Water has always been associated with healing or life-giving properties.

When someone gets wounded water is used to clean the wound. When someone is dying of thirst water can bring back that person to life. Even when a person is suffering from gout he or she is often advised to drink large amounts of water to cleanse their bodies of that disease.

So it can be quite a surprise when some people find out that the one element in the world that can give life or heal many people can also be a substance that can trigger an allergic attack.

What is aquagenic urticaria?

• People who claim to be allergic to water develop hives (urticarial) or even experience burning pain as soon as they come into contact with H2O.
• Aquagenic urticaria is the medical term that describes this condition.
• Mostly women are affected by this condition and it often appears during the onset of puberty.
• Some patients complain that the condition makes them itchy, which is a form of physical urticaria.
• Unfortunately, the cause of aquagenic urticaria is still unknown.
• It is also quite rare, which makes it difficult for doctors to determine the cause of this condition.
• Although, doctors have come up with medications and therapies that have proved to be successful in easing the condition.

Symptoms of aquagenic urticaria

People who suffer from this condition often get hives in areas where water touches their skin. The hives are often small about 1 to 3mm and they often appear as red or skin-colored welts (aka wheals) but with defined edges. These hives often appear on the neck, arms and upper trunk but some people display hives on other parts of their bodies.

With aquagenic urticaria, the hives often disappear after 30 to 60 minutes of staying away from water. Now it may seem that aquagenic urticaria is a direct reaction to contact with water but scientists are proposing that perhaps there is a substance in the water that acts as an allergen and that the water itself is not the trigger to a person’s allergic reaction.

Since it is a very rare condition there is not enough data to determine the cause of aquagenic urticaria. Scientists are still studying this condition and they discovered that many people who suffer from aquagenic urticaria do not have relatives who also have it ruling out genetics as a factor in spreading this disease. There are reports though of families with three generations displaying an allergy to water or toxins in the water but they are rare.

Diagnosing aquagenic urticaria

In order to properly diagnose if a patient is suffering from aquagenic urticaria doctors will conduct tests to determine the patient’s disease. The first test would be the water challenge test wherein 35ºC water will be applied to the upper part of the body for 30 minutes. Doctors will then monitor the patient for any changes to his/her skin. But then again, aquagenic urticaria is very rare so there is limited information on how effective the existing treatments are for some people.

So far, doctors who have treated patients with aquagenic urticaria used the following treatments with variable success:

• H1 antihistamine
• Ultraviolet B (UVB) light treatments (also called phototherapy)
• Propranolol
• Creams that protect the skin from water
• Stanozolol (anabolic steroid)
• Sodium bicarbonate bath (0.1–0.5 kg/bath)
• Low dose of serotonin reuptake inhibitor, combined with cyproheptadine and methscopolamine

Aquagenic urticaria, despite its rarity, is an existing skin disease and some people have it worse than others. One patient shared her story of how life is for her now that she has aquagenic urticaria. She said that her reaction to water is so intense that it feels like a burning pain sometimes. Even her tears can leave red welts on her face and could even make her whole face swollen. But for this patient, and other people like her, she is trying her best to survive this ordeal and live a normal life with the hope that someday someone will find a cure for this strange and debilitating disease.