Chlorine Sensitivity versus Allergy

By: Dr. Grace Ryu

Now that summer is in full swing exposure to chlorine increases due to swimming pool use.  You may notice trouble breathing, rash or runny nose when swimming.  You may wonder are you allergic to chlorine?  The answer is no, but you could be sensitive to chlorine. Chlorine sensitivity can manifest as skin issues, respiratory or nasal symptoms.

Skin problems can present as itchy red skin or hives (itchy raised patches). Chlorine can also cause a flare of eczema (atopic dermatitis) or help calm eczema.  Treatment for skin issues involve, washing the skin with clean nonchlorinated water to remove the chlorine. Occasionally steroid creams maybe needed and for hives use benedryl.

Respiratory problems can present as cough that is worse at night after swimming,  shortness of breath/cough with swimming, wheezing or chest tightness.  If any of these symptoms occur then seeing an allergist to make sure it is not exercise induced asthma is a good idea.  Several studies of elite swimmers suggest that chronic exposure to chlorine increases airway inflammation and airway hyperresponsiveness (constriction of airways). These changes seem to decrease with discontinuation of high level training.

Nasal symptoms consisting of runny nose, sneezing, nasal congestion and itching maybe due to the irritant nature of chlorine or seasonal allergies. If allergy testing is negative then using a nose clip when swimming may help.  A study looking at swimmers with non-allergic rhinitis using nose clips and a control group swimming without nose clips revealed less nasal inflammation and symptoms in the nose clip group. So avoiding direct contact with chlorine can help symptoms.  Other studies indicate that chronic chlorine exposure may increase the risk of developing allergies.

If you experience nasal symptoms similar to allergies, asthma or exercise induce asthma then see an allergist to help you control your symptoms so you can continue swimming.

Source: American College of Allergy, Asthma & Immunology, Journal of Allergy and Clinical Immunology, American Academy of Allergy Asthma & Immunology.