Question: Hello,

I woke up the two days ago with blotches on my face. I went out to a concert and had a few beers and it was quite hot out while tailgating. The next morning, I woke up with a swollen parts of my face and some more blotches and VERY itchy. Today my face is sore and still itchy but not as blotchy or swollen. A doctor once told me that I may have rosacea because I have some blotchiness on my face. Can't cholinergic urticaria cause redness and blotchiness on face?

Some background: I get rashes from my own sweat and from hot showers. I have some permanent blotchiness on my face. I also suffer from dermographism urticaria and possibly cholinergic urticaria.

Anyway, Does this look like hives? Thanks

So my pictures look like hives to you? Thank you for your response.

Dr. Batra,

Thanks for your response. You did not answer if my pictures were hives, so I suppose they were. They are much better now, but I am still left with some patchy redness on my face.

Is it common to breakout in hives the next day after consuming alcohol? I was flushed when I was drinking the alcohol then I got the hives the next day. My face will look swollen and I will have some red bumps/hives???

Also, around my menstrual period, my face will have some red bumps that disappear quickly and I will look slightly swollen. I will also have very itchy eyes and stuffy nose.

And I am not sure if this is related, but I have a lot of dry, red patches on my face. I also have it along side of my nose which is flaky. My skin is so very dry and there is some redness that gets worse with showers, exercise and alcohol. Could this be seborrhoeic dermatitis considering I already suffer from other skin allergies? It's under my eyes near my nose, on either sides of my nose and randomly around my face on my cheeks. It's hard to see in photos though but I will try to take some so you can see.

Thanks so much- XXXXXXX

Dr. Batra,

Thank you for reply. I have a couple other questions for you. It seems that after a hot shower or being out in the sun, my face will feel tight. I also will get a burning rash on my forehead. I uploaded 2 pictures to this query so you could see my forehead. Can urticaria/hives cause tightness in face and rash on forehead? My skin also is a little blotchy in normal conditions. Allergies?

My allergist explained that people with allergies can flush with alcohol and exercise which I do. When I exercise in hot temperatures, my face will look very red. My face will also flush with alcohol occasionally.

Do you have any idea what would cause the tightness in my face after being out in the sun or hot showers? Please view the new photos that I uploaded.

Thank you so much- XXXXXXX

Thank you for your reply. The forehead rash seems to occur after taking warm baths or showers. The rash tends to burn a little bit and makes my forehead feel tight. Is that another form of hives, possibly cholinergic urticaria? Doesn't that occur with rises in body temperature?

Ok, I see what you're saying that people who have allergies tend to flush easier than others. Do you know what that is or what causes it? Also, can allergies cause skin to look blotchy at times- like have some permanent redness?

Thanks so much, XXXXXXX

Dr. Batra,

Thank you for your message. So Cholinergic urticaria and Heat Urticaria are why I flush with exercise, hot showers and occasionally with alcohol? Does anxiety worsen the problem? Can Cholinergic urticaria and Heat Urticaria worsen around my menstrual cycle?

Would medications like singulair help this in addition to zyrtec or allegra? Should I take an antihistamine more often? Would a beta blocker like propranolol be helpful as well?

Do you think it would be useful to follow a low histamine diet?

Thank you so much!! XXXXXXX

Dr. Batra,

Thanks for your reply. I will give singulair a try.

Is it normal for some of that redness to stick around on your face- skin to look a little blotchy at times in allergy prone people? I also tend to get a rash and blotches on my face when I sweat. Is this Cholinergic urticaria as well?

Can Cholinergic urticaria and Heat Urticaria worsen around my menstrual cycle?

Thanks again, XXXXXXX