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Dermatographic Urticaria: Symptoms, Causes and Risk Factors

Dermatographic Urticaria is a condition which is also known as skin writing. When people have this condition, even the light scratching of their skin is making scratches to redden into a raised wheal similar to hives. Usually, these marks disappear in a period of thirty minutes. It is noticed that approximately 5% of people have dermatographic urticaria. It is most common in younger adults and older children. Scratches tend to heal quickly but they can irritate your skin. [1]

It is noticed that some scratches are white against the skin while others redden slightly. It is not known the cause for the dermatographic urticaria but in some people, it can be triggered by medications (such as penicillin), emotional upset, or infections. In most cases, people who have it do not seek treatment. If you have noticed that your signs and symptoms are bothersome for you, then your doctor can recommend you allergy medications, such as diphenhydramine (Benedryl) or cetirizine (Zyrtec).

The symptoms of dermatographic urticaria do not last long but this condition can persist for years. This means that you will experience symptoms repeatedly if you have scratches on your skin on a regular basis. If you have noticed that your symptoms do not respond well to the over – the – counter drugs or remedies, then you should talk with a dermatologist.

Dermatographic Urticaria Symptoms:

The signs and symptoms of the dermatographic urticaria happen when your skin gets scratched. Symptoms do not appear on their own. Instead, these are reactions that happen to scratches themselves. The symptoms can appear for the first time without warning. Here are the symptoms:

  • Swelling or inflammation
  • Itchiness
  • Welts that look like hives
  • Deep wounds
  • You can have raised marks on the skin that look like writing
  • Redness

Dermatographic Urticaria Causes

Usually, the symptoms of dermatographic urticaria will last about thirty minutes at a time [2]. There are rare cases when the symptoms of dermatographic urticaria can last for a day or longer. It is noticed that this condition can last for months or years. The symptoms of dermatographic urticaria can worsen in extreme temperatures. Dry, hot, and cold weather can increase the incidence of dermatographic urticaria [3].

Also, the warm water from the saunas, baths, and hot showers can aggravate the symptoms. Your doctor will make skin test to diagnose the dermatographic urticaria. Also, your doctor will use a tongue depressor and lightly drag it across the portion of your skin to see if any adverse reactions happen. Your doctor will make this test at his office and usually, the dermatographic urticaria is diagnosed within one visit. [4]

Also, your doctor will check other areas of your skin for marks. Your doctor will not make you X-ray or blood tests to diagnose it. Usually, it does not need medical treatment unless it becomes chronic. The term “chronic” means that it is ongoing. Usually, the symptoms are treated over – the – counter medications but also alternative medications can help you. You should never take any supplements, herbs, or medications without talking with your doctor.

Dermatographic Urticaria Causes:

The exact cause for the dermatographic urticaria is not known. It is thought that is triggered by:

  • Certain types of exercises that cause excessive skin rubbing (such as wrestling)
  • Certain medications, including penicillin
  • Infections [5]
  • Excessive rubbing from clothing or bedding
  • A history of allergies
  • Stress [6]

Dermatographic Urticaria Risk factors:

There are some factors which can increase your risk, such as

  • You have a nerve disorder or an internal illness that causes itchy skin
  • You have thyroid disease
  • Experience frequent scratches of the skin
  • Are a young adult
  • You have a history of dermatitis, which is a skin inflammation
  • Have dry skin

There are some studies in which are estimated that about 3% of adults have some form of dermatitis. It is often grouped in this category but its estimates are a bit higher. Children have more chances of getting dermatitis, while teens and young adults have more chances of developing dermatographic urticaria [7].


[1] Laube S. Dermographism urticaria. Medscape. 2018. Retrieved from

[2] Abajian M, Schoepke N, Altrichter S, et al. Physical urticarias and cholinergic urticaria. Immunology and Allergy Clinics of North America. 2014;34(1):73-88.

[3] Stepaniuk P, Vostretsova K, Kanani A. Review of cold-induced urticaria characteristics, diagnosis and management in a Western Canadian allergy practice. Allergy, Asthma & Clinical Immunology. 2018;14.

[4] Rothbaum R, McGee JS. Aquagenic urticaria: diagnostic and management challenges. Journal of Asthma and Allergy. 2016;9:209–13. doi:10.2147/JAA.S91505

[5] American College of Allergy, Asthma & Immunology. Which comes first: Self-reported penicillin allergy or chronic hives? 2016. Retrieved from

[6] Wallengren J, Isaksson A. Urticarial dermographism: Clinical features and response to psychosocial stress. Acta Dermato Venereologica. 2007;87:493–8.

[7] Xu X, van Galen LS, Koh MJA, et al. Factors influencing quality of life in children with atopic dermatitis and their caregivers: a cross-sectional study. Scientific Reports. 2019;9.

Neem Mayur
Neem Mayur
Mayur Neem, a certified dietician having more than 5 years of experience in the field of diet practice. He is working as a diet expert and offering services to body builders, sports persons, celebrities, etc. He is lover of natural remedies and loves to spend most of his free time in his organic farm and offers expert advice on organic farming to local farmers. He is available through [email protected]


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