Can You Be Allergic to Water? (Aquagenic Urticaria)

What is it:

Being allergic to water is a rare condition in which the skin becomes red, patchy and irritated when in contact with water. It can occur with water at any temperature and matter state. People with these conditions generally present with symptoms after coming on contact with any type of water (ocean water, pool water, sweat, and even filtered water). 

This type of allergy is medically referred to as aquagenic urticaria. It is most commonly noted in women, and the first signs typically present in adolescence. 

The underlying cause of this disease is not fully known, and therefore there is no cure available. However, a dermatologist can prescribe methods like UV ray therapy and antihistamines to relieve associated discomfort. 

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Main symptoms

Patients who are allergic to water will typically present with symptoms like:

  • Red rashes that emerge after being in contact with water
  • Itchiness and burning sensation of the skin 
  • Raised bumps on the skin without redness

Normally, these signs emerge around the head, neck, arms and chest, but they can spread to the whole body, depending on the area that was in contact with water. These rashes tend to disappear 30 to 60 minutes after drying off from water. 

In serious situations, this type of allergy can cause anaphylactic shock with symptoms like shortness of breath, wheezing, a swollen throat or a swollen face. If you notice these symptoms, you should go immediately to the hospital to start treatment and prevent respiratory failure. 

Confirming a diagnosis

A water allergy should be confirmed by a dermatologist, who will assess the patient's health history and presenting symptoms to reach a diagnosis.  

Testing may be needed to identify whether the rashes are indeed caused by water. To do so, the dermatologist may soak a cotton ball in water and stroke the skin on the chest to observe the skin reaction. 

Possible causes

Although the underlying causes of water allergies are not fully understood, scientists believe that there are two theories to explain this phenomenon. The first is that the allergy is triggered by substances that are dissolved in the water. These substances enter the body through the skin's pores and cause an exaggerated immune response. 

The second theory states that the allergy emerges when the water comes in contact with the skin to create a toxic substance that leads to rashes. 

Learn about the other possible causes of red spots on the skin and how they can be treated.

Treatment options

Although there is no cure for a water allergy, the dermatologist may prescribe interventions to relieve discomfort: 

  • Anti-histamines, like cetirizine or hydroxyzine: these reduce histamine levels in the body. Histamine is responsible for allergy symptoms, and antihistamine can help to reduce their intensity. 
  • Anticholinergics, like scopolamine: these also help to reduce symptoms when taken before exposure. 
  • Barrier creams or oils: These are indicated for those who exercise or require contact with water for work. They can be applied before exposure to relieve discomfort. 

In more serious cases, patients may experience symptoms of anaphylactic shock. This condition requires treatment with epinephrine, and patients with frequently intense symptoms will typically be prescribed an epi pen to carry for emergencies. 

Preventing flare-ups

The best way to prevent a water allergy is to simply avoid contact with water, however this is not always possible, as water is needed for hygiene and hydration. 

Some considerations that may help include: 

  • Avoid swimming in the ocean or in a pool
  • Take only 1 to 2 showers per week, for less than a minute 
  • Avoid physical exercise, as it may cause intense sweating
  • Drink water using a straw, to avoid lip contact 

You can also apply moisturizing creams to the skin, as well as sweet almond oil or petroleum jelly to relieve symptoms and as an added barrier, so that that your skin is protected from water. This may especially be useful on rainy days, or when it is difficult to avoid total contact with water.