Cholinergic Urticaria with Complete Remission Following Regular Sauna Bathing: A Case Report

Michał Szklarz; Mikołaj Madeksza; Wojciech Matuszewski

doi:10.3889/oamjms.2926.12145

Authors

Michał Szklarz Clinic of Endocrinology and Metabolic Diseases, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-957 Olsztyn, Poland https://orcid.org/0000-0002-4841-3774
Mikołaj Madeksza Clinic of Endocrinology and Metabolic Diseases, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-957 Olsztyn, Poland https://orcid.org/0009-0005-4793-8711
Wojciech Matuszewski Clinic of Endocrinology and Metabolic Diseases, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-957 Olsztyn, Poland

DOI:

https://doi.org/10.3889/oamjms.2926.12145

Keywords:

cholinergic urticaria, sweating therapy, sauna bathing, desensitization, sweat hypersensitivity, non-pharmacologic therapy, case report

Abstract

BACKGROUND: Cholinergic urticaria (CholU) is a condition characterized by small, highly pruritic wheals triggered by sweating. Treatment with histamine H1-receptor antagonists (H1RAs) is often insufficient.

CASE PRESENTATION: We report the case of a 20-year-old male who developed CholU following a period of physical inactivity with reduced sweating. Symptoms were reproducibly triggered by exercise or emotional stress and were most severe after prolonged inactivity. The patient undertook a self-directed desensitization approach using weekly dry sauna bathing. Over eight weeks, he experienced progressive improvement, with complete resolution of symptoms that was sustained with continued sessions.

CONCLUSION: This case suggests that controlled, repeated sweating may reduce disease activity in selected patients. Sauna bathing may represent a feasible, low-cost, non-pharmacologic adjunct in CholU that warrants further investigation.

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