writing on the skin

• Skin Problems and Treatments

What Is Dermatographia?

Dermatographia, also called skin writing, is a condition that causes an allergic reaction when skin is scratched. This reaction looks like hives or welts. It may even happen when the skin is rubbed when pressure is applied.

Experts estimate that 2% to 5% of people have dermatographism. It’s quite common and isn’t dangerous.

Symptoms of Dermatographia

If you have this condition, you get raised red welts where your skin was recently scratched or irritated. These welts or hives develop within 5 to 7 minutes of scratching and usually fade away within 15 minutes to half an hour. In rare cases, the symptoms develop more slowly and may take hours or days to disappear.

This condition is known as skin writing because you can make writing or drawings appear on your skin by stroking it with an object, like your fingernail or a closed ball-point pen. At first, your skin will turn white. Then the redness and swelling will begin, taking the form of the strokes you made.

The symptoms of skin writing can be different for each person, but there are some common signs:

• Raised red lines that form in the same pattern as your fingernails 
• Welts that look like hives or raised patches
• Inflammation

Causes of Dermatographia

Experts aren’t sure of the exact cause of dermatographism. It could be an allergic reaction, but no specific allergen has been found.

Doctors believe that the welts form because of a release of histamine, a chemical that your body makes when it suspects an invading allergen. The histamine causes welts and hives, which are an overreaction because there is no allergen present.

Skin writing may also flare up because of things like:

• Exercising 
• Exposure to heat and cold

Some things may make people more likely to have to dermatographism. Doctors think that people with other skin conditions might be more at risk. These include:

Symptoms of dermatographia can be triggered by simple things or actions. Your clothing or bedsheets rubbing against your skin can cause a reaction. Pressure from leaning or resting on a hard surface can also trigger the hives. Research suggests that there might also be a link between skin writing outbreaks and taking penicillin .

In rare cases, dermatographia can be triggered by infections such as:

• Fungal infections
• Bacterial infections

People of any age can have dermatographia, but it is most common in teens and young adults. You may have it for a short time, like a few months. Or it could be chronic and last years.

Diagnosis and Treatment of Dermatographia

Your doctor can diagnose dermatographia with a simple test. They use a tongue depressor or other tool to gently stroke your skin, drawing lines. They watch for welts to show up within a couple of minutes. ‌

There’s no cure for dermatographia. And because the symptoms usually go away very quickly, you probably don’t need treatment. But some people may find their hives are very itchy or bothersome.

Medications. Your doctor may prescribe an antihistamine to help ease the symptoms of dermatographia. Antihistamines help manage symptoms of allergies. Many are also available over the counter.

A medication called cromolyn has the same effect as antihistamines. It helps stabilize the cell membrane that releases histamine and eases symptoms. Cromolyn requires a doctor’s prescription. ‌

Preventive care. There are a few things you can do to prevent symptoms. First, avoid irritating your skin. This includes wearing soft, loose clothing and avoiding harsh or scented soaps. Hot water during showers can also make dermatographia worse, because heat may be a trigger. ‌

Second, keep your skin moisturized. Apply lotion or cream after showering to hydrate your skin, as dry skin tends to get itchy.

Avoid scratching your skin. It only makes dermatographia worse. The more you scratch, the worse your symptoms will be. 

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Is Dermographism an Autoimmune Disease?

Frequently asked questions.

Dermographism (also called dermatographia , dermatographic urticaria , dermatographic hives , or writing on the skin) is a condition that produces red, itchy bumps or raised lines on the skin, and is considered a type of hives . The marks usually appear after the skin is irritated by scratching, rubbing, pressure, or another form of contact. Some people experience dermographism with autoimmune diseases .

This article will discuss dermographism, the connection to autoimmune disease, causes, treatments, and more.

How Dermographism Works

Up to 5% of people experience dermographism. It happens when the skin is irritated by contact, such as pressure, scratching, or rubbing. Red, itchy bumps appear within five to seven minutes of contact and typically last for 15 to 30 minutes. In some cases, they can last up to a couple of hours.

There may be a connection between dermographism and autoimmune response, but this relationship is not fully understood.

Autoimmune disorders, including thyroid conditions and lupus , have been associated with hive symptoms but more research is needed to explain why. These conditions also include:

• Type 1 diabetes
• Celiac disease
• Pernicious anemia
• Rheumatoid arthritis

Autoimmune Disease Definition

Autoimmune disease occurs when the immune system attacks healthy cells instead of pathogens that cause disease.

There are various triggers for hives, such as allergic reactions to foods or viral infections. Physical irritation or contact with the skin is the trigger for dermographism. When the irritation occurs, a chemical in the body called histamine is released in response, dilating blood vessels and leading to redness and itching. Histamine release also causes swelling.

Dermographism Causes

It is not always clear why some people experience hives after contact with an irritant, but an allergy or underlying disease could be the cause. Many people with autoimmune disease experience hives, and it is believed that there is a link between autoimmune disease and dermographism. Other causes of this condition include:

• Tight clothing

Additional factors that may lead to dermographism or that make hives more likely to appear after irritation include:

• Extreme temperatures (heat or cold)
• Physical activity or exercise
• Stress (physical or emotional)

The most common symptom of dermographism is red, itchy bumps on the skin . Since the reaction occurs in response to physical contact, the marks usually appear in lines or patterns where the skin is scratched. The word "dermatographia" translates to "writing on the skin" and is how the condition got its name.

Dermographism symptoms include:

• Swelling or inflammation
• Raised red lines
• Hive-like welts

Dermographism typically goes away on its own and doesn't require treatment. However, there are treatments to help cope with the discomfort of symptoms. Medications called antihistamines can be used to relieve the itch by blocking the histamine response that leads to hives. Anti-itch creams can be applied directly to the skin and may help relieve symptoms, but are generally not as effective as oral antihistamines.

A healthcare professional, such as a primary care provider, an allergist, or a dermatologist , can recommend specific treatment options.

First-line therapy, avoiding triggers, and second-generation oral antihistamines are effective treatment options for dermographism. People experiencing dermographism can also try preventive strategies to avoid symptoms.

Prevention for Dermographism

• Avoid rubbing, scratching, or applying too much pressure to the skin
• Maintain a comfortable temperature, not becoming overheated or too cold
• Wear loose-fitting clothing
• Manage stress

Dermographism is a form of hives that occurs when the skin is scratched, rubbed, or irritated, leading to itchy, red bumps that last for about 30 minutes. Since dermographism is a reaction to direct contact it can show up in patterns like scratch lines.

The connection between dermographism and autoimmune disease is not fully understood. For some patients, the main presenting symptom of an undiagnosed new autoimmune condition is dermographism or hives. When the autoimmune condition is treated, the dermographism and hives often also go into remission.

This condition does not always need to be treated because symptoms go away quickly, but treatment and prevention options may help to provide relief and decrease the chances of the hives returning.

A Word From Verywell

Living with dermographism can be challenging, especially when the condition becomes frequent and/or comes and goes for a long time. The symptoms can be uncomfortable. If you or someone you know is experiencing dermographism, talk to your provider about prevention and treatment options.

It is not entirely clear what causes dermographism flare-ups. Some things that may make it more likely include physical or emotional stress, exercise, and extreme temperatures.

The relationship between dermographism and the immune system is not fully understood. It is believed that there is a link between autoimmune disease and dermographism, and many people experience both at the same time. Autoimmune disease is when the immune system is activated for an unknown reason and attacks healthy cells.

While dermographism is not considered one of the mast cell disorders, such as mast cell activation syndrome (MCAS), there is a connection between these conditions. Mast cells are a type of white blood cell that are located under the skin and in smaller quantities in other areas of the body. They release histamine, a chemical in the body, which leads to hives or the itchy bumps experienced with dermographism.

American Osteopathic College of Dermatology. Dermatographism .

Jenerowicz D, Błaszczyk A, Raciborski F, Sadowska-Przytocka A, Adamski Z, Czarnecka-Operacz M. Pathogenetic aspects of chronic urticaria. Retrospective and prospective analysis of the patients of the department of dermatology, poznan university of medical sciences .  Adv Dermatol Allergol . 2021;38(1). doi:10.5114/ada.2021.107270

Binmadi N, Almazrooa S. Dermographism in the oral cavity.   Am J Case Rep . 2016;17:421-424. doi:10.12659/AJCR.898247

Bracken SJ, Abraham S, MacLeod AS. Autoimmune Theories of Chronic Spontaneous Urticaria . Front Immunol . 2019 Mar 29;10:627. doi: 10.3389/fimmu.2019.00627.

Murdaca G, Paladin F, Borro M, Ricciardi L, Gangemi S. Prevalence of Autoimmune and Autoinflammatory Diseases in Chronic Urticaria: Pathogenetic, Diagnostic and Therapeutic Implications . Biomedicines . 2023 Jan 30;11(2):410. doi: 10.3390/biomedicines11020410. 

