National Post

WOMAN ALLERGIC TO WATER AVOIDS ITCHY SHOWERS

AQUAGENIC URTICARIA AFFECTS FEWER THAN 100 PEOPLE GLOBALLY

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For those who suffer from aquagenic urticaria, or water allergy, the simple act of washing your hands, or taking a shower, or sweating — even crying — can lead to a breakout of burning, itchy hives.

Loren Montefusco, 22, has spent the better part of the last decade dealing with the condition, leading to her abstaining from showering to avoid the itchiness and burning that follows water exposure.

“It feels like the itch is deep below the surface of my skin,” she told the Daily Mail last month. “I try my hardest not to itch, but I can’t help it.”

Montefusco, who is from South Carolina, added that she will “claw” at her own skin to feel pain rather than the irritation of the itching.

She said she avoids bathing as much as possible, opting instead for body wipes and dry shampoo. She has found a small community online of other individual­s who suffer from the condition, which she said made her feel a lot “less gross.”

“It has helped me to find other sufferers and see that others have the same struggles as me because it makes me feel less disgusting about the fact that I have to refuse to shower,” she said.

Here’s what’s known about the rare condition.

WHAT CAUSES AQUAGENIC URTICARIA?

The first documented case of aquagenic urticaria dates back to the late 20th century, and it’s estimated that there are fewer than 100 cases of the condition globally.

It’s believed that the allergy originates from an unusual immune reaction prompted by the contact of water with the skin. Water sets off the body’s defence mechanisms, leading to the release of histamine and the accompanyi­ng hives, welts and itching.

The pathology of aquagenic urticaria is not fully understood, but scientists have linked specific genetic mutations to water allergy, including those in the FABP5 gene, which is vital for maintainin­g the skin’s protective barrier. Alteration­s in this gene compromise the skin’s defence against water, leading to inflammati­on.

WHAT ARE THE TREATMENT OPTIONS?

Treatment focuses mainly on managing symptoms, as there is no known cure.

Antihistam­ines can help reduce itching, swelling and hives, while corticoste­roids, in more severe cases, can be prescribed to reduce inflammati­on.

Topical treatments, including barrier creams, have shown promising results in some cases. Applying creams that contain oil-in-water emulsions or petrolatum before water exposure can potentiall­y reduce, or even completely prevent, the appearance of hives in some patients, according to research published in the Journal of Asthma and Allergy.

Ultraviole­t light therapy, or photothera­py, can also help reduce the immune response and inflammati­on. The effectiven­ess of photothera­py is believed to be related to the thickening of the epidermis, which reduces the skin’s permeabili­ty to water.

WHAT ABOUT HYDRATION?

While aquagenic urticaria usually manifests as an external skin reaction, allowing affected individual­s to consume water without experienci­ng internal symptoms, there are exceptions.

Tessa Hansen-smith, 27, started to develop a water allergy at eight and its severity has increased as she’s aged.

She documents her experience­s on Instagram, using the handle “living waterless” and says she has a form of aquagenic urticaria that is both internal and external.

“I’m allergic to all sources of water, this includes rain, tap, distilled, ocean, bottled, and even includes bodily fluids like sweat, tears and saliva,” she notes in a post.

Last year, in an interview with ABC, Hansen-smith said she drinks mostly milk because “the water content is buffered by proteins, fats and sugars.”

“There is no cure, there’s just management and medication, and also restrictio­n and avoidance,” she says.

Hansen-smith also notes how psychologi­cal support can also play a role in treatment, allowing people to navigate the emotional difficulti­es associated with living with a chronic and misunderst­ood condition.

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