Hello dear See as per clinical history it seems urticaria. Iam suggesting some medication and precautions Please follow them for atleast two weeks Fexofenadine 180mg 1-0-0. × 7 days. T.Montelukast 0-0-1 × 7 days. I’m addition Apply Tulsi alovera gel twice a day for 1 month Aquaphor moisturizer twice a day for 1 month You may be required to get following tests done Patch test Blood allergy test Intradermal skin test Esr Cbc Crp. In case of no improvement in symptoms consult dermatologist in person for better clarity and show the result to concerned physician only Regards
Body itching tied to environmental changes, stress, or heat can be particularly complex, pointing often to a condition known as cholinergic urticaria, which is a type of physical urticaria. When your body temperature rises due to exertion, hot baths, or stress, small itchy hives may appear. It’s interesting that your symptoms seemed to manifest in climates different from your baseline living conditions in Nigeria. Given that antihistamines and other medications you’ve tried are not offering relief, it might indicate that the itching isn’t primarily histamine-mediated, which is why antihistamines, like cetirizine and fexofenadine, didn’t fully help. A potential, continued course could involve trying medications aimed at controlling mast cells, such as omalizumab, which is an anti-IgE therapy. Some individuals find relief by managing lifestyle triggers — aiming to keep body temperature stable. Before engaging in activities that might trigger symptoms, some find prophylactic use of antihistamines or even a cool shower helpful. Since prednisone provided relief initially, this suggests systemic inflammation might play a part, but we typically avoid long-term steroids due to side effects. One more option for management under specialized care could involve low-dose immunosuppressants, but this approach requires careful medical supervision. Any chronic symptom persistency must be investigated thoroughly, hence a dermatology referral for a more specialized evaluation can be very beneficial. It’s critical to continue working with your healthcare provider to monitor symptoms and adjust treatment as appropriate, especially since body itching may still be a manifestation of another underlying condition. If symptoms persist concerningly or worsen, immediate reassessment is crucial to exclude other possible causes.
Hello Felix, thank you for sharing your concern. Based on your history, this strongly fits a condition called Cholinergic Urticaria / Heat-induced pruritus (sometimes also overlaps with heat-triggered neuropathic itch).
This gets triggered by heat, sweating, warm rooms, stress, exertion.
Start these medications - - Tab. Fexofenadine 180mg ij the morning. × 7 days. - Tab. Levocetirizne+Montelukast at night × 7 days.
Avoid overheating, hot showers. Lukewarm water only. Wear light cotton clothes. Avoid spicy food, alcohol. Reduce sudden temperature changes. Manage stress (stress is a major trigger).
What NOT to do- Repeated steroid courses (prednisolone). Increasing antihistamine dose randomly. Tight or synthetic clothing.
Seek urgent care if you ever get: Breathing difficulty, Lip/tongue swelling, Dizziness/fainting.
Review after 7 days.
Feel free to reach out again. Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Medicine
Hello Felix Thanks for sharing your journey and what you’ve tried so far. It sounds really frustrating to deal with persistent itching, especially when multiple medications haven’t helped. Since you’ve already tried prednisolone (a steroid), several antihistamines (cetirizine, fexofenadine, Atarax), and even changed environments and clothing, it’s clear this is a tough case.
Possible Causes - Chronic urticaria (hives) or allergic reaction: Sometimes, the cause isn’t obvious and can be triggered by stress, environment, or unknown allergens. - Eczema or other skin conditions: These can flare up with climate changes or stress. - Systemic causes: Liver, kidney, thyroid problems, or even diabetes can cause itching. - Parasitic or fungal infections: Sometimes missed in initial checks. - Medication side effects: Any new medicines or supplements?
Next Steps - Blood Tests: Since you’ve done some, results for liver, kidney, Hemoglobin level, thyroid, and blood sugar are important. If you have the report, you can share it here and I’ll help explain what it means. - Skin Examination: Sometimes a dermatologist needs to look closely or do a skin biopsy. - Allergy Testing: Patch tests or other allergy workups can help.
What You Can Do Now - Moisturize: Use fragrance-free, gentle moisturizers. - Avoid triggers: Hot showers, harsh soaps, and tight clothing can worsen itching. - Keep a diary: Note when itching is worse, what you eat, and any exposures.
Please share me your report so that I can prescribe you Medicine accordingly .
