An update on capsaicin and aquagenic pruritus | Day 274

Remember this?

Water is essential to most living things, and the human organism is no exception, with its water content estimated between 55 and 78 per cent. But what if you had a reaction to this most basic of substances, and simply couldn’t bear skin contact with it?

My boyfriend knows exactly what that’s like. Since teenage years he has been experiencing an extremely rare skin condition called aquagenic pruritus (Latin for “water-induced itching”). It means that every time after direct contact with water – showering, bathing, swimming – his skin starts to itch with a thousand pin-pricks, and no amount of scratching can alleviate it; he just needs to wait until it fades away some 20-30 minutes later.

Back on day 161 I wrote about this rare condition, and noted that we would do a primitive ‘study’ at home using capsaicin cream, which was studied in a tiny research trial of five people back in 1994, and found to be effective for their symptoms.

I said I would report back, so here goes.

Firstly, there are significant problems with using capsaicin cream several times a day – the stuff stings. It doesn’t really burn when you put it on the skin, at least it didn’t for neither of us (I tried it on my arm out of curiosity), but capsaicin is really difficult to wash off your hands. Even with soap. Even after several tries.1

“The greatest effect it had was burning my eyes whenever I absently rubbed them. I wish I could say the effect on my pruritus was even fractionally as obvious,” explained boyfriend.2

Perhaps it would have been worth it if the symptoms actually got better, but there was no change. So after three weeks of a twice-daily application protocol, boyfriend quietly gave up. I only realised that a couple weeks later when I asked what happened with the whole capsaicin routine.

Yeah. We’re not scientists.

But there is still a lesson to be learned, apart from the fact that capsaicin cream turned out to be pointless. It’s quite an interesting problem – this obvious lack of solid scientific research into aquagenic pruritus causes and cures. When a disease is not life-threatening, and is also incredibly rare, it makes for a lousy research subject, because the gains ultimately would be small, especially for the pharmaceutical company that might end up creating a treatment. More common diseases inevitably receive more research attention. If they are deadly, that’s a good thing – however, there are also incredibly rare and deadly diseases that don’t get enough funding.

So, in conclusion:

1. Capsaicin cream may or may not work for your pruritus, but it does stay on the hands.

2. Life isn’t fair, and neither are research dollars.

Show 2 footnotes

  1. I ruined a pair of contact lenses with chilli once. I had washed my hands.
  2. Now fiancé, actually.

7 thoughts on “An update on capsaicin and aquagenic pruritus | Day 274”

  1. Does antihistamine blunt the reaction? If not then that is a very interesting allergy…

    I’m “sensitive” by which I mean I occasionally break out in furious itching rashes and at other times maniacal sneezing with no obvious trigger so I always have some antihistamine in my bag.

    1. It’s not really an allergy. I touched upon it in my original post – and yeah, antihistamines don’t really help, although doctors do prescribe them for this.

  2. I have this AP problem for about 29year I have treatment in both African traditional medicine and Western medicine non work,I discovered that it was about sensitive skin, I don’t dry off with any towel after hot shower 3times a day and I use non chemical soap and none scented soap,and I put my clothes on the shower room, with this method I have seen alots of improvement (Tel:8622152667)new Jersey USA

  3. I have this as well. suffering for years especially in the summer months. only relief I can find when it flares up is to take a scalding hot shower then slowly raise the water temp to room temperature then drip dry. I wish I could find relief.

  4. Hi,
    I have been suffering with this few a few years now, possibly due to medication side affects.
    Interestingly I have found that cold showers have reduced the symptoms.
    I have tried non soapy type soaps and good quality moisturizer to no effect.
    When I swim in the ocean it does not seem to affect me as I do not remember itching when I come out, I will have to take more notice.
    I am going to try bathing in a more alkaline solution, (baking soda in the bath water), but haven’t got around to it yet.
    I get itchy for about 25 mins before the itches go away.

  5. I have this condition. I use the capsaicin that has a dobber on it so I don’t have to touch it. It works pretty well for me. Using hot water at the end of the shower directed on my trouble spots helps the most. I have to get my skin really red. I’m trying a low histamine diet next.

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