Dermatographia – Causes, Symptoms, Treatment, Diagnosis and Prevention

What is Dermatographia?

Dermatographia, also known as skin writing, is a skin disorder where light scratching of the skin creates red bruises. When people with dermatographia scratch their skin lightly, the scratches turn into a raised wound that looks like Cholinergic Urticaria (hives). These marks usually disappear within 30 minutes. This illness affects about 5% of the population, with older children and adults most affected.

Although the symptoms do not last long, there is no cure for this illness. In rare cases, a dermatologist will have to provide medical treatment.

What are the symptoms of dermatographia?

Dermatographia symptoms appear mostly when the skin is scratched. These signs and symptoms might develop suddenly and without notice. The following are some of the signs and symptoms of dermatographia: 

• Redness 
• Raised marks on the skin 
• Bruises that resemble hives 
• Itchiness 
• Inflammation or swelling 
• Extreme temperatures and dry weather might worsen the symptoms, which can persist for about 30 minutes to a day or more.

Consult a doctor if the signs and symptoms are very severe.

What are the causes of dermatographia?

Though the exact causes of dermatographia are not known, the conditions that can trigger them include:

• Allergies
• History of stress 
• Excessive irritation from clothing  
• Infections 
• Antibiotics, such as penicillin 
• Excessive rubbing of the skin

Is dermatographia caused by stress? 

Dermatographia may get aggravated or caused due to stress. It is best to reduce the stress, which may assist you in preventing dermatographia flare-ups. Following are some of the tips that may help you reduce stress: 

• Take a deep breath and count till 10
• Get eight hours of sleep every night
• Eat healthily and drink caffeine and alcohol in moderation
• Try exercising daily
• Have a positive attitude
• Keep a journal and write in it daily
• Talk to your friends, family, and a therapist about your life

Dermatographia may be an autoimmune disease.

If you experience dermatographia, it could be an autoimmune disease. Several healthcare providers and medical researchers believe it may be an inappropriate response from your immune system to regard a scratch or pressure as an allergen. Thus, sending chemical histamine to fight and remove the allergen from your body.

When to see a doctor?

If you have a history of developing hives, you should consult a doctor or a dermatologist.

Before meeting any doctor, it is essential to record in the journal skin outbreaks and disturbances, also include the following:

• Clothing worn
• List of food and drinks consumed
• Environmental factors

It helps the doctor to diagnose the condition and identify any potential triggers accurately. The doctor may also conduct a physical examination and look into your personal and family medical history in detail. 

As a standard practice, if the doctor suspects dermatographia, they may replicate potential triggers by scratching your skin with a tongue depressor. The doctor may also use a dermagraphometer to measure the skin’s response to external pressure.

What are the possible risk factors associated with dermatographia? 

You are more likely to develop dermatographia:

• If you have a dry complexion
• If you are a young adult with a history of dermatitis (skin irritation)
• If you scratch your skin regularly
• If you have thyroid problems
• If you have itchy skin as a result of a nerve disorder or an interior condition

How is dermatographia diagnosed and treated?

Diagnosis

Doctors can diagnose dermatographia with a simple test by drawing the tongue depressor across the skin of your arm or back to check if a swollen line, red, or welt (wheal) appears within a few minutes.

Treatment:

Conventional treatment: 

The doctor may prescribe anti-histamines to stop that body from producing histamine. However, loratadine or fexofenadine are some anti-histamines that take time to show results. You can also find over-the-counter medications, such as diphenhydramine and cetirizine, which may cause drowsiness. If you consume an anti-histamine regularly, you may prevent the onset of dermatographia.

However, in severe cases, your doctor may recommend phototherapy. It is one of the many outpatient radiation therapies for various skin disorders and psoriasis.

Alternative treatment:

If conventional treatment fails, you can opt for an alternative treatment option that provides relief from skin hives. These are applied directly to the skin. You can use ingredients such as:

• Oatmeal
• Tea tree oil
• Aloe vera
• Bran rice broth

The National Center for Complementary and Integrative Health (NCCIH) reveals that the following treatments and remedies lack evidence of effectiveness. 

