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Dermatographia
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/Dermatographia/DS00755
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Definition
Dermatographia is a condition in which lightly scratching your skin causes raised, red lines where you've scratched. It's not serious, but it can be uncomfortable. In dermatographia, your skin cells are overly sensitive to minor injury, such as scratching or pressing on your skin. Signs and symptoms of dermatographia include redness, itching and swelling similar to hives.
In most cases, dermatographia symptoms go away in a short time without treatment. But if symptoms are severe or bothersome, your doctor may suggest taking antihistamines. Simple self-care measures also can help you manage dermatographia.
Symptoms
Other than raised red lines on your skin, dermatographia often causes no problems. In some people, however, scratching or rubbing the skin may cause uncomfortable irritation.
Signs and symptoms of dermatographia may include:
- Raised red lines
- Swelling
- Inflammation
- Hive-like welts
- Itching
Simple things can trigger symptoms of dermatographia. For example, rubbing from your clothes or bedsheets may irritate your skin. Cold, heat, pressure, sunlight and emotion also can trigger dermatographia.
You may notice symptoms of dermatographia within a few minutes of your skin being rubbed or scratched. The symptoms may last 30 minutes to a couple of hours, but typically begin to diminish within 15 minutes after the irritation to your skin ends. Rarely, dermatographia develops slowly and lasts several hours to several days and causes burning and pain.
The condition itself can last for months or years.
When to see a doctor
See your doctor if you have signs of dermatographia, such as skin redness and swelling, that recur frequently or don't go away on their own. If your symptoms are severe and very uncomfortable, you may need treatment.
Causes
The exact cause of dermatographia isn't clear. It may be caused by an allergic response, yet no specific allergen has been identified.
Risk factors
Factors that may increase your risk of dermatographia include:
- Age. Dermatographia can occur at any age, but it tends to be more common in young adults in their 20s and 30s.
- Other skin conditions. If you have other skin conditions, such as dry skin or dermatitis, you may be more susceptible to dermatographia. Any skin condition that causes a frequent urge to scratch may increase your risk.
- Allergies. If you have a history of allergies, you may be more prone to developing dermatographia. The same immune system response that causes other allergies may also cause dermatographia.
- Heredity. As with other allergies, dermatographia may run in families.
Complications
Dermatographia generally is harmless. It leaves no lasting marks and often causes only minor symptoms.
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a doctor who specializes in skin conditions (dermatologist) or one who specializes in allergies (allergist).
Here's some information to help you prepare for your appointment.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as not take antihistamines for several days beforehand.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, vitamins or supplements you're taking.
- Write down questions to ask your doctor.
Preparing a list of questions for your doctor will help you make the most of your time together. List your questions from most important to least important. For dermatographia, some basic questions to ask your doctor include:
- What is likely causing my symptoms or condition?
- Other than the most likely cause, what are other possible causes for my symptoms or condition?
- What kinds of tests do I need?
- Is my condition likely temporary or chronic?
- What is the best course of action?
- What are the alternatives to the primary approach you're suggesting?
- I have these other health conditions. How can I best manage them together?
- Are there restrictions I need to make?
- Should I see a specialist?
- Is there a generic alternative to the medicine you're prescribing?
- Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- When did you begin experiencing symptoms?
- Were your symptoms preceded by an illness or a new medication?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- Do your symptoms cause you to restrict your activities or interfere with your lifestyle?
- Do you have allergies? To what?
- Do you have dry skin or any other skin conditions?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
What you can do in the meantime
Keep your skin moisturized and try not to scratch.
Tests and diagnosis
Your doctor can diagnose dermatographia with a simple test. He or she will draw a tongue depressor across the skin of your arm or back. If a red, swollen line or a welt (wheal) appears within a few minutes, you may have dermatographia.
To help find out what's causing your dermatographia, your doctor may ask you to keep a detailed diary of exposure to possible allergens over a period of two weeks to a month and a record of when dermatographia signs occur. Your doctor may also recommend skin testing for allergies.
Because dermatographia may be triggered by many things and because it can be aggravated by stress and other emotions, it's sometimes difficult — even impossible — to determine the cause.
Treatments and drugs
Symptoms of dermatographia usually go away on their own, and treatment for dermatographia generally isn't necessary. However, if the condition is severe or bothersome, your doctor may recommend antihistamine medications.
Antihistamines
Your doctor may recommend antihistamine medications. These drugs block histamine, an inflammatory chemical released by your immune system during an allergic reaction. A low dose of antihistamine usually provides relief at the time of the reaction. There are numerous antihistamines, some prescription and some over-the-counter. No one antihistamine works for everyone, and your doctor may need to prescribe a combination of antihistamines to manage your condition. You might need to take medication on a regular basis if your symptoms are severe.
Prevention
To reduce discomfort and prevent the symptoms of dermatographia, try these tips:
- Avoid possible triggers. If you know you're allergic to certain things, avoid them as best you can. They may be increasing your risk of dermatographia.
- Avoid irritating your skin. Refrain from using harsh soaps on your skin. Don't wear clothing made of itchy material, such as wool. Limit your sun exposure. Avoid any irritants that may make your skin prone to itching and discomfort. Hot showers or baths may worsen the symptoms.
- Don't scratch your skin. If you have dermatographia or other skin conditions that may cause frequent itching, try to avoid scratching your skin. Scratching will aggravate the condition.
- Keep your skin moisturized. Dry skin tends to make skin itchy. Keep your skin moisturized by using lotions and creams. Keep yourself hydrated by drinking plenty of water.
- Dice JP, et al. Physical urticarias. http://www.uptodate.com/home/index.html. Accessed April 8, 2010.
- Urticaria — Hives. American Academy of Dermatology. http://www.aad.org/public/Publications/pamphlets/Urticaria-Hives.htm. Accessed April 25, 2010.
- Bhute D, et al. Dermatographism. Indian Journal of Dermatology, Vereology and Leprology. 2008;74:177.
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