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Have a dry sensitive skin with urticaria and black spots. How to treat ultra sensitiveness of the skin?

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Practicing since : 2005
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My skin behaves differently in various surrounding conditions. I have a dry sensitive skin with known cholinergic urticaria, my skin is so sensitive that if i apply more than expected pressure/ scratch it turns red intially and later it turns black and the black spot remains for months. This has given very uneven tone alongwith spots without acnes

My question is
a) I have noticed that my skin behaves differently to dry climate. It loves the humid weather as it tends to remove the dryness by perspiration, but as soon as I get into dry environment it does not know how to adjust. The same holds true for my hair, they are very brittle, dry without any moisture content and these also behave differently in surroundings. So please share your thoughts on why this happen and how I can manage my skin in dry climate by keeping it humid??

b) How to manage the second condition i.e ultra sensitiveness of the skin.
Posted Mon, 25 Feb 2013 in Skin Hair and Nails
Answered by Dr. Sudarshan 23 hours later
Thanks for writing in.
I understand your problem of sensitive skin.
There are many aspects of management
1. Maintain strict photoprotection while outside and inside of home.Use good quality sunscreen (SPF50)and maintain physical protection against sun regularly.
2.Use good quality non comedogenic moisturizer cream like cetaphil moisturizing cream.moisturization daily at night time is very important forr maintenance of sensitive skin.It protects and hydrates your cream.You can also use glycerin based moisturizer with 15% glycerin cream.
3.Also use a soap free cleaning solution for face wash.cetaphil oily skin cleanser or episoft cleanser is very good for acne prone skin.
4.Take oral antioxidants containing beta carotene and lycopene.They build the skin integrity and protect against aging and photodamage.
5.Take biotin 5mg supplement one per day for atleast 3 months it will help in both skin and hair strengthening.
6.Some procedure like lactic and kojic acid chemical peel will help in acne pigmentation a lot.
They will improve the texture and skin tone.
Hope this helps.
I will be available for follow up .
Dr Sudarshan
MD dermatologist

Above answer was peer-reviewed by
Follow-up: Have a dry sensitive skin with urticaria and black spots. How to treat ultra sensitiveness of the skin? 2 days later

Thanks so much for your reply. I am a cholinergic urticaria patient too and really fed up with it. On wikipedia I have found this in the possible treatment options for cholinergic urticaria

a)Proposed first-line treatment: Rapid desensitization protocol using autologous sweat
b)Non-pharmacological treatment: Forced perspiration by excessive body warming (hot bath or exercise) used daily may reduce the symptoms of prickling pain through exhaustion of inflammatory mediators.Contraindicated in those with CU as a result of hypohidrosis
c)Antihistamines are a commonly prescribed first-line treatment for conventional urticaria, but its effectiveness in the treatment of CU is rather limited in most cases.
d)Treatment(s) with mixed success: omalizumab (anti-igE therapy), danazol (synthetic androgen), propranolol (beta blocker)

I am curretnly using anti histamines(Zyrtec) but its not that much effecyive I would say in last one month or so the effectiveness rate is somewhere around 50%.

My concern is regarding points a) and d) of the treatment.
So for point (a)
I am currently in UK and not able to find any dermatology consultant who provides me the desensitisation option, I am going to be in india in the month of July, could you please tell me whether any dermatologists provided this treatment in india. I am going to be in Mumbai, so if you can recommend me some dermatologists it would help me immensely

For point (b)
At the moment as i dont see myself getting solution (a) I am thinking of trying danazol and propanolol . I will first take chance with danazol as it seems to have high anti-cholinergic material. I know about the long term side effects for both these drugs, but would it be possible for me to try it for a couple of months just to see whether my urticria are responding to this treatment or not. Your thoughts would help me in deciding better.
Answered by Dr. Sudarshan 9 hours later
Hi again XXXXXXX
The option A is infact experimental treatment and its not available even in india.
we here give danazol as a treatment option only on severe resistant cases.
Usual treatment line is to use antihistamines with escalating dosage.
You can use better antihistamines like fexofenadine (180) twice to thrice daily.
It is more effective than zyrtec and is non sedating and safe.
Danazol is a potent drug with side effects and treatment has to be monitored strictly.
Hope this helps.
I will be available for follow up.
Regards .
Above answer was peer-reviewed by
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