Thank you
08-Jan-26 Liver profile Bilirubin (Total) [ 1.72 - 17.1] µmol/l 11.79 Aspartate aminotransferase (AST) [ 10 - 50] U/L 23.8 Albumin (serum) [ 33 - 45] Gm/L 46.8 Random Blood Glucose Glucose (random) [ 3.9 - 7.8] mmol/L 4.6 Renal profile Sodium (Serum) [ 135 - 145] mmol/l 140 Chloride (serum) [ 98 - 106] mmol/l 106 Serum potassium [ 3.5 - 5.1] mmol/l 4.5 Creatinine (Serum) [ 62 - 106] µmol/l 89.7 92 estimated GFR [mls/min/1.73m2]
Test Urea (Serum) Thyroid Function Tests Result 4.8 mmol/L Reference Range 2.5 - 7.5 Free Thyroxine (FT4) 13.9 pmol/L Reference Range 12.0 - 22.0 Free Triiodothyronine(FT3) 5.8 pmol/L Reference Range 3.1 - 6.7 Thyroid stimulating hormone (TSH) 1.8 mIU/L Reference Range 0.3 - 4.2
Hello Felix Get these following test done too -
Specific IgE Test (e.g., RAST, CAP-RAST, ELISA): Detects IgE antibodies to individual allergens, helping diagnose allergies to: Environmental: Pollen, dust mites, mold, pet dander. Food: Peanuts, eggs, milk, shellfish, fish, wheat. Insect Venom: Bees, wasps. Medications
Thank you
Hello Doctor, their is no provision here to upload my result, but I showed the doctors in Malta, they all said the result showed no sign of negativity. I only have goosebumps all over my body while the itching is going but gradually disappear as the itching is relieving me. some says its neuro issue, and I used gabapentin for weeks, no changes, I have also tried different antihistamines all to no avail.
Hello Felix By going through your reports, these all reports look normal . But I have doubts regarding Hemoglobin level. I have seen cases where patient have high hemoglobin due to which these symptoms starts . For such patients we generally prescribed blood donation or cupping therapy . If possible get your blood test done which Includes Hemoglobin level. And it doesn’t seems any neuro problem so not to go with any Gabapentin . And antihistamine provide you with only symptomatic treatment only . Most of these are related with blood . Visit your nearest lab and get Complete blood Count test done which Includes Hemoglobin. Afterwards send or text me your report… we will figure out a better and permanent treatment for it .
Thank you
Complete Blood Count
[PARAMETER
[RESULT]
[REFERENCE RANGE]
White Blood Cell Count
3.97
[10^9/L]
[4.5-11]
Red Cell Count
4.94
[10^12/L]
[3.9-5.6]
Haemaglobin
15.0 [g/L]
[14.1-17.2]
Haematocrit
42.5
[%]
[36-48]
Mean Cell Volume (MCV)
86.0
[FL]
[96-95]
Mean Cell Hb
30.4
[pg]
[27-34]
Mean Cell Hb Conc
35.3
[g/dL]
[30-36]
Platelets
173
[10^9/L]
[140-4001
Mean Platelet Vollume
11.5
[fL]
[03-134]
Red Cell Distribution Width (CV)
13.4
[%]
[11.0-14.6)
Neutrophil Aba
1.39
[10^9/L]
[2.5-7.5)
Lymphocytes Abs
2.08
[10^9/L]
[1.6-3.51
Monocytes Abs
0.47
[10^9/L]
[0.2-0.81
Basophils Abs
0.02
[10^9/L]
[0-0.1)
Eosinophils Abs
0.01
[10^9/L]
[0-0.41
Immature Granulocytes
0.00
[10^9/L]
[0-0.09]
8197
Clinical Details:
BLOOD TEST
08-Jan-26 Investigation
Result
Reference Range
Liver profile
Bilirubin (Total)
11.79
[1.72 17.1] µmol/1
Aspartate aminotransferase (AST)
23.8
[1050] U/L
Albumin (serum)
46.8
[3345] Gm/L
Random Blood Glucose
Glucose (random)
4.6
[3.9 7.8] mmol/L
Renal profile
Sodium (Serum)
[135 145] mmol/l
Chloride (serum)
106
[98106] mmol/l
4.5
Serum potassium
[3.5 5.1] mmol/l
Creatinine (Serum)
140
89.7
[62 106] µmol/l
estimated GFR
[mls/min/1.73m21
Interpretation.
92
Hello Felix Everything looks great . But I am suggesting you some tips and Medicine so kindly follow these for a week or 15 days .
What You Can Do Now - Moisturize: Use a gentle, fragrance-free moisturizer after bathing. - Avoid Hot Showers: Use lukewarm water instead. - Mild Soap: Switch to a gentle, non-irritating soap. - Stay Hydrated: Drink plenty of water. - Avoid smoking or reduce it if doing . - Avoid stress or anger issues. - Rx- Aspirin (75 mg) + Atorvastatin (20 mg): - take half tablet on alternate days for a week mean half tablet on Monday then another half tablet on Wednesday and then another half tablet on Friday. Mean skip days .
Hope this will help you out soon .
Thank you
Visit in person for better evaluation.
