“Cold Urticaria: Causes, Symptoms, and Management”

Overview Types Causes & Risk Factors Symptoms Preventions Treatment

Overview

Cold urticaria (ur-tih-KAR-e-uh) 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 widely, with some experiencing minor reactions and others facing more severe consequences. For certain individuals, swimming in cold water can lead to dangerously low blood pressure, fainting, or shock.

Types of Cold urticaria

There are two primary 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 resolve within an hour or two.
Familial Cold Urticaria (Hereditary Cold Urticaria):
- Passed down in families.
- Symptoms may take longer to appear (from 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 unknown. However, several factors contribute to its development:

Sensitive Skin Cells:
- Some people have exceptionally 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, in severe cases, systemic reactions.

Risk Factors of Cold urticaria

You’re more likely to have cold urticaria if:

You’re 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): After exposure to cold air, water, or objects, individuals with cold urticaria develop itchy welts (hives) on their skin. These hives can vary in size and shape and may appear as red, raised patches. The itching can be intense and uncomfortable.

2. Worsening of Reaction with Skin Warming: As the affected skin warms up (e.g., when moving indoors after exposure to cold), the hives may become more pronounced. This phenomenon is characteristic of cold urticaria and helps differentiate it from other skin conditions.

3. Swelling of Hands and Lips: Holding cold objects or consuming cold food or drinks can lead to localized swelling. Hands may become puffy, and lips can swell after exposure to cold temperatures.

4. Severe Reactions and Anaphylaxis: In some cases, cold urticaria can cause systemic reactions. Anaphylaxis is a severe allergic response that can lead to fainting, rapid heartbeat, limb swelling, and shock. Difficulty breathing may occur, necessitating immediate medical attention.

Preventions of Cold urticaria

To manage cold urticaria:

Take antihistamines as preventive measures.
Avoid exposure to cold air and water.
Be cautious when swimming in cold water to prevent loss of consciousness and drowning.

Diagnosis of Cold urticaria

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

Treatment for Cold urticaria

Treatment strategies include:

Antihistamines: To reduce symptoms.
Desensitization: Gradual exposure to cold to build tolerance.
Avoidance: Preventing cold exposure.
Emergency Measures: In case of severe reactions.

When to seek medical attention ?

If you experience skin reactions after cold exposure, consult a doctor. Seek emergency care if you encounter whole-body anaphylaxis or difficulty breathing.