Is Being Allergic To Water A Real Possibility? Causes, Symptoms, Treatment

Can someone be allergic to water? Surprisingly, the answer is yes. This rare condition, known as aquagenic urticaria (AU), manifests as hives when the skin comes into contact with water. Notably, drinking water does not trigger this reaction. Another related condition, aquagenic pruritus (AP), causes intense itching upon water contact. Here's what you need to know about these unusual allergies.

Symptoms of water allergy

Individuals with aquagenic urticaria may experience:

Burning, itching, or prickling of the skin, indicative of AP

Redness in the affected areas

Wheals, or small areas of swelling, typically 1 to 3 millimeters wide

Wheezing or shortness of breath in rare cases

Symptoms of AU usually appear within 20 to 30 minutes of water exposure and can take up to an hour to subside. In contrast, AP does not produce visible skin changes but causes itching shortly after water contact, which can persist for up to two hours.

Causes of water allergy

The exact causes of both AU and AP remain unknown. However, researchers suggest several potential factors. Histamine, a chemical released during allergic reactions, may play a role in AP. Other possible contributors include:

Hepatitis C

Lactose intolerance

Polycythemia vera (PV), a type of blood cancer

Genetic and environmental factors might also contribute to the development of aquagenic urticaria.

Diagnosis and related conditions

Diagnosing a water allergy involves a healthcare provider assessing your symptoms, personal and family medical history, and performing a physical exam. A water challenge test, where the skin is exposed to water to observe any reactions, can confirm the diagnosis.

Aquagenic urticaria can be confused with other types of urticaria, such as cold and cholinergic urticaria. Cold urticaria occurs after exposure to cold temperatures, while cholinergic urticaria is triggered by sweat from increased body temperature. Despite similar symptoms, these conditions differ primarily in their environmental triggers.

Treatment options

Managing a water allergy can be challenging, as avoiding water is nearly impossible. Treatments may include:

Antihistamines, though they may only be effective for some with AP

Antileukotrienes, medications also used for asthma

Barrier moisturizers containing ceramide

Omalizumab, a medication that targets allergic antibodies

Phototherapy, also known as light therapy

Prevention and complications

There is currently no known way to prevent water allergies. However, minimizing water exposure may help prevent flare-ups, though this is not always practical.

Complications from water allergies can include:

Reduced desire to batheInsomnia

Interference with daily activities due to severe itchiness

Development of prurigo nodules and excoriations, which are hard, itchy bumps

Aquagenic urticaria and pruritus, though rare, highlight the complex and varied nature of allergic reactions. If you suspect you have a water allergy, consulting with a healthcare professional is essential for proper diagnosis and management.