National Institutes of Health. Autoimmune diseases .

American Academy of Dermatology Association. Hives: Causes .

National Health Services. Urticaria (hives) .

American Osteopathic College of Dermatology. Urticaria .

Sparrow. Dermatographia .

American Academy of Allergy, Asthma, and Immunology. An update on treatment options in symptomatic dermographism .

American Academy of Dermatology Association. 10 ways to get relief from chronic hives .

Qureshi AA, Friedman AJ. A Review of the Dermatologic Symptoms of Idiopathic Mast Cell Activation Syndrome.   J Drugs Dermatol . 2019;18(2):162-168.

By Ashley Olivine, Ph.D., MPH Dr. Olivine is a Texas-based psychologist with over a decade of experience serving clients in the clinical setting and private practice.

• Patient Care & Health Information
• Diseases & Conditions
• Dermatographia (Dermatographism)

To test if you have dermatographia, your health care provider may draw a tongue depressor across the skin of your arm or back. If a raised line or a welt appears within a few minutes, you likely have the condition.

Treatment for dermatographia often isn't needed, as symptoms tend to clear up on their own. But if your symptoms are bad or bother you, your health care provider may suggest a mild antihistamine medicine taken by mouth. These are sold at drugstores. First try a type doesn't cause drowsiness, such as fexofenadine (Allegra), loratadine (Alavert, Claritin, others) or cetirizine. If none of these help, your health care provider may prescribe a stronger medicine for use at bedtime. An example is doxepin.

Preparing for your appointment

You're likely to start by seeing your primary care provider. Or you may be referred to a doctor who specializes in skin conditions. This type of doctor is called a dermatologist. Or you might need to see a doctor who specializes in allergies. This type of doctor is called an allergist.

Here's some information to help you prepare for your appointment.

What you can do

At the time you make the appointment, ask if you need to do anything. For example, you may be asked to stop taking your antihistamine pill for a few days before your appointment.

You may also want to:

• List your symptoms, including any that seem unrelated to your skin symptoms.
• List key personal information, including any major stresses or recent life changes.
• List all medicines, vitamins or supplements you're taking.

What to expect from your doctor

Your health care provider is likely to ask you a few questions, including:

• When did you begin experiencing symptoms?
• Were you sick right before your symptoms started?
• Did you start taking a new medicine right before your symptoms started?
• Have your symptoms been nonstop? Or do they come and go?
• How bad are your symptoms?
• Do your symptoms get in the way of your daily activities?
• Do you have allergies? If so, what are you allergic to?
• Do you have dry skin or any other skin conditions?
• Does anything improve your symptoms?
• Does anything make your symptoms worse?
• AskMayoExpert. Pruritus without rash. Mayo Clinic; 2021.
• Bolognia JL, et al., eds. Pruritus and dysesthesia. In: Dermatology Essentials. 2nd ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Sept. 28, 2022.
• Office of Patient Education. Care of Dry Skin. Mayo Clinic; 2017.
• Dinulos JGH. Urticaria, angioedema, and pruritus. In: Habif's Clinical Dermnatology. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Sept. 28, 2022.
• Dermographism. Dorland's Medical Dictionary Online. https://www.dorlandsonline.com. Accessed Sept. 28, 2022.
• Dermatographism. American Osteopathic College of Dermatology. https://www.aocd.org/page/Dermatographism. Accessed Sept. 28, 2022.
• Nobles T, et al. Dermatographism. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK531496. Accessed Sept. 28, 2022.
• Burks AW, et al. Urticaria and angioedema. In: Middleton's Allergy: Principles and Practice. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Sept. 29, 2022.
• Link JL (expert opinion). Mayo Clinic. Nov. 1, 2022.
• Dermatographia

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If You Have This Condition, You Can Write on Your Skin—No Pen Required

The hives appeared the day after my two-week course of antibiotics ended. I lightly scratched an itch on my arm and, moments later, red welts surfaced along the path left by my fingernails.

Those welts faded within half an hour, but more quickly replaced them, taking the shape of whatever object provoked them. Unnerved, I did what any logical person would do: Search the internet. Apparently I had a condition called dermatographia, or “skin writing.”

“It’s probably more common than people think,” says Andrea Kalus, M.D., a dermatologist who practices at UW Medical Center Roosevelt. Doctors classify dermatographia as a type of urticaria , or hives, and suspect it is a histamine reaction.

“It’s like an alarm going off in the skin, alerting the immune system that there might be a breach in the wall. It allows extra blood flow and immune chemicals to come into the area,” Kalus says.

Doctors don’t completely understand dermatographia. It can be short-lived or chronic, severely itchy or mildly so. One recent study showed it can be a kind of “delayed hypersensitivity” reaction to penicillin, typically beginning six hours to several days after exposure. The authors note that amoxicillin can also cause a reaction after treatment ends—exactly what happened to me.

A Chronic Condition—and an Artist's Inspiration

For Ariana Page Russell , who has chronic dermatographia, the exact cause has been harder to pinpoint. Growing up, her skin was sensitive and flushed easily, and once she broke out in a rash after consuming one of her cousin’s bubblegum-flavored penicillin pills. She first noticed welts as a teenager but didn’t think much of them.

Russell was diagnosed in 2004 when she was a University of Washington graduate student in photography. While working on a project involving kelp, she scratched her knee and noticed kelp-shaped patterns on her skin. She photographed them.

“When I had peers and professors in for a visit, they didn’t care about the kelp photographs—they gravitated to the skin stuff,” Russell says. “I didn’t have any answers for them. They were like, ‘There’s something else going on here—this isn’t normal!’” She went to the doctor soon after.

Having a name for her welts was a relief, she says, as was incorporating them into her artwork in order to better understand them—and even find beauty in them.

“It definitely made me feel more confident about my skin,” she says.

Through her photography, she hopes to inspire others with dermatographia or similar conditions to embrace their skin the way it is and not feel ashamed of or embarrassed by it. She also runs a blog  to help educate people.

“I tell people to turn it around, make other people see it in a positive way: ‘I can draw a picture on my skin: What can you do?’ Then you’re the one who has the power over it and how people see it,” she says.

No Cure and Little Research

Russell's dermatographia is less severe now, which she credits to a healthier diet and being selective about the products she uses in her home and on her skin.

Studies about dermatographia would be helpful for those who live with it, but funding is hard to come by, Kalus says. Research dollars typically go toward projects that have a greater perceived health impact.

Until more research can be conducted, treatment typically focuses on symptom management.

“Avoidance of triggers is important. Antihistamines can help with the itching, though non-drowsy antihistamines tend not to work as well. Topical lotions that cool the skin can be helpful,” Kalus says.

After a few weeks of uncomfortable, antihistamine-dulled existence, my dermatographia faded. I was lucky—though also sad to see it leave, in a way. I’d grown almost fond of the skin writing. For an English major enamored by the written word, there was something poetic about being able to etch secret, disappearing messages on my body.

But I definitely don’t miss the itching.

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Dermographism Urticaria

• Author: Simone Laube, MD, MRCP; Chief Editor: Dirk M Elston, MD  more...
• Sections Dermographism Urticaria
• Pathophysiology and Etiology
• Epidemiology
• Patient Education
• Physical Examination
• Medication Summary
• Antihistamines, Second Generation
• Antihistamines, First Generation
• Monoclonal Antibodies
• Media Gallery

The term dermographism (or dermatographism) literally means writing on the skin. Firm stroking of the skin produces an initial red line (capillary dilatation), followed by an axon-reflex flare with broadening erythema (arteriolar dilatation) and the formation of a linear wheal (transudation of fluid/edema); these events are collectively termed the triple response of Lewis.

An exaggerated response to this constitutional whealing tendency is seen in approximately 2-5% of the population and is referred to as dermographism. In a minority of people, it is accompanied by itching (symptomatic dermographism).

See the image below.

Dermographism should be distinguished from other types of urticaria. See the following articles:

Acute urticaria

Cholinergic urticaria

Chronic urticaria

Contact syndrome urticaria

Pressure urticaria

Solar urticaria

The exact mechanism of dermographism remains uncertain. Trauma may release an antigen that interacts with the membrane-bound immunoglobulin E (IgE) of mast cells, which release inflammatory mediators, particularly histamine, into the tissues. This process causes small blood vessels to leak, allowing fluid to accumulate in the skin. Other mediators that may be involved are leukotrienes, heparin, bradykinin, kallikrein, and peptides such as substance P.

Symptomatic dermographism is usually idiopathic, though it may have an immunologic basis in some patients. Passive transfer of the dermographic response with IgE- or immunoglobulin M (IgM)-containing serum has been reported, but no allergen has been identified.

