Imagine a world without water—a life without its essential sustenance. While water is often hailed as the elixir of life, what if it became your enemy? Meet Tessa Hansen-Smith, a 25-year-old Californian facing an unimaginable reality: she suffers from a rare condition known as Aquagenic Urticaria, commonly referred to as water allergy. It transforms the mundane act of touching water into a perplexing medical enigma; documented in a mere 37 cases worldwide. Hansen-Smith was diagnosed nearly eight years ago, and Hansen-Smith’s journey with this affliction has been nothing short of life-altering, with her condition only deteriorating over time.
According to medical research, Aquagenic Urticaria differs from common allergies triggered by substances like pollen, nuts, or animal dander. It is induced by contact with various sources of water—rain, snow, freshwater, seawater, sweat, and even tears—making it a baffling and often challenging condition to manage. The exact cause remain largely unknown, which adds to the complexity of diagnosing and treating the condition.
According to Delhi-based dermatologist Dr Aporva Sanghvi, the reaction may not be to the water itself but possibly due to the release of histamine, leading to the formation of an allergen. “During allergic reactions, mast cells located beneath the skin release histamine, leading to a variety of allergy-like symptoms that differ based on the specific body part affected. This condition is distinct from more common forms of urticaria in that it specifically involves the development of hives when the skin comes into contact with water, regardless of its temperature,” she says.
It is characterised by the development of itchy, red welts on the skin upon contact with water. Individuals affected by this disorder experience hives and itching when exposed to water. While symptoms can manifest anywhere on the body, they are commonly observed on the arms, neck, and upper torso.
The rarity of Aquagenic Urticaria means that standardised treatment protocols are not widely established. However, treatments are often tailored to the individual’s specific symptoms and may include antihistamines to manage itching and swelling. In addressing treatment, Dr Puneet Tripathi, a dermatologist from Pune, emphasises the bespoke nature of managing it. “There’s no one-size-fits-all solution. In some cases, phototherapy has been reported to offer relief, potentially altering the skin’s response to water. Barrier creams may also be recommended to provide a protective layer on the skin, reducing direct contact with water,” he says, adding, “Adapting lifestyles to minimise water contact is often just as crucial as medical interventions in managing this condition.”
As research continues, there is hope for more effective treatments and a deeper comprehension of this perplexing condition.
How to prevent a flare-up
● Prior to showering, coat the skin with mineral oil or 100% petroleum jelly
● Utilise dry shampoo and waterless cleansers while showering to minimise water contact
● Opt for brief, intermittent shower sessions
● Choose clothing designed to wick moisture and perspiration away from the skin