Can I still exercise if I have allergies?

Have you ever experienced this? You suddenly went for a run and your legs started to itch. The more you scratched, the more it itched! Was it because of dry skin? Burning fat? Or friction? Be careful. You may have an allergy to exercise.

Previously, the news that a 13-year-old boy was allergic to playing basketball became a hot topic. “Exercise allergy” instantly attracted everyone’s attention, and netizens often participated in the discussion.

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What is "exercise allergy"? How to confirm whether it is "exercise allergy"? Can I still exercise if I have "exercise allergy"? Let's take a look~

01What is “ exercise allergy ”?

"Exercise allergy", also known as "cholinergic urticaria", is a skin disease that is generally more common in young people, especially men.

Cholinergic nerves are nerve fibers that release acetylcholine as a chemical transmitter from nerve endings, including the secretory nerves that control sweat glands, all sympathetic nerves, somatic motor nerves, etc.

In medicine, urticaria caused by exercise, intake of hot food or drinks, sweating, and emotional excitement, which causes cholinergic nerve impulses, releases acetylcholine, increases the level of cyclic guanosine monophosphate (cGMP) in basophils and mast cells, and causes the release of histamine (the substance that directly causes urticaria), is called cholinergic urticaria.

Simply put, the cause of cholinergic urticaria is that exercise, excitement, sweating and other factors cause the skin temperature to rise, inducing the release of a substance that causes urticaria - "histamine" . The occurrence of cholinergic urticaria is related to personal constitution, that is, the allergic constitution that doctors often tell you about, but its allergic mechanism is different from other urticaria.

Different Types of Urticaria

Source: "Chinese Expert Consensus on the Diagnosis and Treatment of Chronic Induced Urticaria (2023)"

The rash of cholinergic urticaria is characterized by the occurrence of generalized 1-3 mm wheals on the palms and soles, with obvious redness around them, and sometimes satellite wheals. However, cholinergic urticaria is not always accompanied by a rash. Sometimes it only causes severe itching , and the damage lasts for 30-90 minutes, or even several hours . Cholinergic urticaria can recur for months or years, but it can also resolve spontaneously.

Image source: CCTV.com

Most patients have mild symptoms, mainly itching, and there are no prodromal symptoms before exercise, so cholinergic urticaria is easily ignored. However, if you experience shortness of breath, nausea, abdominal pain, and diarrhea, you should stop exercising immediately and seek medical attention in time to avoid shock.

02How to determine whether it is " cholinergic urticaria"?

Any factors that cause the body temperature to rise or the skin to sweat, such as strenuous exercise, hot baths, wearing thick clothes, and going from a low temperature environment to a high temperature environment, may cause the patient to experience symptoms. In addition, emotional excitement, tension, eating hot or spicy food, etc., may also cause symptoms.

Image source: Life Times

"Cholinergic urticaria" is related to personal constitution. If no intervention is given, it may recur. So how do you tell if you have "cholinergic urticaria"? In daily life, you should pay attention to observation. If you find that the occurrence of rash and itching is related to exercise or emotions , you should take the initiative to seek medical attention and let the doctor help with diagnosis and treatment.

You can also do a simple thermal stimulation experiment , such as soaking the body in 42°C hot water for 15 minutes to observe whether wheals appear and whether small satellite wheals appear around the wheals.

Of course, the most professional way is to go to a regular hospital for treatment and let a professional dermatologist make a diagnosis based on the symptoms. The medical differential diagnosis method is to inject 1:5000 methacholine intradermally , which normally produces a typical wheal, and the patient will have small satellite wheals around the wheal.

03Can I still exercise if I have cholinergic urticaria ?

Nowadays, physical education scores account for a higher proportion in the college entrance examination and high school entrance examination. Many parents may worry whether their children can still exercise if they have "cholinergic urticaria"?

Image source: Xinhua News Agency

First of all, please rest assured that exercise is OK ! However, during the acute attack period (symptoms occur frequently, wheals recur with severe itching), you should stop exercising, especially strenuous exercise, to prevent the symptoms from worsening . Seek medical attention actively, work with your doctor to find the cause of the allergy, and actively treat it. You can take oral anti-allergic drugs and apply antipruritic ointments or lotions. After the symptoms are relieved and stabilized, gradually increase the amount of exercise, and do not engage in strenuous exercise immediately.

In daily life, we should also avoid factors that cause excitement, sweating, etc. that may increase body temperature, control diet appropriately, eat less hot and spicy food, and food that may induce urticaria, such as seafood, pickled food, canned food, etc. When going out for fun, it is recommended to bring anti-allergic drugs.

Author: Li Feng, Deputy Chief Physician, Dermatology Department, Putuo District Central Hospital

Editor: Tinker Bell

Title image source: iStock