Cold Urticaria

What is a Cold Urticaria?

Hives are raised welts that appear on the surface of the skin, and hives appearing in reaction to exposure to cold are known as cold urticaria. Some people inherit the condition, while others experience it for no apparent reason. Since cold temperatures are hard to avoid in the winter, the otherwise non-threatening symptoms of cold urticaria can disrupt your daily life.

What are the Symptoms of Cold Urticaria?

As with all forms of hives, your body creates an allergic reaction to a mild to non-existent threat. You don’t need to be exposed to life-threatening temperatures to experience an outbreak of these hives. Even a cold shower or a dip in a pool can result in a bright red rash across your skin.

Symptoms include

  • Swelling, especially if only one body part is exposed to the cold
  • Itching of the rash covered skin
  • Numbness and tingling
  • Anaphylaxis, including a swollen tongue and throat
  • Fainting and lightheadedness
  • Symptoms that fade within 48 hours, with some cases disappearing in under an hour

If the swelling is intense enough, it can interfere with breathing and make it difficult to speak.

Cold Urticaria Causes

It is known that cold urticaria is caused by exposure to cold, dry temperatures, but that’s where knowledge about the condition breaks down. It’s still unknown why exposure to the cold causes mast cells to be activated or why there’s a release of histamine, as well as other inflammatory mediators. The most logical assumption is that cold urticaria may be produced by an existing blood condition or an infectious disease.

Studies have uncovered a connection by some diseases and the development of cold urticaria in the patient. Among the most common diseases linked to the condition are cryoglobulinemia, chronic lymphocytic leukemia, lymphosarcoma, chickenpox, viral hepatitis, and infectious mononucleosis.

As redness of the skin and itching are symptoms of cold urticaria, it’s also suspected that sensitive skin may be a causal factor. Additionally, researchers haven’t ruled out the possibility that hereditary factors may play a part in determining who is susceptible to contracting the condition.

How is a Cold Urticaria Treated?

For the most severe allergic reactions to cold, you’ll need an emergency treatment like epinephrine to reduce the swelling and breathing problems caused by anaphylaxis. If you don’t experience severe symptoms, you may be able to manage cold urticaria on your own just by avoiding cold temperatures and chilly water. Tolerance development through exposure only works for some patients, but your doctor may recommend it.

Cold Urticaria Prevention

As direct causes, other than exposure to cold temperatures, are currently unknown, there’s no way to prevent the initial onset of cold urticaria. However, once an individual has had that first incident, the patient can work towards preventing future outbreaks of the condition. One method consists of taking a non-prescription antihistamine in advance of cold exposure and protecting one’s skin from the exposure of cold or sudden temperature changes, for instance, wearing a wetsuit when scuba diving or wearing extra layers of clothes in wintry weather.

By avoiding extremely cold drinks and foods, individuals can prevent the throat from swelling, which is one symptom of cold urticaria. Another option is to ask a doctor about prescribing an epinephrine auto injector, such as Epipen or Auvi-Q.

In some cases, surgical procedures can induce the onset of cold urticaria. In the event that you’re scheduled for a surgical procedure, advise the primary surgeon about concerns of a recurrence of the condition in the operating room. Steps can be taken to help reduce this risk.

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Last Reviewed:
September 19, 2016
Last Updated:
December 07, 2017