Symptomatic dermographism may be triggered by drugs (eg, penicillin), an insect bite, Helicobacter pylori infection, or an infestation (eg, scabies, Fasciola hepatica ). Congenital symptomatic dermographism has been described as the first sign of systemic mastocytosis. [ 1 ]

Approximately 75% of patients with hypereosinophilic syndrome, which has multisystem involvement and high mortality, have dermographism. Psychological factors and a history of stressful life events have been implicated as triggering factors in 30% of patients. [ 2 ] However, a small prospective study showed no alteration in dermographic reaction after social stress provocation tests. [ 3 ]

One case report describes symptomatic dermographism secondary to trauma from a coral reef. [ 4 ] Symptomatic dermographism may be a presenting feature of dermatomyositis. [ 5 ]

Dermographism is the most common of the physical urticarias and can occur with other forms of urticaria. An increased incidence has been reported during pregnancy (especially in the second half), at the onset of menopause, in atopic children, and in patients with Behçet disease . [ 6 ]

Dermographism can appear in persons of any age but is more common in young adults; the peak incidence is in the second and third decades. Whether a sexual variance in prevalence occurs is unclear. None has been consistently reported, though one study on dermographism in children reported a female predominance. [ 7 ] No racial variance in prevalence is known.

Simple dermographism is the most common variant, and patients with this form are asymptomatic. However, other forms are associated with pruritus, and this can significantly affect quality of life. Most people with dermographism are otherwise healthy. An association with thyroid disease has been described in some patients but remains controversial.

The natural history of symptomatic dermographism is unpredictable. It may last for months or years, or be present intermittently. In many patients, the condition gradually improves and clears after several years. Of the chronic urticarias, symptomatic dermographism appears to have the best prognosis in terms of clearance after 5 years (36%) and 10 years (51%). [ 8 ]

Reassure patients about the benign nature of the disorder, and inform them of the possible prolonged course. Explain the adverse effects of antihistamine therapy. In particular, warn patients about drowsiness, which is especially problematic when they are driving or handling machinery.

For patient education resources, see the Allergy Center and Skin, Hair, and Nails Center , as well as Hives and Angioedema .

Grimm V, Mempel M, Ring J, Abeck D. Congenital symptomatic dermographism as the first symptom of mastocytosis. Br J Dermatol . 2000 Nov. 143(5):1109. [QxMD MEDLINE Link] .

Taskapan O, Harmanyeri Y. Evaluation of patients with symptomatic dermographism. J Eur Acad Dermatol Venereol . 2006 Jan. 20(1):58-62. [QxMD MEDLINE Link] .

Wallengren J, Isaksson A. Urticarial Dermographism: Clinical features and response to psychosocial stress. Acta Derm Venereol . 2007. 87:493-8. [QxMD MEDLINE Link] .

Wu JJ, Huang DB, Murase JE, Weinstein GD. Dermographism secondary to trauma from a coral reef. J Eur Acad Dermatol Venereol . Nov 2006. 20:1337-8. [QxMD MEDLINE Link] .

Rahim KF, Dawe RS. Dermatomyositis presenting with symptomatic dermographism and raised troponin T: a case report. Journal of Medical Case Reports . July 2009. 3:7319. [QxMD MEDLINE Link] . [Full Text] .

Dinc A, Karaayvaz M, Caliskaner AZ, Pay S, Erdem H, Turan M. Dermographism and atopy in patients with Behcet's disease. J Investig Allergol Clin Immunol . 2000 Nov-Dec. 10(6):368-71. [QxMD MEDLINE Link] .

Martorell A, Sanz J, Ortiz M, Julve N, Cerda JC, Ferriols E. Prevalence of dermographism in children. J Investig Allergol Clin Immunol . 2000 May-Jun. 10(3):166-9. [QxMD MEDLINE Link] .

van der Valk PG, Moret G, Kiemeney LA. The natural history of chronic urticaria and angioedema in patients visiting a tertiary referral centre. Br J Dermatol . 2002 Jan. 146(1):110-3. [QxMD MEDLINE Link] .

Lambiris A, Greaves MW. Dyspareunia and vulvodynia: unrecognised manifestations of symptomatic dermographism. Lancet . 1997 Jan 4. 349(9044):28. [QxMD MEDLINE Link] .

Matthews CN, Warin RP. Cold urticaria and cold precipitated dermographism. Br J Dermatol . Jan 1970. 82:91. [QxMD MEDLINE Link] .

Jedele KB, Michels VV. Familial dermographism. Am J Med Genet . 1991 May 1. 39(2):201-3. [QxMD MEDLINE Link] .

Golberg O, Johnston GA, Wilkinson M. Symptomatic dermographism mimicking latex allergy. Dermatitis . 2014 Mar-Apr. 25:101-3. [QxMD MEDLINE Link] .

Hawkey S, Abdul Ghaffar S. Glove-related urticaria: an increasing occupational problem amongst health care workers. Br J Dermatol . 2015 Nov 17. Epub ahead of print: [QxMD MEDLINE Link] .

Schoepke N, Mlynek A, Weller K, Church MK, Maurer M. Symptomatic dermographism: an inadequately described disease. J Eur Acad Dermatol Venereol . 2015 Apr. 29(4):708-12. [QxMD MEDLINE Link] .

Sharpe GR, Shuster S. In dermographic urticaria H2 receptor antagonists have a small but therapeutically irrelevant additional effect compared with H1 antagonists alone. Br J Dermatol . 1993 Nov. 129(5):575-9. [QxMD MEDLINE Link] .

Maurer M, Metz M, Brehler R, et al. Omalizumab treatment in patients with chronic inducible urticaria: A systematic review of published evidence. J Allergy Clin Immunol . 2018 Feb. 141:638-649. [QxMD MEDLINE Link] .

Maurer M, Schuetz A, Weller K, et al. Omalizumab is effective in symptomatic dermographism-results of a randomised placebo-controlled trial. J Allergy Clin Immunol . 2017 Sept. 140:870-873. [QxMD MEDLINE Link] .

Metz M, Altrichter S, Ardelean E, at al. Anti-Immunoglobulin E Treatment of Patients with Recalcitrant Physical Urticaria. Int Arch Allergy Immunol . 2011. 154:177-180. [QxMD MEDLINE Link] .

Vieira Dos Santos R, Locks Bidese B, Rabello de Souza J, Maurer M. Effects of Omalizumab in a patient with three types of chronic urticaria. Br J Dermatol . 2013 Sep 14. [QxMD MEDLINE Link] .

Metz M, Ohanyan T, Chruch MK, Maurer M. Retreatment with omalizumab results in rapid remission in chronic spontaneous and inducible urticaria. JAMA Dermatol . 2014 Mar. 150(3):288-90. [QxMD MEDLINE Link] .

Borzova E, Rutherford A, Konstantinou GN, Leslie KS, Grattan CE. Narrowband ultraviolet B phototherapy is beneficial in antihistamine-resistant symptomatic dermographism: A pilot study. J Am Acad Dermatol . Sept 2008. 59:752-7. [QxMD MEDLINE Link] .

Grattan CEH, Kobza Black A. Urticaria and mastocytosis. Burns DA, Breathnach SM, Cox N, Griffiths C, eds. Rook's Textbook of Dermatology . 7th ed. London, England: Blackwell Science; 2004. Vol 3: 47.1-47.37.

• Dermographism or skin writing on forearm.
• Appearance of the word "Dermatographia" on a human arm 15 minutes after the letters have been traced with a blunt object on the skin. A type of urticaria or "hives", also known as dermatographic urticaria, dermatographism, or "skin writing".
• Dermographism urticaria. Courtesy of Professor Raimo Suhonen and DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/reactions/s/dermographism2.jpg).

Contributor Information and Disclosures

Simone Laube, MD, MRCP Consulting Staff, Department of Dermatology, NHS Lothian, Scotland Simone Laube, MD, MRCP is a member of the following medical societies: Scottish Dermatological Society Disclosure: Conference attendance for: Novartis; Amirall.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology Disclosure: Nothing to disclose.

Paul Krusinski, MD Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology , American College of Physicians , and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Shyam Verma, MBBS, DVD, FAAD Adjunct Clinical Assistant Professor, Department of Dermatology, University of Virginia, State University of New York at Stonybrook, Penn State University

Shyam Verma, MBBS, DVD, FAAD is a member of the following medical societies: American Academy of Dermatology

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MDis a member of the following medical societies: American Academy of Dermatology , Association of Military Dermatologists , Texas Dermatological Society , and Texas Medical Association

Elsbeth Young, MD, FRCP Consulting Staff, Department of Dermatology, Amersham Hospital and Wycombe General Hospital, UK

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If you have ever scratched your skin and the scratches become raised spots on the skin or welt up, this skin condition is called dermatographia. Dermatographia may appear as lines, which is how it got its name from skin writing. Things like rubbing, pressure, and scratching cause the skin to react, and although it usually goes away on its own within half an hour, sometimes what is called skin writing may concern some people, and by understanding what it is, what causes it, and how to treat it can help ease overcome these reactions.

