Cold urticaria is a skin reaction to cold temperatures that appears minutes after exposure to cold. It is a condition that usually occurs in young adults.
People with cold urticaria have very different symptoms. Some have mild reactions while others are more severe. Red, itchy welts (urticaria) usually appear on the affected skin. In some people, swimming in cold water can cause very low blood pressure and even fainting or shock.
What are the symptoms of cold allergy?
The symptoms of hives as a result of cold start soon after the skin is exposed to a rapid decrease in ambient temperature or to cold water. If there is wet and windy weather it can worsen the symptoms, which usually last about two hours.
Symptoms of cold urticaria may include:
- Temporary itchy reddish welts (urticaria) on those areas that have been exposed to the cold.
- Worsening of the allergic reaction when the skin warms up.
- Swelling of the hands when holding cold objects.
- Swelling of the lips when cold foods and drinks are consumed.
However, there are some serious symptoms that can occur and should be taken into account:
- Whole body response or anaphylaxis. This is especially serious because it can cause fainting, racing heart, swelling of the limbs or torso, and shock.
- Swelling of the throat and tongue, which can make breathing difficult.
When should you see a doctor for a cold allergy?
If skin reactions occur after exposure to cold, it is important to consult an allergist. Even if the reactions are not severe, the specialist will want to rule out an underlying disease that could be causing the problems. If, after exposure to cold, a whole-body reaction (anaphylaxis) occurs, it is especially important to see a physician.
Why does cold allergy occur?
It is not known exactly what causes cold allergy. Some people may have very sensitive skin cells due to an inherited trait, virus or disease. In the most common cases of cold allergy, the cold triggers the release of histamine and other substances into the blood, causing redness, itching and sometimes a systemic reaction throughout the body.
Risk factors in cold allergy
Patients may be more likely to suffer from cold allergy if:
- They are young adults. Primary acquired cold urticaria is most commonly seen in young adults.
- They have some undiagnosed condition. Secondary acquired cold urticaria (a less common type) may be due to an undiagnosed health problem, such as cancer or hepatitis.
- Certain hereditary traits. In very rare cases, cold urticaria may be hereditary. This causes painful hives and influence-like symptoms after exposure to cold.
Can complications occur?
The main complication that can occur is a severe reaction, which can occur after exposing large areas of skin to cold, such as when swimming.
Can cold allergy be prevented?
There are some tips that can help prevent an episode of cold allergy:
- Take an antihistamine before exposure to cold.
- Take the medications prescribed by your doctor.
- Protect the skin from cold and/or sudden changes in temperature. For example, if you go swimming, touch the water with your hand and watch for a reaction on your skin.
- Try to avoid ice-cold drinks and food to prevent swelling of the throat.
- Carry an epinephrine auto-injector with you if your doctor has prescribed it.
- If you are scheduled for surgery, tell the surgeon in advance about cold urticaria. The operating room team will then take the correct steps to help prevent symptoms that could be caused by cold in the operating room.