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Dr. Andrew Rynne

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Skin gets itchy post a shower, breakout on chest and legs, use bar soap. Any suggestions?

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Dr. Sujoy Khan

Allergist and Immunologist

Practicing since :1999

Answered : 584 Questions

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Posted on Thu, 23 May 2013 in Asthma and Allergy
Question: I have been having itchy skin problems for at least a couple years. When I get out of the shower, my skin is red and itchy, especially my arms, chest and legs. If I put lotion on, my skin breaks out immediately, but then it feels better later on. I have had issues with heat rash in the past, which leads me to believe that my skin is very sensitive to heat and moisture and my pores react badly if they are covered up my sunscreen or lotion. I normally use bar soap, so I thought it might be related to lye. However, I have used bar soap in the past and I don't remember it being a problem this much. Is it possible to cultivate a skin allergy that you never had before? Taking colder showers helps, and using softsoap may or may not help, hard to tell as of yet. Some other factors about my health that may or may not be relevant are that I have low iron content in my blood and I suspect I may have low blood sugar as well. Not sure if all of these fit together, or if they are separate. Any suggestions?
doctor
Answered by Dr. Sujoy Khan 1 hour later
Hello,

Welcome to Healthcare Magic and thank you for writing to us.

Your symptoms are suggestive of chronic urticaria, and triggers are: hot shower, aquagenic (water contact on skin, although rare), infection-related outbreaks or exacerbations of urticaria, autoimmunity (thyroid disorders).

Normal soap dries the skin and makes the skin itchy, when you itch the pressure triggers another attack or episode of urticaria. So better to use a moisturiser like Cetaphil soap/moisturiser or Aloe vera based after a bath. Cold helps relieve the symptoms as it dampens the effect of histamine. This is the chemical that gets released in urticaria and therefore antihistamines help.

Low iron levels do not help as urticarial eruptions tend to be more frequent in those with iron deficiency anaemia, although the mechanism remains uncertain. So if the levels are very low, I would suggest taking a 3-month iron supplementation.

The following are extended 'urticaria panel of blood tests':
1. Complete blood count MCV
2. Liver function tests
3. Antinuclear antibody screen
4. C3 C4 levels
5. IgE and any specific IgE if history is suggestive
6. 25OH D3 levels
7. TSH fT4
8. Anti-TPO and anti-TG
9. Fasting blood glucose
10. Fasting cholesterol profile

Long-acting antihistamines for a 3 month duration is required, after which another evaluation is done to see if stopping the antihistamine medications have led to a resolution of this condition.

I hope that was useful.
Best Wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sujoy Khan 41 minutes later
Great, thank you so much for your help!!!
doctor
Answered by Dr. Sujoy Khan 32 minutes later
You are most welcome.
Glad to be of help.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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