How Common is Dermatographia?

Skin writing is common and affects around 5% of the general population. The raised marks can become more irritated with continued friction and pressure. Anyone may experience dermatographia, but some are more likely to experience it if they are in their teens or under the age of 20, have dry skin, or have dermatitis. It is a skin condition that is frequently passed down through generations. Although the welts do not hurt, they can cause discomfort if they become itchy, making those with the condition self-conscious. These welts usually go away after about half an hour.

The symptoms vary from person to person, but the most typical signs are discolored or raised lines in pink, purple, or red. The lines will swell and become inflamed; sometimes, these welts may become itchy and look like hives.

Although dermatographia’s exact causes are unknown, there are several triggers: allergies, exercise, extreme heat or cold temperatures, and some medicines may cause a person to be more likely to experience these raised welts. Many who suffer from dermatographia claim that stress causes the skin to react, and reducing stress can help minimize flare-ups. Some known ways to reduce stress are counting to 10, staying active, monitoring intake of alcohol and caffeine, getting a good night’s rest, staying positive, and staying in the community with others.

It is thought that the skin reaction is an immune system response to an allergen. Suppose dermatographia is an auto-immune disease, which some believe. In that case, the body thinks the pressure and scratching are allergens, and it sends histamine to remove the allergen from the body. It is not contagious and should not concern those with visible welts.

How Can Dermatologists Help with Dermatographia?

Visiting a professional dermatologist can help diagnose and treat this condition. The consultation will involve agitating the skin by scratching or pressing the skin on the arm with a tongue depressor. The welts will appear within a few minutes of the agitation. The marks or welts appear where the agitation occurs and may appear like writing, hence the name skin writing.

Treatments for Dermatographia

Although the symptoms are mild, some seek assistance in treating the reaction for faster results. The signs often go away within thirty minutes, but when they don’t, here are some other options:

• Antihistamines can be purchased over the counter.
• A licensed dermatologist can issue prescriptions in severe cases that will block the reaction.
• Topical creams can be applied to the welts and quickly shrink welts and lines.
• Injections can be done during a short office visit at your local dermatologist in cases where other treatments do not work.

Considerations for Antihistamine Use

Antihistamines can be purchased, but knowing potential side effects can avoid alarm. Some commonly known side effects of over-the-counter antihistamines are drowsiness, dryness of the eyes and mouth, headaches, dizziness, sore throat, and dry coughing. These symptoms do not happen to everyone, but if they do occur, it is best to stop use and consult a licensed professional who can ensure you get the treatment you seek that fits your lifestyle.

Preventing Dermatographia

If you suffer from skin writing , one of the best ways to approach this condition is to take measures to reduce the risk of developing signs. It is easier said than done, but one of the best ways to avoid a breakout is to avoid scratching the skin, wear loose clothing, and stay away from scratchy and thick materials, like wool. Sticking to mild cleansers for bathing, patting skin dry instead of roughly rubbing it, and immediately following up with a cream or ointment can be tremendously helpful. Room humidifiers can add moisture to the room and help skin stay hydrated, reducing the temptation to scratch. Showering with water not scorching hot and learning stress management techniques are also known to help avoid symptoms.

Expectations of Dermatographia

If the welts on the skin do not go away within an hour of appearing or they become painful, see a professional dermatologist immediately. Extreme symptoms may be a sign of another skin condition. Experienced and licensed dermatologists can treat all skin conditions and get people the relief they seek. If you have questions or concerns about your skin, contact Buckhead Dermatology today for an appointment with Dr. Sherrie Straughn, who has dedicated her career to helping people manage and treat their skin.

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Dermographism: Writing on the skin

Due to a recent illness, I developed dermographism. Translated, dermographism means skin writing. It is a type of urticaria that usually occurs in teenagers and younger adults and can last a few weeks to a lifetime. Those that develop it later in life do so usually from trauma or an illness. It affects approximately 2% to5% of the population.  There does not appear to be a racial predication or gender specificity, although there is some research that suggests females may be slightly more affected than males.

Also known as dermatographic urticaria, the cause of this illness is unknown, but appears to be related to a mast cell abnormality and is probably autoimmune in nature.  It is theorized that it is a histamine reaction, released by mast cells on the surface of the skin.  Stress, infection, emotion, exercise, heat, and antibiotics such as penicillin can trigger a reaction. When patients with dermographism lightly scratch the surface of their skin, the area reddens and develops a wheal. This usually disappears completely with 30 minutes but has the potential to last for days.

Clinicians can diagnose dermographism easily by using a tongue depressor. Run it over the surface of the patient’s skin. In a few minutes, a wheal should appear where the skin has been touched. Patients with dermographism have been known to use this nuisance creatively. One artist etches elaborate drawings and photographs them before they disappear. 

Dermographism is usually treated with antihistamines to stop the reaction. The treatment uses a combination of H₁ antagonists and H₂ receptor antagonists. Statistically, about half of patients see marked improvement, though others may see no improvement at all. Patients should avoid harsh soaps, wool clothing that might irritate the skin, and scratching. Moisturizing the skin can be helpful. Sedating antihistamines such as hydroxyzine can be useful for those with symptoms that are keeping them from sleeping.

The differential diagnosis includes chronic urticaria, systemic mastocytosis and urticaria pigmentosa as well as latex allergy.

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Dermographism is not life threatening but it can be troubling for those experiencing the symptoms. Young patients may be embarrassed when an outbreak occurs. Clinicians should reassure their patients that this is not life threatening and can be properly managed. Referrals to a dermatologist or allergist are recommended. 

Sharon M. O’Brien, MPAS, PA-C ,  is a practicing physician assistant and health coach in Asheville, NC.

For more information, visit  https://www.dermnetnz.org/topics/dermographism/

• Joanna Wallengren and Anders Isaksson. Urticarial Dermographism: Clinical Features and Response to Psychosocial Stress. Acta Derm Venereol 2007; 87: 493–498.
• Taskpan O., Harmanyeri Y, Evaluation of patients with symptomatic dermographism.   J Eur Acad Dermatol Venereol. 2006 Jan;20(1):58-62.
• Dice, John P., Gonzalez-Reyes, Erika. UptoDate. Physical Urticarias.Dermographism.

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Dermatographism.

Timothy Nobles ; Mikel E. Muse ; George J. Schmieder .

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Last Update: February 20, 2023 .

• Continuing Education Activity

Dermatographism, also known as dermographism urticaria, or urticaria factitia, is an urticarial eruption upon pressure or trauma to the skin. The literal meaning is "to write on the skin." Downward pressure on the skin produces a linear wheal in the shape of the applied external force. Dermatographism is the most common type of inducible/physical urticaria, occurring in approximately 2% to 5% of the population. A small subset of those with dermatographism becomes symptomatic with pruritus along with the erythematous wheals. This activity reviews the evaluation and management of dermatographism and the role of interprofessional team members in collaborating to provide well-coordinated care and enhance patient outcomes.

• Review the differential diagnosis for dermatographism.
• Describe the presentation of dermatographism.
• Summarize the treatment options for dermatographism.
• Outline the evaluation and management of dermatographism and interprofessional team members' role in collaborating to provide well-coordinated care and enhance patient outcomes.
• Introduction

Dermatographism, also known as Dermographism urticaria, or urticaria factitia, is an urticarial eruption upon pressure or trauma to the skin. Urticarial skin reactions present as erythematous wheals in the dermis and can have innumerable causes. Dermatographism is the most common type of inducible/physical urticaria, occurring in approximately 2% to 5% of the population. Downward pressure on the skin produces linear erythematous wheals in the dermis in the shape of the external force applied, earning the name dermatographism, which literally means "writing on the skin." A small subset of people with dermatographism becomes symptomatic with pruritus, stinging, prickling sensations that can be bothersome for the patient. [1]

The exact cause of dermatographism is unknown. However, the release of histamine from mast cells is thought to play a role. [2]  Dermatographism has been seen in people with diabetes, hyperthyroid, hypothyroid, menopause, pregnancy, or medication-related.

• Epidemiology

Dermatographism is the most common type of urticaria, frequently presenting in young adults with the peak incidence in the second and third decades. There has not been shown a relationship between race and dermatographism. One study of pediatric patients showed a female predominance. [3]  One report cited a case of familial dermatographism. [4]

Hypereosinophilic syndrome is associated with atopic children and increases dermatographism; these are associated with atopic children and an increased number of eosinophils in the blood. One-third of patients that experience traumatic life events, along with psychological co-morbidities, experience dermatographism. [5] Furthermore, stressful events like pregnancy (commonly in the second trimester) and the onset of menopause have seen a higher incidence of the condition. Behcet disease, a condition marked by oral and genital ulcers, is another disease where dermatographism is a common integumentary finding.

