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