Acquired hypohidrosis is a rare condition of unknown pathogenesis, while idiopathic cholinergic urticaria is relatively common. We report the case of a 18-year-old male with idiopathic cholinergic urticaria and acquired hypohidrosis. He presented with an intermittent pruritic eruption precipitated by mild activity, such as mild exercise or laughing, for last 4 years. He was diagnosed with cholinergic urticaria associated acquired hypohidrosis, successfully treated by herbal medicine applied Gejimahwanggakban-tang(桂枝麻黃各半湯).