Is Dermographism an Autoimmune Disease?

Table of Contents
View All
Table of Contents

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.

itchy skin
HeikeKampe/E+/Getty Images

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 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 and attacks the area as if it were trying to protect the body from harm, leading to hives.

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:

  • Pressure
  • Rubbing
  • Scratching
  • 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)
  • Vibration


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
  • Itching


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.

Frequently Asked Questions

  • What causes dermographism flare-ups?

    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.

  • Does dermographism affect the immune system?

    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.

  • Is dermographism a mast cell disorder?

    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.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Osteopathic College of Dermatology. Dermatographism.

  2. 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 sciencesAdv Dermatol Allergol. 2021;38(1). doi:10.5114/ada.2021.107270

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

  4. National Institutes of Health. Autoimmune diseases.

  5. American Academy of Dermatology Association. Hives: Causes.

  6. National Health Services. Urticaria (hives).

  7. American Osteopathic College of Dermatology. Urticaria.

  8. Sparrow. Dermatographia.

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

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

  11. 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. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development.