Have you ever had a bath in the night and instead of having the usual relaxed feeling that accompanies a night bath.
You experience this persistent itching on the body.
A times the itches occurs as a result of particles which irritates and stimulates sensory receptors on the body surface leading to itches.
These itches go away after few minutes but in some occasions they last for more than 30 minutes.
This whole process of scratching your body like a confused being is often the most discomforting event I have ever seen in my entire life and I this itches after tell you something it isn’t funny at all.
A lot of us who have found ourselves in these conditions have been at the confusing state of what is actually wrong with us.
Why do I have to itch all over just because I took a bath?
Isn’t a bath meant to be relieving, relaxing and soothing?
What is this itching about?
Ok! Relax I will tell you.
Most of itches occur as a result physical irritants in the water we use in bathing.
But a more serious condition can be the cause.
A condition known as Aquagenic pruritus
Aquagenic pruritus is a condition in which contact with water of any temperature causes intense itching, without any visible skin changes.
The symptoms may begin immediately after contact and can last for an hour or more. The cause of aquagenic pruritus is unknown; however, familial cases have been described.
It may also be a symptom of polycythemia Vera or another underlying condition. Overall, treatment is a challenge.
Symptoms of aquagenic pruritus
Aquagenic pruritus causes intense itching in the parts of the body that come in contact with water The legs are most frequently affected, followed by the arms, chest, back, and abdomen.
More rarely, the head, neck, face and hips may be affected. The palms, soles, and mucosa are usually not affected.
Because aquagenic pruritus may be one symptom of polycythemia vera or another condition, it is important to look for problems in other parts of the body to rule out other conditions.
The cause of aquagenic pruritus is actually unknown as no scientific research has been able to vividly explain the physiological basis for its occurrence.
Meanwhile some cases it is a symptom of polycythemia vera or another condition.
Other conditions associated with aquagenic pruritus includes;myeloproliferative neoplasms,hypereosinophilic syndrome and juvenile xanthogranuloma.
Lactose intolerance and hepatitis C may also induce aquagenic pruritus.
Drug induced aquagenic pruritus has also been reported in patients treated with clomipramine(a tricyclic antidepressant),bupropion(prescribed for smoking cessation),hydroxychloroquine and chloroquine (antimalarial drugs also used for rheumatoid arthritis and lupus).
Possible underlying causes of aquagenic pruritus that have been proposed include:
- increased mast cell degranulation – release of granules rich in histamine and other compounds into the body by mast cells, a special type of cell that plays a role in the immune system
- increased circulating histamine
- release of acetylcholine – a chemical in the body which sends signals from nerves to muscles and between nerves in the brain
- increased skin fibrinolytic activity – activity that controls clot size by promoting the breakdown of clots
As stated earlier, that aquagenis pruritus has no definite causes.
There have also been familial and genetic cases where this condition arises from the parents to the offspring.
However,to our knowledge no gene has been proven to be responsible for aquagenic pruritus alone has been identified.
There is no specific exam that confirms a diagnosis of aquagenic pruritus. The diagnosis is generally made by ruling out other conditions. The following criteria may help to make the diagnosis;
- Severe itching (may be the only symptom), prickling, stinging, or burning that consistently develops after skin contact with water, regardless of water temperature or salinity
- Lack of visible skin manifestations.
- Reaction within minutes of exposure to water and lasting anywhere between 10 minutes to 2 hours.
It is difficult to find effective treatments for aquagenic pruritus because the underlying cause is poorly understood.
Therapies that have been attempted with varying success include:
- Analgesics (pain relievers)
- Opioid receptor antagonist
- Topical capsaicin cream
- Adding sodium bicarbonate to bath water
- Selective serotonin reuptake inhibitors
- UV Therapy- shown to be effective in about 50% of patients
- PUVA therapy
- H1 and H2 receptors e.g.loratydine
- Using baby oil or other hydrophobic emollients (skin softeners that repel water) before and/or after showering.
- Watch your towels daily if possible change them often.
- Do not spread your towels in damp places as this provides a breeding place for microorganism.
- Do not use water that has been stored over a period of time.
Have More Questions?
People with questions about the management of aquagenic pruritus should speak with their doctor about available treatment options.