DR FLO: Why do I itch when I am exposed to cold water?

Dr Flo, I always itch for about 10 minutes after a cold shower and when I swim in cold water. I also itch when my skin is exposed to cold wind, and when doing laundry. Sometimes I may not itch at all. I have tried taking Piriton, which reduces the itching somewhat (I give it 70 per cent), but I don’t want to get hooked? How can I cure the itch? Njagi

Dear Njagi,
You have aquagenic pruritus, which means itching caused by water. It is a kind of allergy to water.

Contact with water produces intense itching of the skin, usually with a prickling sensation, without any observable rash or swelling. The symptoms can last anywhere from 10 minutes to two hours, and usually resolve on their own.

There is no good reason why some people develop this problem, though sometimes it may be associated with some underlying blood conditions. Showering with hot water may prevent the itching because the heat affects the cells (mast cells) that trigger the allergic reaction. But if the water is too hot and you shower for too long, you may also itch because the skin will dry out.

You can use anti-allergy tablets (like Piriton) and creams/lotions for the itching, though they do not work very well.

Avoid using harsh soaps for bathing, or harsh detergents for your towels, because the chemicals in the soap can also cause itching. Clean your towel regularly, like once or twice a week, to avoid growth of bacteria on a damp towel.

Unfortunately, the condition cannot be cured.

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Dr Flo, I always feel like plucking out my toes every evening after work when I take off my shoes and socks. My feet are usually so inflamed, I have to step in cold water for occasional relief. I have tried several treatments but my foot ends up swelling (oedema). What is the cause of this and how can I deal with the situation? Fredrick.

Dear Fredrick,

Itching of the feet and pain could be due to a nerve problem.

When nerves are damaged, they are more likely to become overactive and misfire. You may also have a burning sensation that is mild or severe, and it may be accompanied by a tingling feeling, or pins and needles.

The feet may also be sensitive to touch or pain. Other possible causes include fungal infection on the feet, sweating of the feet, impaired blood flow and inflammatory skin conditions like skin allergy, eczema, or psoriasis.

Rarely, other conditions like liver and kidney disease can also cause itching of the feet and oedema.

To manage it, do not stand for long and move around every few minutes to help with blood flow and relieve pressure from your nerves and muscles.

You can also sit down after standing for a while, and raise the legs with a pillow or footrest. You can use cold packs to cool your feet or soak your feet in warm water and then massage them to improve blood supply.

Wear clean socks and well-aerated shoes with good insoles, and don’t wear the same shoes on consecutive days. Avoid walking on wet surfaces to avoid getting a fungal infection.

It would also be good to be reviewed by a doctor. Some tests including a blood sugar test, vitamin deficiency test and nerve conduction study can be done and if a particular illness is suspected, tests targeting that specific illness can also be done.

If an underlying cause can be identified, treating the cause will stop any further nerve damage. For example, if the problem is diabetes, the best way to control the symptoms is by controlling blood sugar levels.

Unfortunately, nerves do not heal easily and any damage they may have suffered already may not be reversible.

Painkillers, pregabalin, amitriptyline, or gabapentin can be prescribed for the nerve pain. Vitamin B supplements may also be given.

If you have a fungal infection, it can be easily treated with antifungal medication. Inflammatory skin conditions can also be managed with creams and oral medications.

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