Symptomatic dermatographism is thought to be generally idiopathic, but various explanations have been considered. The higher consensus revolves around Helicobacter pylori , antibiotics such as penicillin, bites, or scabies as the more common presentations to suggest this correlation. Lastly, congenital symptomatic dermatographism is the presenting sign in systemic mastocytosis. [6]

• Pathophysiology

No concluding mechanism explains why dermatographism occurs. Mechanical trauma activates vasoactive mediators released from mast cells secondary to antigen interaction to the bound IgE. This is thought to cause an exaggerated biological response known as the "triple response of Lewis." Initially, the capillaries become dilated, producing a superficial erythematous phase. Next, an axon-reflex flare and communication to sensory nerve fibers cause an expansion of erythema, secondary to arteriolar dilation. Lastly, the linear wheal is formed through fluid transudation. This entire response takes, on average, up to 5 minutes after an external stimulus stroking of the skin. The wheal can persist anywhere from 15 to 30 minutes, unlike the normal triple response of Lewis that subsides in under 10 minutes. Mediators such as histamine, leukotrienes, bradykinin, heparin, kallikrein, and peptides such as substance P are all considered to play a role in this process.

• Histopathology

The histopathology of dermatographism demonstrates dermal edema with few perivascular mononuclear cells similar to acute urticaria histology.

• History and Physical

Dermatographism lesions appear following mechanical trauma to the skin, most consistently stroking of the skin. A wheal forms and develops in approximately 5 to 10 minutes. The wheal will persist for about 15 to 30 minutes. The deeper the edema into the dermis, the larger the wheal will appear. In symptomatic dermatographism, pruritus accompanies the wheal. The pruritus worsens at night (thought to be related to the pressure of the bedding and sheets contacting the skin) and friction to the area from external stimuli, heat, stress, emotion, and exercise.

Dermatographism most commonly involves the trunk and extremities, and other body surfaces. The least common areas reported are the scalp and genital area; however, symptomatic dermatographism has been correlated in the literature with dyspareunia and vulvodynia. [7]

There are several rare subtypes of dermatographism:

• Red dermatographism (small punctate wheals, predominantly on the trunk)
• Follicular dermatographism (isolated urticarial papules)
• Cholinergic dermatographism (similar to cholinergic urticaria – large erythematous line marked by punctate wheals)
• Delayed dermatographism (tender urticarial lesion reappears 3 to 8 hours after the initial injury that persist up to 48 hours)
• Cold-precipitated
• Exercise-induced
• Treatment / Management

Prevention and avoidance of precipitating factors such as physical stimuli and decreasing stressors are important factors in controlling dermatographism. Most patients are asymptomatic, and therapy should be restricted to symptomatic patients. Choice therapy includes treatment with H1 antihistamines such as cetirizine or loratadine. H2 antihistamines can be combined for more complete therapy if H1 blockers are insufficient to control the pruritus. Hydroxyzine, a sedating antihistamine, is a valid option and can be taken before sleep.

Omalizumab is under consideration in research trials focusing on treating dermatographism with 72% efficacy on 150 mg and 58% efficacy on 300 mg. Notably, patients' Dermatology Life Quality Index (DLQI) scale improved by at least 4 points, showing a statistically significant clinical difference. [8]

Light therapy has shown some efficacy in treating dermatographism, yet most patients relapse within 2 to 3 months of completing therapy.

Adjunctive treatment with over-the-counter vitamin C 1000 mg daily is thought to help degrade histamine and increase removal, diminishing the triple response of Lewis. [9]

• Differential Diagnosis

If dermatographism is the leading differential, false dermatographism must be ruled out, a condition that presents clinically similar to dermatographism but has a different underlying mechanism. False dermographism has several different forms, including white, black, and yellow. White dermatographism is secondary to allergic contact dermatitis and is prevalent in atopic individuals. Black dermatographism occurs after contact with metallic objects. Yellow dermatographism is due to bile deposits in the skin.  

Another condition that presents similarly to symptomatic dermatographism is latex allergy. This commonly is seen on the hands and genital region and will often be related to a history of physically contacting latex in gloves, rubber bands, balloons, toys, or contraceptive use.  [10]  Mastocytosis, a disorder caused by an increase in the number of mast cells, can also present with pruritic red-brown pigmented lesions. Mastocytosis can be cutaneous or systemic, depending on what area is infiltrated with mast cells. One sign of mastocytosis is called the "Darier sign," which is swelling, pruritus, and erythema in response to pressure applied to the skin. Systemic mastocytosis is more common in adults, and symptoms are based primarily on the organ affected, such as the liver, spleen, bone marrow, or small intestine. Urticaria pigmentosa is the most common cutaneous mastocytosis in children, is rare and benign. [11]

Dermatographism is a benign condition. In a minority of cases, pruritus can accompany the condition. Compared to the other chronic urticarias, symptomatic dermatographism displays the most expedited clearance of the condition after 5 years (36%) and 10 years (51%). [12]

• Complications

Dermatographism has no direct complications. However, if the patient uses sedating antihistamines for treatment, they may need to exercise caution before engaging in certain activities such as driving or operating machinery.

• Deterrence and Patient Education

Dermatographism can be unsettling in its laborious course without resolve. However, the condition is benign, and patients must be aware of this. The treatment involved, antihistamines, can result in drowsiness; therefore, it is best to advise the patient not to take the medication before operating a vehicle.

• Enhancing Healthcare Team Outcomes

Dermatographism is a benign yet startling lesion to most patients and their parents. Thus, it is imperative to educate the patient and their parents properly on the risk factors associated with the onset of dermatographism to avoid such stressors. To properly educate, it is ideal to target the audience in a team-based approach.

• Evaluation by the primary care physician
• Consult the dermatologist when the diagnosis is in question
• Encourage reduction of external stimuli, effective management, and treatment options.
• Review Questions
• Access free multiple choice questions on this topic.
• Comment on this article.

Illustration of forearm displaying dermatographism on skin. Contributed by Chelsea Rowe

Disclosure: Timothy Nobles declares no relevant financial relationships with ineligible companies.

Disclosure: Mikel Muse declares no relevant financial relationships with ineligible companies.

Disclosure: George Schmieder declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Nobles T, Muse ME, Schmieder GJ. Dermatographism. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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• Review [Round Table: urticaria with a physical cause]. [Allergol Immunopathol (Madr). ...] Review [Round Table: urticaria with a physical cause]. Martorell A, Sanz J. Allergol Immunopathol (Madr). 1999 Mar-Apr; 27(2):85-96.
• Dermatographism in popular culture. [Clin Dermatol. 2022] Dermatographism in popular culture. Russell AP, Gailey JH, Abdulkarim B, Levell NJ, Parish LC, Hoenig LJ. Clin Dermatol. 2022 Nov-Dec; 40(6):768-772. Epub 2022 Aug 7.
• Dermal and bronchial hyperreactivity in urticarial dermographism and urticaria factitia. [Allergy. 1996] Dermal and bronchial hyperreactivity in urticarial dermographism and urticaria factitia. Henz BM, Jeep S, Ziegert FS, Niemann J, Kunkel G. Allergy. 1996 Mar; 51(3):171-5.
• The effect of psoralen photochemotherapy (PUVA) on symptomatic dermographism. [Clin Exp Dermatol. 1989] The effect of psoralen photochemotherapy (PUVA) on symptomatic dermographism. Logan RA, O'Brien TJ, Greaves MW. Clin Exp Dermatol. 1989 Jan; 14(1):25-8.
• Review Physical urticarias and cholinergic urticaria. [Immunol Allergy Clin North Am....] Review Physical urticarias and cholinergic urticaria. Abajian M, Schoepke N, Altrichter S, Zuberbier T, Maurer M. Immunol Allergy Clin North Am. 2014 Feb; 34(1):73-88. Epub 2013 Oct 28.

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Dermographism (Dermatographic Urticaria)

Medically reviewed by The Dermatologists and written by Dr. Alexander Börve

Dermographism (Dermatographic Urticaria) (02) skin [ICD-10 L50.3]

Dermographism (Dermatographic Urticaria) (01) skin [ICD-10 L50.3]

Dermographism (Dermatographic Urticaria) (07) skin [ICD-10 L50.3]

Dermographism (Dermatographic Urticaria) (08) back [ICD-10 L50.3]

Dermographism (Dermatographic Urticaria) (03) arm [ICD-10 L50.3]

• In A Nutshell
• Often self-diagnosable
• Symptoms: Flare or welt, burning, itching
• Color: Typically red
• Location: Anywhere on the skin
• Treatment: No treatment necessary

ICD-10: L50.3 ICD-9: 708.3

Dermographism means “writing on the skin” and is a chronic form of urticaria (hives). This condition usually has no symptoms, and most people with dermographism are healthy. However, symptomatic dermographism may limit activity and thus reduce quality of life.

