affects the person’s ability to exercise or perform other physical activities. Cholinergic urticaria occurs when the nerve fibers in the sweat glands react to heat and sweat as the body temperature goes up. The word “cholinergic” refers to a part of the nervous system that controls muscle contraction, dilation of the blood vessels, and slowing the heart rate. 

What are the symptoms?

The rash can occur anywhere on the person’s body but are more common on the trunk or arms. The rash includes a combination of the following:

  • Itching or tingling at the onset of rash
  • Burning or itching on the affected areas
  • Small weals or red, raised bumps on the skin
  • Larger weals that could lead to more swelling


Cholinergic urticaria occurs when a person sweats or gets too warm either from exercise, hot baths, exposure to hot weather, fever, stress, and eating spicy food. According to studies, these activities and or situations raise the body’s temperature and causes the body to release histamine, a compound that the body tends to release in response to injury.

How is it diagnosed?

Doctors would confirm the diagnosis of cholinergic urticaria by performing an exercise challenge wherein the doctor would monitor the patient for signs of cholinergic urticaria, a passive warming test, which requires the patient to sit in a warm room so the doctor could check for signs of cholinergic urticaria, and a methacholine skin challenge test, in which the drug called methacholine is injected into a person’s skin to see if hives appear.


Treatment may range from medications to lifestyle changes such as avoiding triggers. Athletes may have a hard time doing this, so a doctor may recommend medical management right away. Doctors may also advise to use antihistamine and anticholinergic drugs to prevent symptoms. For people who manage the condition through lifestyle changes, they should avoid too much exercise, spicy food, hot showers and baths, and prolonged exposure to heat.

When it comes to diet, specialists recommend to adopt a low-histamine diet to help with the condition. Histamine is a chemical involved in the body’s allergic response. Low histamine diet should reduce or avoid too much salt, fish and shellfish, nuts, alcohol, and foods high in preservatives or additives, among others. 

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