H2-Oh no! Utah teen diagnosed with rare water allergy

water crownAfter waking up and finding herself covered with itchy, red hives after a day of swimming, then 12-year-old Alexandra Allen knew something was wrong. Initially thinking she could be having an allergic reaction to the chlorine in the pool, she later realized it was not the chemical in the water she was allergic to, but actual water itself.

As reported by ABC News, Allen later came across a story about aquagenic urticaria on the Internet and brought her research to her doctor’s attention. She fit the profile perfectly to her doctor’s amazement. 

While technically not a true allergy, this condition causes severe allergy-like reactions, according to an article in the Journal of Allergy Immunological Practice, one of the few studies to describe the disease. It tends to affect women more than men and usually first appears during puberty.

The cause of aquagenic urticaria is not well understood, but one theory is that the sweat glands within the skin produce a toxin that triggers the allergic response. Or it could be that antigens that cause the immune system to produce antibodies are absorbed in the skin after dissolving in water to trigger the allergic reaction.

Urticaria, literally means “hives,” the article states, and when it is aquagenic urticaria, it means small hives or wheals of edema occur when water touches the skin. Normal activities such as showering, crying, or getting wet from rain can all cause a reaction, which typically appears within minutes of water exposure.

“Individual hives last 24 hours or less. However, the course of a hive episode may be days to weeks, but usually there is spontaneous resolution when the response ‘burns out,’” Lawrence Eichenfield, MD, chief of pediatric and adolescent dermatology at the University of California, San Diego, told Yahoo Health.

We really don’t know how rare aquagenic urticaria is, Eichenfield added, but in general, urticarias aren’t very rare at all. People will commonly have this type of hive responses to infections, drugs, food or environmental allergies. However, since Allen’s story broke, numerous people have commented online about their forms of urticaria.

“I would like to say that I am not the only one with this illness, and there is a great deal of other illnesses like it,” Allen writes on her blog. “I am willing to speak out about mine and let my story become one of these news-cycle fads because I know that somewhere there is a 14-year-old girl who can’t go swimming with her friends when they invite her. And I know that she feels freakish.”

As stated in the article, a doctor can diagnose aquagenic urticaria by applying tap and distilled water to the skin and watching for a reaction. The cause of the condition remains a mystery, but patients can tame aquagenic urticaria reactions with antihistamines – just like they can with other allergies. Other therapies can be also considered for more serious cases, such as those associated with manifestations beyond the skin response, including headaches, Eichenfield said.

Finding ways to avoid water has definitely been a challenge, Allen said in an article. Obviously swimming is out and she has become a vegetarian to reduce the oils in her skin, avoids sweating and can only take two to three very short, cold showers a week. Even humid climates can bring on a reaction, she said.

Thankfully, drinking water does not cause a reaction for Allen and Eichenfield said he is unaware of anyone ever reporting this, as aquagenic urticaria is a different kind of response than a classic food allergy.

“At least I’m not allergic to dogs — and it does get me out of doing the dishes,” Allen said.

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