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Why Do I Break Out in Hives When I Workout?

You’ve probably heard of the “runner’s high.” But what about the “workout itch?” Some people experience hives or welts when they exercise. Here’s why.


Breaking out in hives during or after a workout can be a frustrating and distressing experience. Hives are inflammatory skin reactions that can result from a variety of causes, and some of those causes include exercise. Most commonly, those afflicted will experience red, raised patches on their skin with itching and/or burning sensations accompanying the rash. If you find yourself regularly breaking out in hives while exercising, it is important to consult with your doctor to help identify the specific cause of your reaction and determine the best course of action. In this article we’ll explore some of the primary reasons why you may find yourself experiencing hives as you work out.

Causes of Exercise-Induced Hives

Exercise-induced hives, or physical urticaria, is a condition where hives or welts appear on the skin after exercising. It is a common disorder that can range in severity from mild to severe. It is important to be aware of the causes of exercise-induced hives so that you can prevent them from occurring. In this article, we will take a look at the potential causes of exercise-induced hives.


Exercise-induced hives can be caused by a variety of causes, including allergies and sensitivities. While exercise itself is rarely the cause, it does act as a trigger for certain sensitivity reactions or allergens. Allergies to pollen, dust mites, animal dander, and certain substances such as cleaning agents, fragrances and cosmetics can cause hives when exposed to exercise. People who are allergic to food may also experience hives during or after exercising due to an allergic reaction to components in their food.

In addition to allergies, various hormonal imbalances can contribute to the development of exercise-induced hives. This is due primarily to the fact that hormones have a direct impact on the body’s ability to regulate its internal temperature and control sweat production. If one or more of these hormones are not balanced properly they can cause increased sweating which in turn increases histamine release which then causes hives.

Finally, exercise induced hives may also be caused by an underlying medical condition such as lupus or contact dermatitis. People with lupus may experience a type of hive known as “lupus flare-up” which consists of bumps that appear on any part of their body hours after physical activity or when exposed to sun light for an extended period of time. Contact dermatitis referrers to redness accompanied by itching or burning that occurs on areas where sweat has accumulated during exercise.


Stress is one potential cause of exercise-induced hives. Anxiety and physical exertion can often lead to a sudden release of histamine in the body, triggering the red, itchy rash known as hives. Prolonged periods of anxiety can also act as a catalyst for skin irritations.

Exercise can be a powerful stress reliever, but it is important to consider that engaging in high-intensity exercise may actually increase levels of cortisol and other hormones which can lead to hives. Surprisingly, too much rest and relaxation may also be responsible for an outbreak due to lowered immunity. Balancing out workout intensity with adequate rest is essential for avoiding unwanted side effects from exercise. It is recommended to gradually build up intensity and time over a span of several weeks in order to slowly adjust your body to new levels of activity.


Heat is one of the most common trigger factors that causes exercise-induced hives in people. Activity creates body heat, and some individuals may experience skin rashes under their workout clothes as they perspire, exacerbated by compression or wear-and-tear of tight-fitting garments. This can lead to chafing or abrasion of the skin’s surface, creating an ideal location for the development of hives. Additionally, when a person has already had a reaction to exposure to such things as pollen, mold and certain medications and then experiences an increase in body temperature during a workout routine, it can trigger allergic reactions that result in hives.


One of the primary factors that can cause exercise-induced hives is sweat. For some people, sweat is an irritant to the skin and can trigger hives to form. This type of reaction is likely caused by substances that are secreted in sweat, such as lactic acid or histamine. Sweating may also develop sooner than normal when exercising and cause skin irritation – even greater if moisturizing creams, sunscreen or certain types of clothing are used. These hives tend to appear shortly after exercise and result in painful, itchy and red bumps on the skin. In order for these reactions to be prevented, people should take a shower immediately after finishing a workout session, as this will help remove any irritating agents on the skin and reduce their risk of developing hives or other reactions. Additionally, individuals must be sure to keep their bodies hydrated throughout the session by drinking plenty of water or electrolyte drinks.

Symptoms of Exercise-Induced Hives

Exercise-induced hives, also known as exercise-induced urticaria or physical urticaria, can cause uncomfortable symptoms both during and after exercise. It is characterized by itchy red hives that appear on the skin during or shortly after physical exertion. This condition can appear suddenly and may last from several minutes to several hours. The hives can quickly come and go, which makes them difficult to treat.

Common symptoms of exercise-induced hives include:

-Itching skin that develops into raised weals
-Wheals that are red, raised, with a pale center caused by fluid buildup in the area
-Itchy bumps that tend to last for around 30 minutes
-Hives often appear in areas where clothing is binding against skin or on the arms and legs
-Individuals who suffer from exercise-induced hives may or may not experience an allergic reaction such as runny nose or sneezing
-Feeling flushed and hot while exercising due to increased skin temperature

Physical activity can cause an increase in body temperature which in turn triggers histamine production resulting in exercise induced hives. Other factors, such as poorly fitting shoes or clothes that cause friction on the skin, a rapid increase in heart rate, environmental changes (e.g., temperature changes) or specific forms of exercise (e.g., running) may all worsen symptoms of this condition. Taking appropriate steps before working out can help reduce the risk of triggering an attack of hives when exercising.

Diagnosis of Exercise-Induced Hives

Exercise-induced hives, also called cholinergic urticaria (CU), is an allergic reaction that some people experience when they exercise. It can be a difficult condition to diagnose and is often misunderstood by healthcare practitioners. The most common symptom of CU is red raised hives or welts, but other symptoms may include itching, burning, tingling or even a feeling like something “moving under the skin.”