• Borage oil
• Fish oil
• Multivitamins
• Primrose oil
• Vitamin B-6, B-12, D & E

Acupuncture is another alternative medicine that does not have evidence to prove its effectiveness.

Lifestyle Therapies :

Stress can be one of the contributing factors to dermatographia. Therefore, practising yoga and meditation using deep breathing techniques and regular exercises boost endorphins and reduces stress. According to the NCCIH, children with this condition find relaxation techniques the most beneficial. However, if lifestyle changes fail to decrease stress and improve the symptoms, you may need expert medical advice.

Trigger avoidance :

Avoiding triggers that result in dermatographia is one of the best ways to treat the condition. Specific lifestyle changes can help you improve your health and decrease symptoms naturally. 

Keeping a journal to write down the triggers helps in avoiding them. The common triggers are as follows:

• Dry Skin: It is the most common trigger. You can easily avoid it when you use non-drying soaps, detergents, non-irritating emollients, and other skincare products.  
• Trauma: No more scratching or rubbing the skin; opt for loose-fitting clothes, including undergarments.
• Temperature: for some, temperature triggers hives. If you are one of them, avoid time in heat or cold. If heat is the trigger, avoiding extremely hot temperatures during baths is best. 
• Fabrics: Clothes made from wool and synthetic fibres scratch the skin, thus triggering dermatographia. Therefore, choose less irritating fabrics such as cotton and linen.
• Diet: Include food rich in anti-inflammatory to witness improvements in the symptoms of dermatographia.
• Stress: Mental health is vital in reducing stress. Ensure that you get adequate sleep, exercise, and mental health support.

How To Get Rid of Dermatographia?

Typically, the symptoms of dermatographia are mild and reduce within 30 minutes. However, if the severe and lasts for more than 30 minutes, the following are the treatment options:

• Over-the-counter anti-histamine tablets
• Prescription cromolyn to bloc allergic reactions
• Moisturiser for the affected areas

If the above treatment fails, doctors may treat the symptoms with an injection of prescription biologic therapy. Minimising stress with meditation, yoga, breathing exercises, and muscle relaxations helps reduce the condition’s symptoms.

What are the side effects of anti-histamine?

The following are the side effects of anti-histamine:

• Drowsiness
• Dry mouth and eyes
• Dizziness
• Headache, cough, and sore throat

What Can You Expect if You Have Dermatographia? 

If you are diagnosed with dermatographia, you have to worry about it as it only causes minor, temporary irritation and symptoms. You may have this condition for months, years, or your whole life. However, there is no cure for it, as it goes away on its own in a year or two or becomes milder.

Who Could Get Dermatographia?

Around 5% of people experience this condition, which is more common among young individuals, particularly children. Also, you are more likely to develop the condition if you are suffering from the following:

• Thyroid
• Diabetes
• Reactive polyarthritis
• Behcet’s disease

It is essential to note that this is a genetic condition. Pregnant women and women going through menopause may also develop this condition. 

Conclusion

Dermatographia symptoms don’t stay long, yet the disorder might last for years. This means that if one scratches the skin frequently, they may have symptoms regularly. Consult a dermatologist if the symptoms do not respond to over-the-counter medications to receive drys or ointments to help relieve symptoms.

Frequently Asked Questions

What triggers dermatographia?

The exact triggers of dermatographia are unknown. Simple things, such as when your skin brushes against the bedsheet, or sometimes, it develops soon after infection, stress, or reaction to medications like penicillin. 

Is dermatographia a form of eczema?

Dermatographia is not a form of eczema.

Does dermatographia last forever?

The symptoms of dermatographia may not last long. However, the condition may remain for several months to years. In simple terms, you may frequently get the symptoms. 

Can anxiety cause dermatographia?

Stress and anxiety are one of the triggers of dermatographia. Reducing stress helps minimise the symptoms of dermatographia.

Why is my dermatographia getting worse?

Your dermatographia is getting worse due to the extreme temperature. Dry weather or warm water from hot showers, baths, and saunas are some reasons for aggravated symptoms.