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EspañolDermatographia symptoms: What are the early signs of dermatographia?
Overview: What does dermatographia look and feel like?
Dermatographia (or dermatographic urticaria) is a harmless skin condition. It is the most common form of physical urticaria, or hives that break out due to physical causes such as heat or sweating. For dermatographism, reactions are provoked by rubbing, friction, or other pressure on the skin. Even bedclothes, belts, towels, or bracelets can provoke a reaction.
The word “dermatographia” means “skin writing” because the redness and raised bumps (wheals) take the form of a skin disturbance. For instance, if someone runs a fingernail over the skin, in a few minutes, the scratched area will turn into a red line and then become a raised welt. Most people have no other symptoms, but in some cases, the affected skin might itch. The skin returns to normal in about 30 minutes.
Dermatographia usually affects the skin on the torso, arms, and legs, but could affect skin anywhere on the body. The skin on the scalp and the genitals is rarely affected.
Key takeaways:
Dermatographia is a common health condition that can affect anyone regardless of age, sex, race, or ethnicity.
Early signs of dermatographia include skin redness followed by raised wheals.
Dermatographia does not require immediate medical attention.
Dermatographia reactions are induced by pressure, friction, scratching, or disturbing the skin. The cause of dermatographism is unknown. You may be at risk for developing dermatographia symptoms if you are a teen, young adult, or female. Other risk factors include stressful events, dry skin, scabies, dermatitis, and penicillin treatment.
Dermatographia is usually self-diagnosable.
Dermatographia generally does not require treatment. Dermatographia symptoms typically resolve without treatment in 15 to 30 minutes.
Treatment of dermatographia may include over-the-counter antihistamines, moisturizers, vitamin C, light therapy, or prescription drugs. Read more about hives treatments here.
Untreated dermatographia does not have health complications.
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What are the early signs of dermatographia?
The earliest sign of dermatographia is skin redness. This usually occurs about five minutes after a small traumato of the skin, like scratching, rubbing, friction, or pressure. Skin redness is usually followed by a welt within the red area.
Other dermatographia symptoms
The symptoms of dermatographia are:
Skin redness
Welts (raised skin areas in the form of lines or nodules)
Skin warmth
Itching (pruritus)
Burning sensation (rare)
These symptoms typically begin five to 10 minutes after the skin has been mildly disturbed by scratching, rubbing, or other pressure. The welts fade in 15 to 30 minutes. In rare cases, they may persist for hours or days.
Dermatographia vs. hives
Dermatographia is a type of hive, but it is very distinct in its appearance and causes. It’s also a long-term condition. Once symptoms first appear, people are vulnerable to dermatographia reactions for five to 10 years. What distinguishes dermatographia from other types of hives are the cause, appearance, itchiness, and duration of the welts:
Cause
Dermatographia is specifically caused by skin irritation, while other hives breakouts are due to allergens, insect bites, poisonous plants, stress, autoimmune disorders, sweating, or heat.
Appearance
Dermatographia welts take the shape of whatever has disturbed the skin. One can write one’s name on the skin with a fingernail and see the name written out in red lines or welts in a few minutes. Other forms of urticaria usually produce round raised welts, either a single one in case of a bug bite or a bunch of them clustered together.
Itchiness
Itchy skin is a very common symptom of most hives reactions. However, only a minority of people with dermatographia get itchy skin in addition to the redness and welts.
Duration
An outbreak of hives usually lasts a few days to a couple of weeks. Dermatographism episodes usually last 30 minutes but rarely go on longer than an hour.
RELATED: Hives treatments and medications
Types of dermatographia: How can I tell which one I have?
Healthcare providers distinguish between two major types of dermatographia:
Asymptomatic dermatographia does not cause itching or other pain, only skin redness and welts—this is the most common type of dermatographia that people experience
Symptomatic dermatographia causes itching or worse, such as pain or a burning sensation
In general, healthcare professionals don’t worry about asymptomatic dermatographia. If they advise treatment, it will be self-treatment with preventive measures and over-the-counter antihistamines. However, symptomatic dermatographia may require treatment, particularly in severe cases.
Three subtypes of dermatographia differ from standard dermatographia in appearance or onset:
Follicular dermographism causes skin redness and small raised bumps on the affected skin
Cholinergic dermographism produces red-colored raised areas where the skin has been disturbed
Delayed dermatographism doesn’t have skin symptoms until three to eight hours after the skin has been disturbed; these skin symptoms can last up to two days
When to see a doctor for dermatographia symptoms
Dermatographia is usually a harmless condition that lasts for about 15 to 30 minutes. Medical help is not needed unless there’s itching that affects sleep or daily life. If dermatographia involves pain, a burning sensation, or prolonged itching, see a doctor to get relief. Emergency medical treatment is not necessary.
