What is the Main Cause of Dermatographia

Dermatographia is a skin condition caused by scratching the skin. It is a common condition affecting about 3 to 5% of the population (1). It creates welts and light swelling on the tissue that can be there for up to 30 minutes, accompanied by local itching and burning sensation. This can also be termed skin writing, dermographism, or urticaria.  

 

The cause of the condition is unknown, but it can occur due to stress, taking medication, or maybe some underlying infection (2). Reports show that the period of this disease is over 6.5 years on average (3).

 

Types of Dermatographia

 

• Simple Dermographia: It is the simplest and most common type.
• Delayed Dermographia: When the welts appear late after the point of contact.
• Cholinergic Dermographia: Welts appear after sweating.
• Follicular Dermographia:  It involves skin follicles.
• Familial Dermographia: When it has a genetic connection sometimes (4).

 

What Triggers Dermatographia? 

The common triggers of this condition are combing, drying after showering, and tight clothes. Dermatographia usually occurs on the back, legs, and arms mostly. On the other hand, it can be genetic, but its relevance is unknown. It is believed that the reaction could be allergic, but no form of allergen is observed. It can occur at any age but is common in teens or young adults. The condition is highly associated with other skin conditions like eczema.

 

Additionally, the skin can flare up because of exposure to heat or cold, pressure, exercise vibration, or stress in many cases. Researchers suggest that there might be a link between taking penicillin and having dermographia.

 

 

The Process of the Reaction

 

In the skin, there is a type of cell known as Mast cells that spread all over the body. These mast cells contain a chemical called histamine, responsible for increasing the permeability of blood vessels for white blood cells, and some for these proteins when there is an entry of a foreign body that is germ. 

When the mast cells release histamine, tissue fluid tends to collect in the area of the release leading to localized swelling. However, in individuals with dermographia conditions, the mast cells have a weaker cellular membrane compared to a normal person. These cells tend to rupture even with a small physical force. Therefore, the stored histamine will be released leading to swelling in the local area by physical force.

 

Is it an Autoimmune Condition?

This could be an autoimmune disease, as some scientists believe the immune system signals an appropriate response when you scratch the skin and send histamine to remove the allergen from the body (5). This condition is not contagious as it does not spread through skin-to-skin contact or bodily fluids.

 

Symptoms of Dermatographia

The common symptoms of this condition are raised, discolored, or the same color as your skin lines, swelling inflammation, hive-like welts, and itchy or burning sensations. The common cause of this condition is stress and it can be prevented by adopting certain lifestyle modifications.

 

Treatment of Dermatographia

There is no cure for this disease as it usually fades away in some time. If the condition is too severe and bothersome, then you can use an antihistamine, an over-the-counter drug. It reduces the swelling and prevents it from happening (6). It can be for years, a lifetime, or a short period.

There is a doctor’s prescribed drug called cromolyn, which has the same effect as antihistamines, which helps in stabilizing the cell membrane and preventing the release of histamine in the body. However, there is no permanent scarring of the tissue. 

 

How to Prevent Dermatographia

 

To prevent the condition, shower or bath with warm water, and apply enough thick cream or body oil to create a layer on the skin surface to prevent dryness and itching. Do not scratch, and apply non-soapy things on your body to prevent skin irritation. Wear clothes that are not skin tight or too tight as it can make the derma uncomfortable. Lifestyle modifications to adopt are:

• Stay hydrated
• Reduce alcohol and caffeine intake
• Practice deep breathing when stressed or burdened
• Exercise routinely or at least 5 times a week
• Eat healthy foods
• Journal your thoughts
• Maintain positive thoughts
• Sleep 8 hours at night
• Seek support from friends and family. 

 

 

Personal Case

I have been suffering from Delayed Dermographia for the past 3 years now. I noticed these welts on my skin when I was 23 years old, skin writing randomly appeared on my skin after scratching. I don’t have any other skin condition, but sometimes, I get derma fungal infections. They appear late and last up to 30 minutes before they fully settle. My doctor says it’s because of the COVID-19 vaccine, but they are not 100% sure about it. The cause remained unknown. I usually apply plenty of body lotion and try to keep myself healthy by creating lifestyle changes. I noticed that antihistamines help to reduce the occurrence in my case. My case is not severe, but stress makes it worse sometimes. So, the best I can do is to be happy and positive.

 

Conclusion

Dermatographia is not a fatal disease, but the severity of this can hinder personal lifestyle and daily life. Healthy lifestyle modifications are necessary to maintain this condition, which in turn helps to reduce stress and decrease the severity. 

 

 

By: Shefali Daima, MSc Global Health

Reviewed by: Selam Temesgen Alemu M. D.