“Cold Urticaria: Symptoms, Causes, and Management”

Overview Types Causes & Risk Factors Symptoms Preventions Treatment

Overview

Cold urticaria, also known as cold-induced hives, is a skin condition characterized by an allergic reaction to cold temperatures. When exposed to cold air, water, or objects, affected individuals develop itchy welts (hives) on their skin. The severity of symptoms varies, with some people experiencing minor reactions and others facing more severe responses. In extreme cases, swimming in cold water can lead to very low blood pressure, fainting, or shock.

Types of Cold urticaria

There are two main types of cold urticaria:

Acquired Cold Urticaria (Essential Cold Urticaria):
- Occurs in individuals with no family history of the disease.
- Symptoms typically appear within minutes of cold exposure and usually resolve within an hour or two.
Familial Cold Urticaria (Hereditary Cold Urticaria):
- Passed down in families.
- Symptoms may take longer to appear (30 minutes to 48 hours after exposure) and can last for a day or two.

Causes of Cold urticaria

The exact cause of cold urticaria remains unclear. However, several factors may contribute:

Sensitive Skin Cells:
- Certain individuals have overly sensitive skin cells, possibly due to an inherited trait, viral infections, or other illnesses.
Histamine Release:
- Cold triggers the release of histamine and other chemicals into the bloodstream, leading to hives and sometimes a whole-body reaction.

Risk Factors of Cold urticaria

You are more likely to develop cold urticaria if:

You are a young adult (primary acquired cold urticaria is most common in this age group).
You have certain inherited traits.
You have an underlying health condition, such as chronic lymphocytic leukemia, cryoglobulinemia, or viral infections.

Symptoms of Cold urticaria

Cold urticaria symptoms include:

1. Temporary Itchy Welts (Hives): Develop on exposed skin after cold exposure. Itching and redness are common.

2. Worsening Reaction with Skin Warming: As the skin warms up, the hives may become more pronounced.

3. Swelling of Hands: Holding cold objects can lead to hand swelling.

4. Swelling of Lips: Consuming cold food or drink may cause lip swelling.

5. Severe Reactions: Anaphylaxis (whole-body response) with symptoms like rapid heart rate, limb or torso swelling, and shock. Tongue and throat swelling, making breathing difficult. Loss of consciousness and drowning (especially during full skin exposure, such as swimming in cold water).

Preventions of Cold urticaria

Preventive measures for cold urticaria include:

Taking antihistamines.
Avoiding exposure to cold air and water.
Being cautious during outdoor activities in cold weather.

Diagnosis of Cold urticaria

Diagnosing cold urticaria involves a thorough medical history, physical examination, and cold stimulation tests. A doctor may expose a small area of skin to cold and observe the reaction. Blood tests and allergy testing may also be performed.

Treatment for Cold urticaria

Treatment strategies include:

Antihistamines: To reduce symptoms.
Avoidance: Preventing exposure to cold triggers.
Emergency Measures: In severe cases, seek immediate medical attention.

When to seek medical attention ?

Consult a doctor if you experience skin reactions after cold exposure. Even mild reactions should be evaluated to rule out underlying conditions. Seek emergency care if you encounter anaphylaxis or difficulty breathing.