Aquagenic Pruritus

Aquatic pruritus is when contact with water makes your skin itch. You might itch after showering, being out in the rain or even sweating. It might also feel like stinging, tingling or burning. These sensations can be severe and distressing.

Aquagenic pruritus might feel like an allergy to water, but it’s not an allergic reaction. It doesn’t come with any other skin symptoms, like hives or a rash. It can start shortly after water contact and last for 10 minutes to two hours.

What causes aquagenic pruritus?

You can have aquagenic pruritus on its own. But sometimes, it’s a symptom of another health condition. The most common of these is polycythemia vera, a type of blood cancer. Other conditions associated with it may include:

• Hepatitis C
• Hypereosinophilic syndrome
• Myelodysplastic syndrome
• T-cell lymphoma

Rarely, certain medications can also cause aquagenic pruritus. These include antimalarial drugs and antidepressants (like bupropion and clomipramine).

Whether or not another condition causes it, experts aren’t sure why water makes some people itch. Some suggested root causes include the release of nervous system or immune system chemicals.

How do doctors diagnose aquagenic pruritus?

Healthcare providers diagnose aquagenic pruritus based on your symptoms. They might ask when you experience the itching and if anything helps it feel better. They might perform tests to rule out potential causes, like blood tests.

How is it treated?

Antihistamines are the most common treatment for aquagenic pruritus. But no single treatment works for everyone. Others that your healthcare provider may suggest include:

• Capsaicin creams or anti-itch creams
• Nerve pain medication like pregabalin
• Antidepressants
• Opioid antagonists like naltrexone
• Medications for cardiovascular issues, like propranolol or clonidine
• Phototherapy, a treatment that exposes your skin to ultraviolet light

If you have a health condition that’s causing the itching, treating that condition may help.

Other methods you could try include:

• Taking shorter baths or showers
• Using cooler water (to avoid scalding your skin)
• Moisturizing your skin immediately after bathing, while your skin is still damp

When should I see a healthcare provider?

Contact a healthcare provider if your skin itches, burns, stings or tingles after contact with water. Sometimes, it’s a sign of another health condition. Even if it’s not, itching can affect your physical and emotional health. A provider can help you find relief.