Exercise-Induced Urticaria

Uticaria is the medical term for the allergic reaction known commonly as hives that causes itchy and irritated skin. For certain individuals, urticaria may be caused by physical activity. Exercise-induced urticaria is more common in younger athletes. Urticaria typically begin as just an itchy skin rash; however, exercise induced urticaria can progress to anaphylaxis. Anaphylaxis is marked by an increase in the hives, as well as airway constriction, a decrease in blood pressure, rapid pulse, or dizziness. Anaphylaxis is a serious medical condition and if left untreated can result in death.


  • Hives during or after exercise.

  • Flushing of the skin.

  • Itch.

  • Headache.

  • Nausea.

  • Swelling of the throat and upper airway.

  • Difficulty breathing.

  • Dizziness.


For certain individuals, exercise may cause the body to elicit an immune response. Antibodies cross-link on the surface of mast cells. The mast cells release substances that create the symptoms of an allergic reaction, such as hives, itching and the other symptoms that accompany this syndrome. The antigen release in this condition can be caused by:

  • Exercise.

  • Gradual heating of the body.

  • Water loss of the body.


  • Weather extremes (hot or cold).

  • Drug reactions.

  • Food stimuli.

  • Increased emotional response.

  • Menses.


  • Before symptoms occur (prophylactic) antihistamine use.

  • Avoid taking medications you are sensitive to prior to exercising.

  • Avoid eating shellfish or other foods you are sensitive to prior to exercising.

  • Avoid exercising in extreme temperatures, either cold or hot.


As soon as symptoms appear, stop exercising, cool off, and seek medical attention for an allergic reaction. Individuals who have been diagnosed with exercise-induced urticaria or anaphylaxis may be prescribed injectable epinephrine to treat symptoms. If you have been prescribed medication, it is important that you know how to administer the injections. Symptoms can become severe quickly so prepare to seek emergency medical attention. It is advisable to wear a medical alert bracelet in case of collapse. It is also a good idea to exercise with a partner who is aware of your condition. If symptoms develop, cease exercise and find a cool place to rest. As mentioned previously, prophylactic antihistamines may not be beneficial in all cases.