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Getting rashes on forehead from heat. Suffering from seasonal allergies, eczema, and dermographism. Any treatment?

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Dermatologist
Practicing since : 1996
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Hello,

I get a blotchy rash on my forehead from hot showers, heat, hot sun and anxiety. It does not itch or burn and it's slightly raised. The rash goes away in about a 1/2 hour after I cool down. I also get a rash on my forehead when I sweat. The rash is sometimes at the top of my hairline and there will be some small red blotches on my scalp.

I suffer from seasonal allergies, occasional eczema, and dermographism.

Do you think this rash is related to my allergies? I have attached some pictures to this query.

Thank you, XXXXXXX
Posted Wed, 29 Aug 2012 in Skin Rash
 
 
Answered by Dr. Bharat Chawda 1 hour later
Hi!,

Thank you for posting the query,

You have provided with good information regarding your health concern and it is a very good description. I appreciate it.

The condition what you have described is known as CHOLINERGIC URTICARIA .It typically manifests as red raised patches on body or face especially following heavy exercise,sweating ,emotional stress ,spicy foods,heat ,hot shower etc. It may remain for couple of hours and then subside .And it is definitely a part of your seasonal allergy & dermographism.

You can take any anti histaminics like cetrizine ,loratidine etc to reduce you problem ,but the most important thing would be to look for the precipitating factor and avoidance of the same,like heavy exercise, any activity that causes sweating, such as elevated environmental temperature, hot food, sauna baths, immersion in hot water, gustatory stimuli, emotional stress etc.

You should also wear light cotton clothes which would allow the sweat to evaporate faster.You can try modify your diet too as cholinergic urticaria attacks can sometimes result from hot foods and beverages, highly spiced foods, and alcohol.Rapid cooling helps good in conditions where heat and sweat is a factor.

Hope I've answered your query.

Should you have additional concern regarding the same ,I would be happy to address it.

Please accept my answer in case you do not have further queries.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
Follow-up: Getting rashes on forehead from heat. Suffering from seasonal allergies, eczema, and dermographism. Any treatment? 2 minutes later
Hello Dr. Chawda,

Thank you for your fast response- I really appreciate it! So my pictures look like CHOLINERGIC URTICARIA? Doesn't CHOLINERGIC URTICARIA usually itch? Is that a form of hives?

Thank you again!! XXXXXXX
 
 
Answered by Dr. Bharat Chawda 12 minutes later
Hi! XXXXXXX

Thank you for writing back,

Yes its a form of hives and it usually itches ,but not necessarily. Going through the precipitating factors you have and the pictures it does seems to be cholinergic urticaria.

Other conditions which manifests as redness on face and which aggravates on stress is Rosacea .But Rosacea would not subside on its own in half an hour.Its only urticaria which can subside so fast .

I would also advise you to consult a dermatologist for his clinical view and proper prescription.

Hope this answers your query.

Wish you good health.

Regards,

Dr.Bharat chawda XXXXXXX specialist, Dermatology.

Above answer was peer-reviewed by
 
Follow-up: Getting rashes on forehead from heat. Suffering from seasonal allergies, eczema, and dermographism. Any treatment? 1 minute later
Thank you for your followup. It doesn't look like rosacea, does it?
 
 
Answered by Dr. Bharat Chawda 7 hours later
Hi! ,

Thank you for writing back,

No it doesn't look like rosacea at all.In rosacea lesions are not raised & they usually persists for long.

Hope this answers your query.

Wish you good health.

Regards,

Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
Follow-up: Getting rashes on forehead from heat. Suffering from seasonal allergies, eczema, and dermographism. Any treatment? 4 hours later
Thank you for your reply.

My face tends to get very red after exercise as well and I have read that can be from having physical allergies (cholergenic urticaria). Is that correct? Although my mom does not have allergies and she gets very red with exercise, sun, heat, etc. but does not get any rashes.

My cheeks do have some blotchy redness in areas that does not go away- that's why I asked if my forehead looks like rosacea. I have not been to a dermatologist recently but when I went a few months ago, my doctor said that the redness is probably from allergies.

If I lie on my side, my cheek and neck will look red/blotchy (dermographism?). And like the pictures show, I get a rash on my forehead from hot showers, sweat, heat.

It's been quite a mystery for me to figure my skin out but I am grateful for this site as the doctors have been very helpful.

I want to add that I broke out in hives on my face after drinking alcohol and being in the hot sun a couple of weeks ago. I will attach the picture to this query.

Is is possible that my allergies could be causing any of the blotchiness o n my cheeks?

Thanks again,
 
 
Answered by Dr. Bharat Chawda 35 hours later
Hi!,

Thank you for writing back,

I went through the pictures you have posted.

You have few symptoms of rosacea too,but still I would like to call it as cholinergic urticaria since features are more in favor of that.What I observed in the last picture is that the red patches are slightly raised over the lower jaw area,which again favors urticaria.

Cholinergic urticaria is definitely a part of your allergy.

Since you have a persisting redness on cheeks ,there is a possibility that you have both urticaria and rosacea (especially on cheeks) ,since few of the precipitating factors are common in both the conditions.

Similarly alcohol & sunlight can be a precipitating factor in both the condition.

Treatment in such a case would keeping in mind both the conditions.

Start using a broad band sunscreen daily at-least three times a day.If the redness on the cheeks is persisting then you can use tacrolimus cream (0.03%) over the patch.But such creams are prescription based creams ,so you need to consult a dermatologist for the same.

You should avoid direct sunlight as much as possible & also avoid other precipitating factors.

Other treatment aspects would remain same as I had discussed earlier in the post.

Wish you good health.

Regards,

Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
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