Q I get urticaria when I exercise. Should I just give up on exercise?
A Exercise-induced urticaria is often cholinergic urticaria, where rising body temperature and sweating stimulate mast cells. There is no need to completely give up exercise — a method of gradual adaptation with low-intensity, short-duration exercise is recommended. Taking an antihistamine 30 minutes before exercise may help with prevention.
Detailed Answer
Cholinergic urticaria occurs when body temperature rises more than 1°C and acetylcholine stimulates mast cells, causing small wheals to spread throughout the body. It occurs not only with exercise but also with hot food intake, bathing, and tension and excitement. For mild symptoms, desensitization training that gradually increases exercise intensity to build tolerance may be effective.
Korean Medicine Perspective
In Korean medicine, excessive sweating during exercise means the surface defense (表衛) becomes deficient, making it easy for external pathogens to invade. Okbyeongpung-san (玉屛風散) type prescriptions with Hwanggi (Astragalus), Bangpung (Ledebouriella), and Baekchul (Atractylodes) are suitable for exercise-induced urticaria constitution to strengthen surface qi (表氣). After exercise, immediately stabilizing body temperature and showering with warm water is recommended.
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