The chance of dermographism increases during pregnancy (especially in the second half), at the onset of menopause, in atopic children, and in patients with Behçet disease. Dermographism can appear in persons of any age but is more common in young adults, in their twenties and thirties.

Ask a dermatologist today and get peace of mind

When you lightly scratch or firmly stroke the skin, a red or white line appears. The initial line turns into a flare and will remain for about an hour. The welt can look similar to an allergic reaction, even though dermographism is a form of urticaria (hives). You may experience burning and itching at the affected areas. It may last for months or years, or be present intermittently.

Stress, insect bite, anxiety, and excessive heat or cold can trigger the condition. The use of drugs, such as penicillin, can also trigger such reaction.

What can I do?

Do not scratch or rub the skin and do not wear close-fitting clothes, as this may worsen the condition. Studies have reported the successful use of relaxation, hypnosis and a combination therapy of psychotropic drugs and antihistamines in patients with chronic urticaria.

Should I seek medical care?

Usually, medical care is not necessary. However, you should seek medical care if dermographism is significantly affecting your quality of life. A doctor can diagnose the condition with a tongue depressor across the skin of your arm or back to see if a red, swollen line or a welt (wheal) appears within a few minutes.

The swelling typically goes away within an hour. The condition does not need treatment, but antihistamines, such as diphenhydramine (Benadryl), fexofenadine (Allegra) or cetirizine (Zyrtec), can reduce inflammation.

Simone Laube, MD, MRCP. Dermographism Urticaria. Medscape. Available at: http://emedicine.medscape.com/article/1050294-overview#a6

Taşkapan O, Harmanyeri Y. Evaluation of patients with symptomatic dermographism. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16405609

Joanna Wallengren and Anders Isaksson. Urticarial Dermographism: Clinical Features and Response to Psychosocial Stress. Available at: http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-0306&html=1

Mayo Clinic. Dermatographia – Test and diagnosis. Available at: http://www.mayoclinic.org/diseases-conditions/dermatographia/basics/tests-diagnosis/con-20025360

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Dermatographism

16 photos that show what dermatographism looks like.

Editor's Note

Any medical information included is based on a personal experience. For questions or concerns regarding health, please consult a doctor or medical professional.

When the average person rubs or scratches their skin, they may expect to see a bit of redness or irritation – but this typically fades quickly. However, for people with dermatographism, even the slightest amount of pressure on the skin can provoke a different reaction entirely.

“Dermatographism literally means ‘to write on the skin,’” Jason Miller, M.D. of Schweiger Dermatology Group in Freehold, NJ explained to The Mighty. This means people with the condition develop quick-onset linear wheals (raised skin welts or hives) where the skin has been rubbed, scratched or had pressure applied.

These red, raised marks can be painful, itchy and frustrating to deal with when they arise. However, “there is often no persistent rash to explain the sensations,” Dr. Miller explained. “The symptoms usually come and go within minutes, but can recur frequently enough to cause a patient to seek the care of a medical professional.”

Even if you don’t have wheals 100 percent of the time, you are not alone if the pain or discomfort has an impact on your quality of life. Miller added that some people with dermatographism may experience worsening symptoms at night, which can affect your quality of sleep – leading to fatigue over time.

According to Miller, between 2 and 5 percent of the population develops dermatographism at some point in their lives. Though the cause is usually unknown, Miller said some people have experienced it as a reaction to certain medications (such as antibiotics) or systemic infections.

Although there is no cure for dermatographism, there are several treatments available to manage the symptoms. “The mainstay of therapy for dermatographism, like other forms of hives, is to avoid triggers (if they are identified),” explained Miller. Antihistamines can also be beneficial for both preventing symptoms and managing flare-ups. It’s always important to speak to your doctor before starting, stopping or adjusting the dosage of a medication.

We wanted to understand how this condition affects those who live with it, so we  asked our  Mighty community  to share a photo that shows what it looks like to have dermatographism. If you experience this condition as well, let us know how it affects you in the comments below.

Here’s what our community shared with us:

1. ‘Dermatographia for me means painful hives from the slightest bit of pressure or scratch.’

“Dermatographia for me means painful hives from the slightest bit of pressure or scratch. After a tongue depressor was run along my back by doctors in the early morning during testing, we could still play tic-tac-toe on my back late into the evening.” – Alexis M.

2. ‘Imprints hurt and itch.’

“When I scratch I get welts, imprints hurt and itch and there are times when it’s so much worse. Here’s a kitty paw imprint from my kitty standing on my arm and she’s a tiny 6 lbs.” – Charia U.

3. ‘It burns and itches when things like this happen!’

“My daughter fell asleep on me for a few minutes! It burns and itches when things like this happen! My pants and underwear leave imprints that leave me itching for hours!” – Hannah G.

4. ‘I was so embarrassed by my skin in school.’

“I was so embarrassed by my skin in school. If I had an itch and scratched it, my skin would turn bright red. My pale skin would often turn bright red or purple for seemingly no reason in gym class. If I bumped into anything the entire surrounding area would turn red. It takes hardly any pressure and it takes a long time to go away. I was always asked things like, ‘Why is your (insert body part here) so red?!’ ‘Did you cut yourself?!’ ‘Why did you scratch yourself?’ ‘Does that hurt?’” – Austin M.

5. ‘You have to laugh when you’re a human Etch A Sketch.’

“(This was before it went red.) It’s become a party trick. I send little hearts to friends of mine and we have a giggle about it. You have to laugh when you’re a human Etch A Sketch.” – Daisy-Ella O.

6. ‘[I] took this picture after writing my name on my arm…’

“I was diagnosed with systemic mastocytosis, secondary to EDS [Ehlers-Danlos syndrome]. I then saw another specialist who said it can’t be true because mastocytosis is too rare and comes with dermatographia. I told him I do get this on occasion and being on my masto meds at the time he scratches my arm and said it’s not writing up so I don’t have it and my previous diagnosis was wrong. Later that week I woke up after a 12-hour span without any of my meds and took this picture after writing my name on my arm to show him. He hasn’t questioned the diagnosis since.” – Jamie H.

7. ‘My parent’s cat sat on me… This was 30 minutes later!’

“My parent’s cat sat on me to clean himself. This is from all the places the tips of his claws (which were retracted still) rested. I also had pants on. This was 30 minutes later!” – Alexandria P.

8. ‘Can’t seem to stop it from happening…’

“Lightly pressing my arm with a bobby pin. Can’t seem to stop it from happening, despite all the antihistamines I’m on.” – Marridian T.

9. ‘Ran my fingernail across my arm…’

“Ran my fingernail across my arm…” – Angie S.

10. ‘I wrote this on my thigh… I snapped the pic almost 10 minutes later!’

“I wrote this on my thigh with my (very short, very dull) fingernail after getting out of the bath. I snapped the pic almost 10 minutes later! It was no longer as raised, but still very red.” – Melissa H.

11. ‘It’s not constant but comes in flares.’

“My surgery set off my MCAS [mast cell activation syndrome]. It’s not constant but comes in flares. It feels like my skin is burning underneath but if I itch it burns more.” – Nicolette K.

12. ‘On the plus side, I can make cool patterns!’

“It always looks like I have a rash every time I scratch an itch. I always turn red any time my body touches anything. On the plus side, I can make cool patterns and doodles like this!” – Ashley B.

13. ‘I had always thought that I just had fair, sensitive skin.’

“I had always thought that I just had fair, sensitive skin. All I had to do for the ‘Hi’ is run my fingernail over the top of my hand. This means if I brush past a corner, it looks like I’ve been cut. [Right:] This happened when my dog walked over my arm.” – Sean F.

14. ‘My own pallet swatches.’

“My own pallet swatches (back of the finger used).” – Sierra S.

15. ‘I call it “cat scratch” because it looks like a cat clawed me.’

“I call it ‘cat scratch’ because it looks like a cat clawed me. I was diagnosed by a dermatologist with chronic idiopathic urticaria/dermatographism several years ago. This picture of my back was taken last summer after mosquito bites. They, of course, itched like crazy so I used my wooden back scratcher and you see the end result. A light fingernail barely touching my back can sometimes cause it.  I have internal/external itching on a constant basis, some days are worse than others. Certain factors (mosquito bites, stress…) cause it to flare. My allergist recently ruled out suspected autoimmune urticaria and mastocytosis. MCAS is still TBD. I also have rheumatoid disease, and several other conditions. As far as the welts go, it appears on my back, neck, chest, arms, legs, trunk.” – Jenny S.

16. ‘People tend to look at me odd for having marks all over my body.’

“I was recently diagnosed (end of 2018). The photo shows the test being done to confirm dermatographia with my new allergist. Lbs of pressure vs the reaction on my skin. The biggest impact it has had is so many false positives with allergy testing, and tests where doctors don’t know dermatographia is a thing. I also scratch and inflame super easy so if skin is exposed people tend to look at me odd for having marks all over my body. As if something more serious has transpired or is going on. It’s exhausting so I tend to cover up even on super hot days.” – Christine B.