A healthcare professional will diagnose dermatographia based on the symptoms and medical history. Most people will see a primary care provider, but the clinician may refer the case to a specialist in skin diseases called a dermatologist or a specialist in allergies called an allergist.
The clinician will probably try to induce a reaction by rubbing a tongue depressor along the skin on the arm or back and waiting for skin redness and welts to appear. An allergist may perform allergy skin tests to identify possible allergens.
Complications of dermatographia
Dermatographia does not have clinical complications. However, severe dermatographia that causes burning or prolonged itching reduces a person’s quality of life and could interfere with sleep.
How to treat dermatographia symptoms
Most people with dermatographia do not need treatment if the only symptoms are skin redness and welts. In those cases, avoiding skin irritation is usually the most effective treatment, along with good skin care and moisturizers.
People with minor itching can self-treat at home with anti-itch creams or over-the-counter non-drowsy antihistamines such as fexofenadine to provide symptom relief. Antihistamines block the effects of histamines, the substances that cause swelling, redness, and itching.
If medical help is needed, the standard treatments are avoiding skin irritation and using over-the-counter antihistamines to relieve symptoms. The clinician may also advise taking vitamin C supplements daily. Vitamin C is believed to help the body eliminate histamines more quickly.
A doctor may prescribe cromolyn if there’s evidence that allergies are involved. Cromolyn shuts down mast cells, the cells responsible for producing histamines and other substances that cause allergic reactions or skin reactions.
For people whose symptoms prevent them from sleeping, the clinician may prescribe a bedtime dose of the antihistamine hydroxyzine to both relieve skin symptoms and induce drowsiness.
In severe cases that aren’t helped with antihistamines, alternative treatment options include:
Light therapy
Light therapy involves regular doses of ultraviolet B light exposure several times a week for several weeks. One study has shown light therapy produces total remission, but the remission lasts only a few months.
Biologic drugs
Commonly used to treat severe cases of hives, omalizumab is a synthetic IgE antibody that prevents immune system cells from launching an immune response. In severe cases of dermatographia where antihistamines don’t work, omalizumab injections have been shown to completely prevent or at least reduce the incidence of dermatographia reactions.
RELATED: Allegra vs. Claritin: Differences, similarities, and which one is better for you
Living with dermatographia
Dermatographia often goes away in a few years, but some people may experience outbreaks all their lives. Since dermatographia is a chronic condition, the most effective way to handle it is to prevent skin irritation. Here are a few tips:
Reduce stress—although stress does not bring on a reaction, it can worsen it
Avoid overheating—overheating also aggravates dermatographia
Wear loose clothing
Avoid tight belts—dermatographia reactions commonly occur around the belt area
Avoid wristwatches and bracelets
Make sure bedding is loose when sleeping
Above all, avoid scratching. Not scratching the skin is universally considered the most important medical advice for anyone with itchy skin. Since dry skin is one of the most common reasons people scratch, good skin care is one of the most effective ways to prevent scratching:
Regularly use moisturizing lotions or creams, especially after showering or bathing
Use allergen-free, mild soaps
Do not take hot showers or baths
Do not stay in the water for too long
Use a humidifier
When skin is itchy, apply an ice pack or cold, wet cloth to the affected skin instead of scratching. Other alternatives include applying a topical anesthetic, menthol, or calamine to the itchy skin. Refrigerated moisturizing lotion is also effective.
Most importantly, don’t worry
Dermatographia can be startling the first couple of times it happens, but don’t worry. It clears up on its own in a short time and does little more than alter the appearance of the skin. There are exceptions, though. Some people will have itchy skin or worse during a reaction. Symptoms may last for several hours or even a couple of days. In most cases, these outbreaks can be effectively managed with OTC antihistamines just like any other mild skin or allergic reaction.
What’s next? Additional resources for people with dermatographia symptoms
Test and diagnostics
Dermatographia (dermatographism) diagnosis and treatment, Mayo Clinic
Dermatographism, StatPearls
Treatments
Dermatographism, American Osteopathic College of Dermatology (AOCD)
Dermatographism, StatPearls
Hives treatments and medications, SingleCare
Omalizumab, StatPearls
Scientific studies and clinical trials
Narrowband ultraviolet B phototherapy is beneficial in antihistamine-resistant symptomatic dermographism: a pilot study, Journal of the American Academy of Dermatology
Omalizumab is effective in symptomatic dermographism—results of a randomized placebo-controlled trial, The Journal of Allergy and Clinical Immunology