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Can Shower or Bath Water Cause Rashes?

Woman in Shower with Purified Water

While most people get skin rashes from different sources, including infections, immune system disorders, heat, medications and allergens, some people get rashes from water. People allergic to water go through what is known as “aquagenic urticaria”. This water allergy is rare yet serious and not many medical professionals have complete knowledge about it.

Showering rids our skin of its natural protective oils, especially if you shower with hard and hot water. Once the oils are removed, the skin is left dry, which can cause itching and inflammation. Aquagenic urticaria can be caused by water from different sources, including tap water, seawater, sweat, and pool water. This allergy affects only a small part of the population. The allergy manifests in the form of a painful skin reaction once the body makes contact with water. It does not create a histamine-releasing allergic reaction, but it is still considered an allergy, and a serious one at that.

This condition is also known as aquagenic pruritus, which literally means water-caused itching. Since urticaria (hives) may be sometimes produced even by a medical saline, the allergy is not significantly affected by the different temperatures of water. According to most researchers and dermatologists, these hives are far different than those caused by histamine release. However, in some cases, the additives, such as chlorine or fluoride might aggravate the allergy. So:

Yes, harsh chemicals, salts or presence of bacteria in water may affect this condition

The term “urticaria” is derived from the Latin word “urtica”, which means stinging hair or nettle and was first used by William Cullen, a Scottish physician, in 1769. This rare condition can cause hives to develop within 15 minutes after contact with water. The hives usually fade away within 10 to 120 minutes. However, in some cases, these hives can last for days, weeks and even months. Walter B. Shelly first reported Aquagenic urticaria in 1964 and it is classified as a subtype or a branch of urticaria. The allergy occurs more commonly in females, especially during puberty. Males are not as vulnerable.

So, the next time you get out of the shower or swimming pool and notice little red splotches on your skin that don't disappear shortly, you should definitely see your doctor. These splotches can appear practically anywhere on the body and can be itchy. You should not scratch these splotches, as that will only cause further skin irritation.

Symptoms

The symptoms of water allergy are somewhat similar to those of other allergies. Symptoms include small raised hives, red spots on various parts of the body, irritation, intense itching, and even burning. You may experience the symptoms minutes after taking a shower, bath or swimming. Small welts or wheals with fine and noticeable edges can also develop on the body. While these hives and wheals can appear anywhere on the body, they are most likely to show up on the neck and shoulders as those are the body parts which come in contact with the water the most.

Most doctors diagnose aquagenic urticaria by exposing the patients to both distilled and regular water and observing the different reactions. If you experience skin rashes after taking a bath or a swim, you can check if you have it yourself using the same method. You can apply tap water and distilled water on each hand and notice the reactions. Distilled water does not have chlorine or ions, while tap water and the water in swimming pools does. Distilled water does not usually cause rashes or hives while water in swimming pools and tap water can cause an immediate effect.

Most people with this allergy do not take proper precautions, such as consulting a dermatologist or using advanced filters for the bath, making their skin even more vulnerable and sensitive. The chlorine content in the water can also cause skin irritation and other water related allergies. Hot showers also contribute to water allergies as you inhale a significant amount of chlorine via the steam.

It is better to take a mild temperature shower and use a shower filter when there is chlorine in bath water.

How to Prevent Rashes and Hives

While prevention techniques may vary from person to person, there are a number of steps you can take to prevent water allergies. You can use certain creams that keep chlorine and other additives from entering your body before you go for a swim. You can also install filters on the taps and showers to make sure the water you use is free of chlorine, clean and pure. A good idea is also to install a whole house water purification system such as here on the main water line in your home, which will allow produce purified water at every faucet.

For well water, make sure there's no harmful bacteria anywhere in the plumbing system, including water tanks. Periodic shock chlorination of the well with bleach may help with this, as well as whole house UV system like this.

How to Treat the Allergy

What is listed below does not constitute medical advice. Please consult your doctor for more information.

As of now, there is no definite treatment for water allergies. However, there are many ways to reduce the effects of the allergy while making your skin tolerable to water. Surprisingly, antihistamines, including hydrochloride, terfenadine, cyproheptadine, and hydroxyzine, are used to minimize pain and rashes. They also help with hives and wheals, helping you heal more quickly. In the past, parental corticosteroids or topical corticosteroids were used for treating water allergies. This method is still used to treat patients with water rash.

PUVA therapy is a modern way of treating patients with aquagenic urticaria using ultraviolet light therapy. This helps reduce itching and lesions by thickening the epidermis. Once the epidermis becomes thick, it does not allow the water to penetrate through the skin keeping chlorine and other additives from entering the body and making contact with the cells. PUVA therapy also makes the skin cells less reactive to water hence minimizing the effects of aquagenic urticaria. Or you can simply spend more time outside in the sun.

Now that you are aware of the risk of water allergies, you should take the necessary measures to reduce the risk and prevent it to improve your life!