What are the best treatments for Aquagenic urticaria?

Aquagenic urticaria is a rare condition characterized by the development of hives or welts on the skin after contact with water. This condition can be quite distressing and significantly impact a person's quality of life. While there is no known cure for aquagenic urticaria, there are several treatment options available to manage the symptoms and provide relief.

Treatment Options for Aquagenic Urticaria

1. Antihistamines

Antihistamines are commonly prescribed to alleviate the symptoms of aquagenic urticaria. These medications work by blocking the effects of histamine, a chemical released by the body during an allergic reaction. Antihistamines can help reduce itching, redness, and swelling associated with hives. Over-the-counter antihistamines like cetirizine (Zyrtec) or loratadine (Claritin) may provide relief for mild cases, while stronger prescription antihistamines may be necessary for more severe symptoms.

2. Topical Steroids

In cases where antihistamines alone are not sufficient, topical steroids may be prescribed. These creams or ointments contain corticosteroids, which help reduce inflammation and relieve itching. Topical steroids should be used under the guidance of a healthcare professional, as prolonged or excessive use can lead to skin thinning and other side effects.

3. Phototherapy

Phototherapy, also known as light therapy, involves exposing the skin to specific wavelengths of light to reduce symptoms. Ultraviolet (UV) light therapy has shown some success in managing aquagenic urticaria. This treatment is typically administered in a controlled medical setting and requires multiple sessions over a period of time. Phototherapy should only be performed under the supervision of a dermatologist.

4. Avoidance of Triggers

Identifying and avoiding triggers that exacerbate aquagenic urticaria can be helpful in managing symptoms. While it may not be possible to completely avoid water, certain factors like water temperature, pressure, or chemical content can influence the severity of the reaction. Taking lukewarm showers instead of hot ones, using hypoallergenic soaps, and minimizing exposure to chlorinated water may help reduce symptoms.

5. Supportive Measures

Implementing supportive measures can also contribute to symptom management. These include:

• Moisturizing: Regularly applying a hypoallergenic moisturizer can help soothe dry and irritated skin.


• Cool compresses: Applying cool, damp compresses to affected areas can provide temporary relief from itching and inflammation.


• Loose clothing: Wearing loose-fitting, breathable clothing can minimize friction and irritation on the skin.


• Avoiding scratching: Although it can be difficult, avoiding scratching the affected areas can prevent further irritation and potential skin damage.

6. Experimental Treatments

In some cases, experimental treatments may be considered for individuals with severe and refractory aquagenic urticaria. These treatments are still being researched and may not be widely available. Examples include omalizumab (Xolair), a medication used for allergic asthma, and plasmapheresis, a procedure that filters the blood to remove antibodies.

It is important to consult with a dermatologist or allergist to determine the most suitable treatment approach for aquagenic urticaria. They can provide a personalized treatment plan based on the severity of symptoms, medical history, and individual factors.