Cholinergic urticaria is caused by exercise, eating hot food or drinks, sweating and emotional excitement that cause cholinergic nerves to impulse and release acetylcholine, which stimulates inflammatory cells to release a substance called histamine. This causes the patient to experience a sensation of itching on the scalp or all over the body, and wind clusters appear on the skin. It occurs mostly in young men. Mild cholinergic urticaria has been reported to occur in 15% of adolescent boys and girls. The clusters can subside on their own when the mood calms down, or when the body temperature drops. For patients with more severe symptoms, oral antihistamines can be administered. Generally, second-generation antihistamines such as ketostatin or centrum (choose one) are given orally during the day, and first-generation antihistamines such as ketotifen or cyproheptadine (choose one) are given orally at night before bedtime. Vit C and calcium supplements are also taken. There are many choices of antihistamines, and it is important to choose the one that you have used effectively. Once you have chosen a regimen that works, take it for a little longer and taper off slowly. Don’t stop taking the medication as soon as you feel it’s working, as it will recur. This disease, generally with the age of the disease, can improve on its own to disappear.