What To Know About Being Allergic to Water

You may wonder if anyone can be allergic to water—and the answer is yes. Also known as aquagenic urticaria (AU), water allergy presents as hives when your skin is exposed to water but not necessarily if you drink it. This type of allergy is one of many rare allergies; one study found that fewer than 100 cases have been reported.

Another condition, aquagenic pruritus (AP), can be related to aquagenic urticaria. In this case, the skin becomes itchy following contact with water at any temperature. Here's what you need to know about having a water allergy.

What Are the Symptoms?

People with a water allergy can experience the following symptoms:

• Burning, itching, or uncomfortable prickling of the skin, which are signs of AP
• Redness of the affected areas
• Wheals—areas of swelling—around 1 to 3 millimeters (mm) wide
• Wheezing or shortness of breath in rare cases

AU can take a little while to develop. Symptoms may appear within 20 to 30 minutes of water exposure and can take up to 60 minutes to resolve.

AP makes the skin itchy but doesn't result in any visual skin changes. Its symptoms occur quickly but may last longer. A person may experience itching between two and 15 minutes of exposure, which can take one to two hours to resolve.

What Causes Water Allergy?

Both aquagenic urticaria and pruritus have unknown causes, but there are theories about what plays a role in their development. For example, researchers have suggested that AP may be linked to histamine, the substance your body produces when it comes into contact with an allergen.

Other possible factors for AP include:

• Hepatitis C
• Lactose intolerance
• Polycythemia vera (PV)—a type of blood cancer

Histamine has also been suggested as a factor in aquagenic urticaria development. Additional causal factors may be related to genetics, environment, or both.

How Is It Diagnosed?

The diagnosis of a water allergy entails a healthcare provider asking about your symptoms, personal history, and family history. They may also do a physical exam and a water challenge test, which helps them determine if a person has a reaction to water.

Related Conditions

Aquagenic urticaria can present similarly to other types of urticaria—namely, cold and cholinergic urticarias. Cold urticaria occurs after exposure to cold or cold items, like ice, and cholinergic urticaria happens following exposure to sweat due to increased body temperature.

While the symptoms of all three conditions may be similar, cold and cholinergic urticaria are still different from aquagenic urticaria. The primary differences stem from the environmental triggers that cause them.

What Are the Treatments for Water Allergy?

Many of the treatments are the same for AP and urticaria. Other than attempting to avoid or limit exposure to water—which can be near impossible to do—treatments may include:

• Antihistamines—though they may only be helpful for some people with AP
• Antileukotrienes—medications that help individuals with asthma and, in some cases, those with allergies
• Barrier moisturizers containing ceramide
• Omalizumab—a type of medication that binds to antibodies released as a response to allergens
• Phototherapy, also known as light therapy
  

Prevention

Researchers haven't identified what can prevent water allergy. Although it may be possible to prevent flare-ups by avoiding water, that may not be feasible.

Complications

With either aspect of a water allergy comes potential complications. Other complications of AP can include:

• Decreased desire to bathe
• Insomnia
• Negative impact on normal activities due to severe itchiness
• Prurigo nodules and excoriations—hard, itchy bumps

Possible complications of AU may be similar to those from having urticaria in general. With urticaria, especially chronic urticaria, a person might experience:

• Anxiety, depression, or both
• Excoriations as the result of scratching the hives
• Sleep and daily activity disruption

In addition, any allergy may run the risk of anaphylaxis, or a very severe allergic reaction. These reactions require immediate medical care and may include symptoms like:

• Anxiety
• Chest tightness or discomfort
• Coughing, wheezing, or high-pitched breathing sounds
• Difficulty breathing
• Dizziness
• Eye, face, or tongue swelling
• Hives
• Nasal congestion
• Slurred speech
• Unconsciousness

Living With Being Allergic to Water

There doesn't appear to be a cure for water allergy, and determining the exact prognosis for individuals with a water allergy is difficult. Some researchers have posited that, for example, the prognosis for aquagenic urticaria may be varied following treatment.

While there is little research about the outcomes for people with water allergies, consulting with a healthcare provider can help determine the best treatment plan. People who are allergic to water may find that, with the right treatment plan, they have the chance to manage their symptoms better.