Diagnosis of exercise-induced hives is generally made through an allergic skin test known as a “prick-to-puncture challenge (PPT).” During this procedure, tiny indented spots are made on the patient’s skin and filled with either water or an allergen such as exercise. Once the spots have dried, the patient will then be asked to sweat in order to bring out any allergic reactions at the site where the allergen was introduced.

If the individual does not show any allergic reactions after sweating in this manner, then further testing for exercise induced hives may not be necessary. However if hives occur within minutes of stopping exercise, this could be indicative of CU and further investigation would need to take place. The most common type of additional testing involves having the individual perform different kinds of physical activities such as running on a treadmill or swimming while monitored closely for indications of an allergic response. If hives appear during one activity but not another then it could help healthcare practitioners determine that exercise-induced hives are present in this individual case.

Treatments for Exercise-Induced Hives

Hives can be a very uncomfortable, itchy condition caused by the body’s reaction to physical activity. Many people experience exercise-induced hives when they don’t take any steps to address the underlying cause. The good news is that treatments are available and can help people manage their hives when working out. Let’s discuss some of the available treatments for exercise-induced hives.

Avoid triggers

Avoiding triggers is the most important part of managing exercise-induced hives. Exercise, in general, can trigger symptoms, so any activity that increases body temperature should be avoided if possible. Heavy clothes, warm or humid environments, saunas and hot tubs should all be avoided. Additionally, it’s important to be mindful of personal hygiene before and after exercise to reduce the risk of breaking out in hives. Make sure you take a shower after exercising and wear clean clothes to prevent bacteria from accumulating on your skin.

Certain foods and beverages can also act as triggers for exercise-induced hives in some people. Pay attention to when you break out in hives and try to identify any foods or drinks that frequently precede outbreaks; then, work on avoiding them before exercising. Caffeine, alcohol and spicy foods are common triggers for many people suffering from hives and should be limited as much as possible before participating in physical activity. If a particular food seems to cause a reaction consistently while eating it before a workout session or race, it is best omitted from the diet altogether. Additionally, keeping an eye on environmental allergens such as pollen or pet dander could also help reduce the risk of exercise-induced hives since allergies can cause flare-ups during physical activity

Take antihistamines

Taking an over-the-counter antihistamine like loratadine or cetirizine can help reduce the swelling and itching of hives. Make sure to follow the directions on the label and contact your doctor if you experience any concerning side effects. It’s important to note that antihistamines can cause drowsiness, which may impair your ability to exercise safely. As such, it’s not recommended that you take antihistamines before a workout — however, they can be taken afterward to help reduce symptoms.

Another option is to use cold compresses or ice packs directly on the affected areas of your skin for 10 minutes at a time several times throughout the day. This will help reduce inflammation as well as reduce any itching sensation caused by the hives. However, be sure not to leave cold compresses or ice packs on for too long as this could further irritate the skin and cause further inflammation. If symptoms persist, it is highly recommended that you seek medical attention from a health care professional.

Use topical creams

Topical creams may be prescribed for those suffering from exercise-induced hives in order to soothe and relieve symptom severity. Common antihistamine creams are H1 antagonists, which helps to decrease inflammation. They can be administered as an ointment or cream and are available over-the-counter or by prescription. If a cream is used, it should always be rubbed into the skin until fully absorbed. It should not be left on the surface of the skin as this will increase irritation and inflammation. In some cases, oral antihistamines may also be prescribed if hives are particularly severe or widespread.

Use cold compresses

Cool compresses can be an effective, fast-acting remedy for exercise-induced hives, as they help reduce itching and burning sensations. Applying cold compresses numerous times a day, when symptoms are present or when they start to flair up, is recommended. For the cold compress, use a clean washcloth or towel soaked in cool water and wrung out until it no longer drips. Apply the cloth gently for 10 to 15 minutes and reapply frequently throughout the day as needed. You can also try wrapping an icepack in a damp cloth and applying it directly to affected areas for relief from hives associated with exercise.

Prevention of Exercise-Induced Hives

If you have been suffering from hives or urticaria caused by physical activity, there are steps you can take to prevent it. However, some cases of exercise-induced hives may not be preventable and may require medical attention.

To help with the prevention of exercise-induced hives, it is important to maintain proper hydration before and during a workout session. It is also suggested that you avoid drinking alcohol, eating foods containing preservatives or known allergens, and participating in activities that cause rapid changes in temperature or altitude prior to working out. Additionally, try to maintain an ideal body weight and wear clothing made from natural fiber materials as synthetic fibers can irritate the skin when it is dampened with sweat.

Finally, warm up fully before each workout session as this will reduce your risk of triggering an allergic reaction in your skin while exercising. If an unexplained outbreak of hives occurs while exercising even after taking these preventive measures, it is advised that you seek medical treatment as soon as possible for further assessment and individualized treatment plan.


After looking at the possible causes of hives when you workout, it appears that the most likely explanation is physical activity-induced urticaria. Although it’s not a serious condition, the hives associated with PAI can be very uncomfortable and difficult to manage. Therefore, it is important to see your doctor to determine the best course of treatment for you.

In most cases, medications and lifestyle modifications can significantly reduce your risk of developing exercise-induced hives. Taking antihistamines prior to physical activity can help reduce your reaction, as well as avoiding triggers such as hot temperatures or certain fabrics. Your doctor may recommend other steps such as avoiding alcohol or caffeine prior to exercising or taking more breaks during intense sessions. Additionally, desensitization by gradually increasing exposure may help you become more tolerant of physical activity over time.

Overall, while exercise-induced hives can be an inconvenience, they are generally treatable with a few simple lifestyle changes and medications prescribed by your doctor. By understanding the causes and taking preventative actions, you will be able to stay healthy and active without worrying about breakouts in hives during physical activity!

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