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Heat urticaria is usually treated effectively by antihistamines to control the conditions and eliminating such exposures help to prevent hives. Corticosteriods and anabolic steroids are also used. Some patients with this condition are desensitized with hot bath therapy, but this should only be tried under medical supervision. UVB therapy, sweat and exercise therapy, and diet changes may also be used to help in the management of heat urticaria.
Cholinergic or generalized heat urticaria is the onset of small wheals surrounded by a large area of redness, associated with exercise, hot showers, sweating and anxiety ( for picture). The rash first appears on the neck and upper chest, giving a flushed appearance. This is accompanied by intense itching. The rash spreads gradually to the face, back, and extremities, and the wheals increase in size. In some people the hives join up and resemble angioedema. Watering eyes, increased saliva production and diarrhea can occur at the same time. Cholinergic urticaria is the only form of hives that can be caused by emotional responses.