How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Vakul Aren Your Own Question

Vakul Aren
Vakul Aren, Doctor
Category: Medical
Satisfied Customers: 3351
Experience:  MBBS,DTM&H,30 years of experience
Type Your Medical Question Here...
Vakul Aren is online now
A new question is answered every 9 seconds

I have a problem of itching when I exercise, starts a few minutes

Resolved Question:

I have a problem of itching when I exercise, starts a few minutes into running particularly. What causes it, and what can I do about it (non-drug treatment preferably).

PF Mahuma, Centurion, South Africa
Submitted: 1 year ago.
Category: Medical
Expert:  Vakul Aren replied 1 year ago.
In some people,exercise induces a spectrum of allergic reactions which range from erythematous,irritating skin eruptions or urticaria to serious anaphylaxis reactions.The skin and systemic symptoms are due to exercise induced changes and are secondary to cholinergic urticaria.Mast cell degranulation results in release of vasoactive chemicals which result in these skin and systemic symptoms.Depending on the level of reaction seen,use of antihistaminic drugs and epinephrine,airway support and vascular support may be needed.Some predisposing factors include drugs like aspirin and NSAIDs , certain seafood,celery,wheat and cheese which if taken before exercise may result in these symptoms.There may be itching,a choking sensation,gastrointestinal colic,nausea,headache and wheezing.These symptoms last for about 40 minutes to 4 hours after exercise like running,activities like dancing,skiing and hardwork in the yard.The diagnosis is made by your doctor /dermatologist by taking a history and examining you.Patients should abstain from exercise for upto 4-6 hours after eating,avoid taking aspirin/NSAIDs like ibubrufen ,avoid exercising during menses,stop exercising if symptoms appear and seek emergency help if symptoms like choking are seen.Drug therapy like use of Hydroxizine/Atarax,nonsedating antihistaminics like Claritin(loratidine) or Allegra(Fexofenadine),mast cell stabilizers like Monteleukast,Cromolyn(Intal)may help prevent further symptoms.Use of epinephrine subcutaneous may help prevent anaphylaxis.
Customer: replied 1 year ago.

I wonder if lactic acid, cold weather, dry skin, warming-up exercises has anything to do with it. When I do low key exercise like gardening or swimming, I do not itch. Anectdotally people have advised that once the itching starts, one must just continue exercing, and it will eventually disappear.


I wonder about long term use of antihistamine if the condition is not so severe.


I have done skin tests for allargies which have come back negative.


Please feel free to engage at a higher academic level or refer further(I happen to be a specialist family physician)

Expert:  Vakul Aren replied 1 year ago.

You need to stop the exercise session rather than continue when urticaria occurs.The danger of a serious anaphylactic reaction occurring after continuing exercise cannot be ruled out.Dry skin and cold weather may predispose to itching.Use of leukotriene modifying drugs like Zafirlukast(Accolate) and Zileuton(Zyflo)apart from monteleukast will help prevent the urticaria.Omalizumab is a recombinant humanised monoclonal antibody against IgE/Immunoglobulin E.It acts by binding free IgE,thus reducing mast cell degradation.Successful treatment has helped in a few studies by eliminating the problem in some patients.Use of nonsedating antihistamines may help control the condition if severe.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020292/ is a site of interest.

Vakul Aren, Doctor
Category: Medical
Satisfied Customers: 3351
Experience: MBBS,DTM&H,30 years of experience
Vakul Aren and 3 other Medical Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    44473
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/DrThomasMd/2012-7-25_134438_Imagess1.64x64.jpg Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    44473
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
  • http://ww2.justanswer.com/uploads/MY/mysticdoc/2012-6-8_15615_mysticdoc3.64x64.jpg Dr. D.J.'s Avatar

    Dr. D.J.

    Board Certified Physician

    Satisfied Customers:

    13579
    MD
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2522
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/DrDLove/2009-08-12_141522_DrDLove.jpg Dr. D. Love's Avatar

    Dr. D. Love

    Doctor

    Satisfied Customers:

    11042
    Family Physician for 10 years; Hospital Medical Director for 10 years.
  • http://ww2.justanswer.com/uploads/DO/DoctorRich/2012-9-12_72454_Doctorweb.64x64.jpg Dr. Natasha's Avatar

    Dr. Natasha

    Doctor

    Satisfied Customers:

    8749
    American Board Certified in Emergency Medicine and Ivy League trained. Medical Review Officer trained in Drug Testing