Ariana Page Russell's skin sometimes has an unusual reaction when she gets a slight scratch: Within minutes, her skin feels warm and the area that was scratched gets red, puffy, and raised like a hive.
Next, it turns white and then a little pink. Twenty minutes later any swelling, itchiness, or markings are gone, and her skin looks normal.
To Russell, it's just "this weird thing my skin does." It wasn't until she sought out a dermatologist that she realized this odd reaction had a name: dermographic urticaria.
Also called dermographism, meaning "writing on the skin," this exaggerated skin reaction is a type of hive, or "urticaria."
If Russell, a 33-year-old New York City artist, scratches the letters of a word on her forearm, upper thigh, or stomach, you'd be able to read it because it will look like she has been writing on her skin.
"This reaction is due to a histamine release," says dermatologist Dr. Joanna Wallengren, who has studied dermographic urticaria. "This is the same response as in spontaneous hives." (Histamine is also what's released in an allergic reaction.)
These hives occur anywhere from 2 to 10 minutes after skin is scratched. First, the skin becomes red, and then a raised welt forms, followed by white hives along the scratch line.
"Often the central part is whiter than the surrounding redness," explains Wallengren, an associate professor in the department of dermatology at Skane University Hospital in Lund, Sweden. "There is often an itching or burning sensation," she adds.
Wallengren says that pressure on the skin is the most common trigger of dermographic urticaria. This can be from the pressure of tight-fitting clothing or from carrying a heavy bag that rubs against the skin. Some people get it after showering and scrubbing their skin.
This exaggerated skin reaction is usually not inherited, and most people with it do not have allergies or sensitive skin, according to Wallengren. Emotions and stress may worsen symptoms, she says.
Although the exact cause of dermographic urticaria is unclear, Wallengren says that people normally respond to treatment with antihistamines taken on a daily basis. "Sometimes one pill is not enough," to relieve itchiness, "and the dose needs to be doubled or tripled," she points out.
Roughly 5 percent of the population is thought to have dermographism, and it's most common in young adults in their 20s and 30s.
Russell first noticed her skin had this odd reaction when she was in high school. Russell, who says she has a mild form, decided to play around with it and use her skin as a canvas for her artwork. Then she photographed the results.
"This was a unique way for me to make art," she explains. She uses blunt knitting needles to make her designs. Sometimes she draws freehand and other times she creates stencils with intricate patterns that she traces onto her skin.
"It doesn't hurt, but I know other people tell me that dermographic urticaria causes them pain," Russell says.
Asked about the reaction to her skin-related artwork, Russell admits, "Some people think it's weird, strange, or disgusting."
"But then I get hundreds of emails from people with skin issues who are so appreciative that I am putting my skin condition out there," she adds. "They tell me I'm doing something beautiful with a weird condition."
When people with dermographic urticaria see her photographs, it helps them know that they are not a freak, she suggests.
"I'm just trying to show that this is skin, and everybody's skin does different things," Russell says. "There's nothing to be ashamed of."