Vibratory urticaria is a rare condition that causes allergic-like skin reactions after exposure to certain types of vibration, stretching, or friction. Treatment involves trigger avoidance and medications.
Urticaria is a clinical term for skin hives. The hives or welts develop as a reaction to numerous causes, including illnesses, allergies, and physical irritants.
As the name suggests, vibratory urticaria is caused by vibration against the skin. It can also be brought about by repetitive stretching and friction. It’s a rare condition that may also have a hereditary component, though some cases are also idiopathic (meaning the cause is unknown).
Hereditary variants of this condition are transmitted with an autosomal dominant pattern. This means if a parent has the mutated gene (and the condition), their child has a 50% chance of inheriting the gene and the condition.
If you suspect you have vibratory urticaria, make an appointment with a doctor. A doctor can diagnose what’s causing your urticaria and recommend a treatment plan to help manage your symptoms.
This article examines the symptoms, causes, diagnosis, and treatment of vibratory urticaria.
Symptoms of vibratory urticaria generally occur within minutes of exposure to the aggravating stimulus. Sometimes, the reaction can last between 1 and 2 hours at a time, and you might have recurring symptoms throughout the day.
Most of the symptoms of vibratory urticaria develop on the part of the body that’s exposed to vibration and friction. The resulting hives may be:
- raised welts in varying sizes
- pink, red, or skin-colored, depending on your natural skin tone
- varying shapes, such as large patches or rings
- extremely itchy
- swollen
- prickly or burning
While rare, it’s possible that the reaction may become more systemic. As such, you might experience:
- facial swelling, flushing, or both
- headaches
- blurry vision
- metallic taste in your mouth
- fainting
- low blood pressure
Other types of urticaria
There are several types of urticaria, which may be chronic (lasting more than 6 weeks) or acute (lasting less than 6 weeks).
Acute cases of urticaria are the most common. These may be caused by allergies, viral infections, and medications.
Other types of chronic urticaria are triggered by external physical or environmental factors,
- cold
- heat
- pressure
- sunlight
- sweat
- water
These types of chronic urticaria may be spontaneous or idiopathic. Up to
Vibratory urticaria hives most often develop around your hands or trunk due to the types of stimuli that cause these reactions.
You might experience symptoms after everyday activities, such as:
- working with machinery or power tools, such as jackhammers or drills
- running
- riding in a car
- cycling
- mowing the lawn
- towel drying
- clapping your hands
- horseback riding
The exact prevalence of vibratory urticaria isn’t known. However, it is just one type of physical urticaria. As an umbrella, physical urticaria is rare. It is thought to affect 5 in every 1,000 people.
However, researchers believe there may be a hereditary component involved in the development of vibratory urticaria. Most people who have this type of urticaria have at least one parent with the same condition.
This may be related to ADGRE2 gene mutations, which are normally responsible for providing instructions to immune cells, such as mast cells. Still, not everyone with vibratory urticaria has an ADGRE2 gene mutation.
Why does vibration release histamine?
If you have vibratory urticaria, the mast cells may release histamine in response to skin vibrations. These can then cause allergy-like symptoms and subsequent signs of vibratory urticaria.
If you have had recurring hives for more than six weeks, it’s important to see a doctor to help diagnose possible chronic urticaria.
At your appointment, a doctor will look for signs of urticaria and ask you about the symptoms you’ve been experiencing. They will also ask you about any daily activities that might contribute, and may look at your medical history for risk factors of chronic urticaria.
Since the signs and symptoms of vibratory hives are similar to other forms of physical urticaria, much of the diagnosis involves determining your exact triggers while also eliminating other possible causes.
One test a doctor might consider is called a vibratory provocation (challenge) test. This works by mimicking a common stimulus against your forearm with a machine for 5 minutes. Your skin is then checked for hives and other symptoms several minutes after the test.
Blood testing and a skin biopsy may also be ordered to rule out other underlying causes of your hives.
Vibratory urticaria is best managed by avoiding known triggers as much as possible. However, trigger avoidance might not always be possible, and you may experience symptoms from time to time.
When symptoms do occur, a doctor may recommend taking non-sedating antihistamines to reduce itchiness and swelling. These are considered first-line treatments for chronic urticaria, including vibratory forms.
While some antihistamines are available over the counter, it’s important to consult with a doctor before using them to manage vibratory urticaria. A doctor can help monitor your response to these medications and also recommend dosage or brand changes as needed.
Antihistamines cannot cure vibratory urticaria, but are instead tools you can use as part of your overall management plan to improve symptoms that might otherwise interfere with your quality of life.
Due to the rarity of this condition, the exact outlook isn’t known. Vibratory urticaria is usually successfully managed with both avoidance of vibratory stimuli and treatment with antihistamines.
However, it’s estimated that up to 15% of people with chronic urticaria may experience symptoms twice a week or more over the long term. This may also include vibratory forms.
Vibratory urticaria is a rare condition that causes allergic-like reactions in the form of hives, swelling, and other symptoms. It’s triggered by vibratory stimuli in your everyday environment, which can cause chronic recurring symptoms for several weeks.
Once a doctor has confirmed vibratory urticaria, they can help you manage this condition so that you develop fewer reactions over time. This involves a combination of trigger avoidance and the use of antihistamines.
While there is currently no cure for vibratory urticaria, the condition can be managed.