6th year Medical student, SMAHS
UTG Medical Students’ Association
Exercise, an important part of a healthy lifestyle, promoted and held in high regard by people from all works of life, race, and background, across nations and in every continent of the world is actually a nightmare to some people who are allergic to it. These people develop sweat rashes during or after exercise, and though it’s not a medical emergency, it has some serious cosmetic consequences especially to young people who care so much about their looks and social image. This is especially troubling in cases where people are advised by a doctor to engage in exercises for some specific health reasons. It’s even more devastating to young men and woman who want to pursue their dreams by joining the army when they get rejected due to the development of sweat rashes in the course of exercise.
What is a rash and what are sweat rashes?
A rash is a reaction that occurs on the skin usually after the skin makes contact with an allergen (anything normally harmless but can provoke a response from the human immune system in some individuals).
Sweat rashes are rashes that appear on the body of some individuals most common on the face, chest, upper back and arm after excessive sweating from jogging or any exercise. It happens mostly when your skin cannot evaporate sweat with ease. Occurring, mostly in places of your body where your skin rubs against itself, like the armpits, back of your knees, between your legs, in the groin, and between and under the breast.
These rashes are often warm to touch, tingly and itchy.
Theory said that people who have this are said to be suffering from a disease called cholinergic urticaria.
People with this disorder are often mildly allergic to their own sweat. So, during exercise or any external heat which stimulates the body to produce sweat, the skin reacts to the sweat as an allergen and result in formation of rashes.
These rashes generally appear within minutes into exercise and often last between half an hour to an hour.
Heat rash is caused by a blockage and inflammation of sweat ducts in heat and high humidity.
It is common in newborn babies as their sweat glands haven’t developed properly yet. It can also happen in older children.
Who is at risk?
o People who are prone to intense sweating
o Those regularly involved in high and intense physical activity or exercise
o Those who take drugs that trigger sweating
o Eating food that you are allergic to before exercise.
Symptoms of exercise-induced urticaria/ cholinergic urticaria
Symptoms may occur during or after exercise. Common ones include:
o Hives.
o Itching of the skin.
o Flushing (redness) of the skin.
o Trouble breathing or a choking feeling.
o Stomach cramps.
o Headache.
o Swelling of the face, tongue, or hands
Diagnosis of exercise induced urticaria
It can be diagnosed based on history, an exercise challenge test, or a methacholine skin test.
Complications
Heat rash usually heals without scarring.
People with brown or Black skin are at risk of spots of skin that get lighter or darker in response to inflammatory skin conditions.
These changes usually go away within weeks or months.
A common complication is infection with bacteria, causing inflamed and itchy pustules
How to prevent sweat rashes
People who have severe cases may need to avoid exercise all together.
Other people may be able to exercise if they avoid triggers.
These can include certain types of exercise or foods.
Keep track of what you eat before you exercise.
If you notice a pattern to your symptoms, stop eating that food. If hives and symptoms also stop, tell your doctor. They probably will tell you to avoid the food. The doctor may tell you not to exercise for 4 to 6 hours after you eat.
Preventing exercise induced rashes or sweat rashes can be tricky especially for those going into the military training schools since they can’t do away with exercise at all.
The first line of defense is taking antihistamines either topical or oral. These antihistamines work by Inhibiting the body’s natural allergic response.
Taking or applying antibiotics before exercise can also help you keep moving without having the risk of developing rashes.
Taking temporal steroids can also help with the immune system.
Cool down to avoid sweating.
Try to avoid heat and humidity; stay in air conditioning or near a fan, and make sure there is good ventilation.
Keep the skin dry.
Try to wear loose cotton clothing which can help prevent you from overheating and making the itch worse.
Avoid fabrics which irritate your skin, like wool or scratchy fabrics.
A cool bath or shower may help provide short-term relief from any itching, but excessive showering or bathing should be avoided as this can reduce the natural oils that protect the skin and may make it worse.