We want to hear your story.

Do you want to share your dermatographism story? Click here to find out how.

Paige is passionate about helping people with chronic health issues share their stories and connect with one another.

COLLEGE FOOTBALL 25 TEAM BUILDER DEEP DIVE

Create your own dream team with team builder in ea sports college football ‘25..

Hey College Football Fans, welcome back to the Campus Huddle! We have one last topic prior to the worldwide launch of EA SPORTS™ College Football 25 tonight. Did you think that we forgot about Team Builder?

The most important thing to know is Team Builder for College Football 25 will arrive later TONIGHT on web! Before we let you in to create your dream team, let's see what is in store for you.

BUILDING TEAM BUILDER

When the Team Builder tool was unveiled back in 2009, millions of fans were able to bring their custom creations to the field. Now, with the release of EA SPORTS™ College Football 25 we’re thrilled to be able to bring back this feature which was beloved by so many.

When the return of our College Football 25 was confirmed, it became clear that fans wanted Team Builder to return as well. One of the first things we did as a team was figure out what it would take to bring the feature back, and to improve upon what we had already built. 

We met with creators, spent hours rewatching many different Team Builder videos, read blogs and wish lists, and even hired people from within the community to help design and build Team Builder. One of the first people brought back onto the team was Senior Engineer Chris Markuck, who was one of the original architects of Team Builder in 2009. When Chris got word that Team Builder was coming back, it was an easy decision for him to return to EA and lead the charge of bringing one of the community’s favorite features back. 

Our approach to Team Builder centered around three core pillars. First it was about creating a Deep Creation Suite where our players felt a strong sense of ownership and were empowered to create and customize their schools more than ever before. Our second pillar was Discover & Share , which was about making it easy to discover great content and content creators, as well as providing the ability to share your creations with others. Finally, our third pillar was about Elevating Creators where we wanted to celebrate creators for their creative accomplishments.

With our three core pillars in mind, let’s dive into the details where we will outline how you can create teams using the Team Builder website and import them into your Dynasty.

ACCESSING THE WEBSITE

To access the website, you’ll need to create or use your EA Account information to log in. After that, you’ll utilize the College Football URL to access Team Builder for College Football 25.

This main screen is where we showcase and elevate all the work done by our most devoted fans. You’ll be able to see the top downloaded and highest-rated teams by members of the community. We’ve also made it easier to search for existing content. In addition, our filters allow you to sort by uniform provider or by state. Think you’ve got what it takes to make it to the top of the list?

CREATING A BRAND AND IDENTITY

After selecting “Start Creating,” the first thing you’ll be tasked with is creating your school’s identity and brand. This is where you’ll get to define the basics of your program, like its name, nickname, logos, uniform provider, and team colors. 

For logos, you will be able to add a primary, secondary, and tertiary logo. Your primary logo is what will be used throughout the in-game UI in Dynasty mode. Your secondary and tertiary logos will be able to be added to your uniform and field. As a part of your logo creation, you will be able to upload your own logos or choose from one of our recolorable generic logos.

In College Football 25’s Team Builder you will be able to select Nike, Adidas, or Under Armour as your uniform provider. This will impact the equipment your players wear, the name and number fonts you can choose from, as well as what jersey and pant stitch pattern your team uses. For example, if you select Nike you will be able to choose from the Vapor Fusion and Vapor Untouchable jersey stitch patterns. The stitch pattern you select will change which stripe patterns that are available and compatible with that stitching.

When selecting your team colors, you can utilize the eyedropper tool to set the team colors from your primary logo. For more advanced users, you can customize each color’s hue, saturation, brightness, Hex, or RGB value. We’ve also provided all existing school team colors under Presets.

In an age where teams are constantly trying to expand and modernize their uniform suite, we wanted to give users the ability to reflect that in their work. To give users the ultimate amount of customization, we’ve expanded the amount of uniform presets you can have to 5 total. If you’re counting socks, that means your team can have up to 5 helmets, 5 jerseys, 5 pants, and 5 socks or 625 uniform combinations, giving you the ability to showcase new looks on the field each game.

Before we go into how you can customize the various uniform parts, let’s orient you to the preview area. This is where you can navigate the camera to rotate the parts of the uniform you are editing. In the center of the screen, is the preview area, utilizing the mouse button you can scroll around the assets horizontally or vertically. Or zoom in and out using the scroll wheel. There are auto preset camera controls that you can select that will auto focus to various angles for you to view your creations. Test around as you desire.

Once in the editor, the helmet is the first part of the uniform that you can customize. Start by choosing your base color and then choose your reflectiveness. For the helmet reflectiveness, you can choose from matte, shiny, or chrome. In addition to customizing the base helmet shell reflectiveness, in the accessories section you can change the color and reflectiveness of the facemask, chinstrap strap and cup, front bumper, and back bumper.

Once you’ve customized the base helmet shell, it’s time to start decorating it with logos and stripes. Begin by choosing your helmet stripe from one of our available presets and customize its color. If you’d like to add helmet numbers you can do that too. We’ve added four preset placement options (front, back, left side, and right side), but you can also use the advanced placement editor to customize the size, position, and spacing to place them anywhere on the helmet.

Now let’s talk about where the fun really begins with custom layers.

CUSTOM LAYERS

No modern uniform editor would be complete without the ability to incorporate custom designs and logos. So we’re giving users the ability to add custom layers onto each element of the uniform. Under “Custom Layers'' for helmets, for example, you’re able to add up to 7 custom layers on the helmet, each having their own unique properties and placement options on the helmet. For each layer, you will have the ability to choose from one of our existing assets or upload your own image. You can then customize the finish of that layer choosing between shiny, matte, satin, or chrome.

Adjusting the logo once it’s on the helmet is easy. You can adjust the dimensions, flip or rotate it, and place it in the exact spot you want. This is the same functionality for both titles. You will even be able to customize the reflectiveness of every single logo!

Customizing the Jersey represents a big area of opportunity. For College, you’ll have the ability to select from Adidas, Nike, or Under Armour, to better represent the wide variety of uniforms used at the FBS level and beyond.

Based on your apparel brand that you selected, you’ll have a specific set of Jersey stitch patterns, or chassis, available for you to start with. Once you select the stitch pattern, you’ll then have that provider’s real-life stripes, designs, cuffs, collars, and fonts available to you. Note that certain chassis go with specific stripe patterns and designs.

For college, the design team has worked closely with all 3 providers with authenticity in mind. And if we’re missing something? Don’t worry. We’re working closely with each company to release additional post-launch content throughout the year to give users more ways to create the perfect look. 

There’s still room for customization if you’d like to add your own personal touch. Don’t forget you can still add layers on the jersey asset. So if you want to put your team name on the front of the jersey or have a unique design running down the sides of your jersey, it’s all available to you. Just make sure to save so you don’t lose your work!

PANTS/SOCKS

After you’ve completed the perfect jersey, it’s time to work on the pants. You’ll have plenty of stripes to choose from, as decided by the provider. You still have the ability to add layers to your pants, as well as set the color of the accessories.

For the socks, you’ll be able to set the color on the “Oversock”, the color of the “Base/Undersock '' and the Brand color on the sock on the collegiate site. And just like that, you’ve completed your first uniform set! But you’ve still got more work to do.

GOTTA HAVE ALTERNATIVES

Creating an alternate uniform is easy. Let’s say you want to create a set that’s the same as your away uniform but with different colors. When you’re creating one of the uniform elements like helmets or jerseys, select the Preview Uniform option in the right-hand corner.

When you’re creating one of the uniform elements like helmets or jerseys, select the Preview Uniform option in the right-hand corner.

Then, click the plus sign and select Duplicate from “Away” to pull over all the existing designs, and name the new uniform. Then you can close preview, select the new alternate at the top, and get to editing!

YOUR OWN HOME FIELD

Now that your team is swagged out with the perfect uniform suite, it’s time to create the perfect home stadium. You’ll have 8 components of your stadium that you can set: Stadium, Crowd, Surface, Logos, Endzone, Numbers, Sidelines, and Benches. Each component has unique properties that you can set. 

Start by choosing from one of the existing 134 team stadiums and rename it to be your own. With your stadium set, it’s time to customize your crowd. You can set the primary and secondary color your crowd wears on gameday. Want everyone to do a white out every Saturday? Set both your primary and secondary crowd colors to white. You can also adjust the percentage of the crowd that wears each color by adjusting the slider. 

Once your stadium and crowd are locked in, it’s time to customize your field. Start by selecting whether your field is grass or turf, as well as its color. You can choose a natural field color or go crazy with any color you can think of. Next add logos to your field. We’ve added preset locations at midfield and the 25/20 yard-lines for you to quickly create your field. With that being said, if you want to go deeper with customization you can add up to 5 custom layers and place those logos anywhere on the field. For your endzones, you can choose from one of the existing endzone designs and recolor it or you can build your own custom endzone with custom layers. 

