How can a patient manage the persistent red itchy patches on his face, jawline, and neck?

Question

Hello doctor,

I have small patches on my face which randomly start itching and turn red without touching. The patches usually continue to itch for ten minutes, and then everything becomes normal. I am unsure if I have these patches due to histamine reactions, but they often occur on my face, jawline, and chin multiple times a day. I currently use a hydrating facial cleanser and a gel daily.

Answer 1

Hello,

Welcome to icliniq.com.

As per the history provided, they may be cholinergic urticaria. It may stay for minutes to hours and then subside. For some individuals, the rashes may appear after stress, bathing, working out, and sun exposure. It is a hypersensitivity reaction meaning your body is more sensitive than usual to temperature changes following sun exposure, and may also cause reactions to insect bites.

There is nothing to worry about as there are medications for the same. The medications can be taken for up to a month and then may be stopped. But since it may also appear with temperature changes later in life, the same medication may be used. For some, it may eventually stop occurring in the future. But others may experience the same on and off again. It is not contagious and will always reduce in a few hours. I suggest you do the following:

Take the tablet Fexofenadine 120 mg and the tablet Montelukast 10 mg at night one hour before going to sleep after dinner. Use the medication for one month.
Hydrocortisone 1 % cream may also be used on the red rashes when they appear. However, it is a strong medication and should be used only in the smallest quantity possible in a very thin layer only once daily for a maximum period of ten days. Their usage is not mandatory as the rashes may subside within a few minutes to hours. However, this medication would help reduce excessive itching.
Avoid stress as much as possible, and in case of itching after sun exposure, it is advised to protect yourself by using physical protectants like a cap, goggles, long-sleeve shirt, etc.
Avoid spicy and hot food, red meat, and fried food to prevent sudden changes in body temperature. Consume more fruits and vegetables and follow a healthy diet as much as possible. Consume 12 glasses of water daily to maintain your body temperature and hydration.
This medication can be used later also if symptoms develop. Since it is the body's internal response to allergens, they may appear on and off in case of changes in body temperature. However, it is also suggested to note any specific allergen while consuming particular food items and avoid them.

Consult a specialist doctor, discuss with them, and take medications with their consent.

Hope I could be of help.

Stay healthy, happy, and safe.