With your base field in place, put the finishing touches on it by customizing your field number font, the number position , the number frequency (every 10 yards or every 5 yards), the arrow position (top, center, or bottom), whether a G appears at the goal line, and the number color and outline. Additionally, you can color the 20 and 50 yard lines, as well as the goal line. Lastly, customize your field sidelines and bench areas. Both options allow you to choose from one of our existing recolorable templates.

PROGRAM/FRANCHISE

The last piece is the players. On the last tab, you’ll have the opportunity to modify the players that will play for you on the field.

On the College Football 25 side, you’ll be able to set your playbooks and select from 7 generic roster types that you can further adjust to fit your playing style. You want to adjust your starting running back to be a 5 '5, 350-lb bowling ball? Or how about a pair of 6’8 receivers on the outside. Go for it.

Once you are satisfied with your creation, you are ready to submit and publish your team. Hit the submit button and this will take you to a Preview Screen where an overview is presented for approval. After you review all your uniforms and team data, you will publish the team that you can jump over to the console and import into your College Dynasties!

DOWNLOAD CENTER

Now it’s time for you to explore our download center, are you looking to download your friends or favorite creators' custom teams? How about looking to share your custom team? Head over to the Create and Share section in the main menu and select the Download Center . This is where you will be able to begin exploring!

Once you're in, you can browse through a diverse array of content. At the very top is featured content. This is content that we have handpicked to showcase the great work of creators. This will be updated periodically to ensure we are always keeping the download center fresh, while also giving creators the ability to showcase their incredible work.

Once you find the school that you feel suits you best all you will need to do is just download it directly to your console. And don't worry, we've made it super easy to keep the community safe and enjoyable, you can report any offensive content you come across and even preview items before downloading.

If you’re hunting for something specific, just press the Triangle/Y  button on your controller. This will open up a powerful search tool where you can look for content by keywords, usernames, content types, and more. It's all about making sure you find exactly what you’re looking for.

IMPORTING YOUR TEAM INTO DYNASTY MODE

As we talked about in the Dynasty Deep Dive , importing a Team Builder team into Dynasty is available only in a private cloud Dynasty. You will be able to import up to 16 teams per Dynasty. When you’re starting a new league, only the commissioner has the ability to import custom teams and this can happen exclusively at the beginning of the season and will not be possible at any other point.

When importing a team, you have the option whether or not you want to replace the team’s roster. This allows you to maintain the existing team’s roster and only change their uniforms and field. Regardless of whether or not you replace the roster, your Team Builder team will inherit some of the characteristics of the team it’s replacing. This includes their rivalries, their coaching staff (unless you decide to bring in a new coach), their My School grades, and their team records. Be sure to keep this in mind when you are deciding who to replace.

A NOTE FROM US

When developing Team Builder, our goal was to give fans the freedom to bring their creativity to life and share their passion and designs with the community. In order to facilitate this, we knew that we had to offer you the ability to bring your creations to life with deep customization while building an experience that matched what we set up to do.  

This goal meant we needed to lean into a more robust tool set for a web-based solution that gave fans as much freedom for creation and customization as we could build.

Since this Team Builder experience will be new not only for you but our team as well, we want to ask for your feedback. Since this is a new journey, we are inviting you, the community, to share your feedback with us in our official College Football 25 Community Forum so we can hear your thoughts on the experience for creators and fans of those creations. We will use that space and our other channels to keep you informed of changes, enhancements and quality-improvements we will be making throughout the year. We would love your feedback and input as our team  continues to evolve Team Builder throughout the season.

TIME TO BUILD YOUR TEAM

Now, all that’s left is to take them to glory. We are so proud that we could bring this beloved feature back to you and we can't tell you enough how excited we are to see what creations you all will put together to make this feel like it is your game. Well, it is time to put our pens down and get to creating our own teams as well! Are you ready?

 - Team Builder Developer Team

College Football 25 launches worldwide on July 19th, 2024. Pre-order the Deluxe Edition* or the EA SPORTS™ MVP Bundle** and play 3 days early. Conditions and restrictions apply. See disclaimers for details. Stay in the conversation by following us on Facebook , Twitter , Instagram , YouTube , and Answers HQ .

Score the MVP Bundle*** to make game day every day, and get both Madden NFL 25 (when Early Access goes live on 8/13) and College Football 25 with bonus pre-order content.

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“You Missed” is the direct respond from Tom MacDonald about the public response to the attempted assassination attempt on former President, and Presidential Candidate, Donald Trump on July 13, 2024.

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Stream It Or Skip It: ‘Simone Biles: Rising’ on Netflix, a Four-Part Documentary Look At The All-Time Gymnastics Great

Where to stream:.

• Simone Biles Rising
• simone biles

11 Best New Shows on Netflix: July 2024’s Top Upcoming Series to Watch

Alyssa farah griffin goes against ‘the view’ co-hosts and defends simone biles’ husband for calling himself the “catch” in their relationship: “he treats her like a queen”, stream it or skip it: ‘michael che: shame the devil’ on netflix, where the ‘snl’ star serves up leftovers, ‘golden’ on peacock is a must-watch for all olympic gymnastics fans.

Simone Biles is an Olympian without peer, a gymnast so great that moves previously thought impossible now bear her name. Being great isn’t easy, though. On the eve of the 2024 Paris Summer Olympics , Simone Biles: Rising , a new four-part documentary on Netflix, gives us a look into the American star’s success and struggles.

SIMONE BILES: RISING : STREAM IT OR SKIP IT?

The Gist: The pressure to be great can be crushing. That’s a through-line in Simone Biles: Rising , a four-part documentary that gives tremendous access into Biles’ life. Interviews with Biles, those close to her, and figures from around the sport are mixed with competition footage. Together, they tell the story of her rise and her struggle with the demands one faces at the top of the sporting world.

What Movies Will It Remind You Of?: Netflix is gearing up their sports-documentary content in advance of the Paris games, and a recent comp is their excellent track-and-field-focused Sprint . Where that series focuses on a collection of top athletes, however, Simone Biles: Rising is–as you’d expect–all about one.

Performance Worth Watching: Are you really watching anyone else when Simone Biles is performing? C’mon. Get your head in the game.

Memorable Dialogue: “I knew it wasn’t just like, ‘oh, oops, sorry’,” Biles recalls thinking after her first failed vault attempt in Tokyo. “I was like, ‘how am I supposed to tell them that this is bad bad?”

Sex and Skin: None.

Our Take: Simone Biles is among the most-decorated gymnasts of all time, and arguably (or even inarguably) the greatest performer the sport has ever seen. There are currently five different moves in the women’s artistic gymnastics scoring system named after her. She’s the kind of athlete that other athletes stand in awe of, and a mainstay on magazine covers, cereal boxes and record books. “I don’t think anyone in any other sport has been that dominant, ever,” marvels Biles’ US Olympic teammate Joscelyn Roberson. “It’s like an NFL team never losing the Super Bowl.”

Simone Biles: Rising doesn’t open with a triumph, though.

The specter of the 2020 Tokyo Olympics (held in 2021, due to COVID) looms over Biles’ present. Expected to dominate the Games much as she had five years earlier in Rio de Janeiro, Biles instead introduced many viewers to the dreaded-in-gymnastics notion of “the twisties” – a suddenly inability to orient oneself in midair that can prove devastating to a gymnast’s performance and even dangerous to their well-being. She pulled out of the Tokyo games, shocking the sports world while citing mental health concerns.

The tension in that moment provides a leaping-off point for the real story of Simone Biles: Rising –that of the immense pressures placed on high-level athletes, pressures that have begun long before we see them step onto the floor at the Olympics. Those pressures were only heightened under the COVID restrictions during the Tokyo games. As former gymnast Onnie Willis recalls, “I immediately said, ‘she’s alone’. Like, the fact that the athletes have to travel without family, without friends, without their network, and it grossly underestimates the importance of connection and community to our physical performance and possibilities.” In this moment, the years of intense, militaristic training that future Olympians go through truly came to a head.

Simone Biles: Rising isn’t a story of victimization, though; it’s a story of an athlete taking back their narrative. In the wake of her withdrawal from the Tokyo games, she faced a deluge of criticism from commentators and fans, with some accusing her of quitting on her team. It wasn’t fair or right then, but Biles has the stature to fight back. This documentary is a great look inside a tremendous athlete’s life, but it’s also a statement; she will not let others tell her story. She’s here to give the full picture.

Our Call: STREAM IT. Not every athlete is worthy of a documentary, but Simone Biles isn’t just any athlete. Simone Biles: Rising is a well-crafted document of one of the best to ever do it.

Scott Hines, publisher of the widely-beloved Action Cookbook Newsletter ,  is an architect, blogger and proficient internet user based in Louisville, Kentucky.

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