Cold urticaria signs and symptoms include:
- Temporary reddish, itchy welts (hives) on the area of skin that was exposed to cold
- A worsening of the reaction as the skin warms
- Swelling of hands when holding cold objects
- Swelling of lips and throat when consuming cold food or drink
Severe reactions may include:
- A whole-body response (anaphylaxis), which can cause fainting, a racing heart, swelling of limbs or torso, and shock
- Swelling of the tongue and throat, which can make it difficult to breathe
Cold urticaria symptoms begin soon after the skin is exposed to a sudden drop in air temperature or to cold water. The majority of cold urticaria reactions occur when skin is exposed to temperatures lower than 39 F (4 C). But some people can have reactions to warmer temperatures. Damp and windy conditions may make cold urticaria more likely.
The worst reactions generally occur with full skin exposure, such as swimming in cold water. Such a reaction could lead to loss of consciousness and drowning.
In some people, cold urticaria goes away on its own after weeks or months. In others, it lasts longer.
When to see a doctor
If you have skin reactions after cold exposure, see a doctor. Even if the reactions are mild, your doctor will want to rule out underlying conditions that may be causing the problem.
Seek emergency care if after sudden exposure to cold you:
Nov. 21, 2014
- Feel dizzy
- Have trouble breathing
- Feel your tongue or throat swelling
- Goldsmith LA, et al., eds. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=740. Accessed Aug. 28, 2014.
- Mauer M. Cold urticaria. http://www.uptodate.com/home. Accessed Aug. 28, 2014.
- AskMayoExpert. Physical urticarias. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- AskMayoExpert. Urticaria and angioedema. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Sciallis GF, et al. Localized cold urticaria to the face in a pediatric patient: A case report and literature review. Pediatric Dermatology. 2010;27:266.
- Ombrello MJ, et al. Cold urticaria, immunodeficiency, and autoimmunity related to PLCG2 deletions. New England Journal of Medicine. 2012;366:330.
- Isik S, et al. Idiopathic cold urticaria and anaphylaxis. Pediatric Emergency Care. 2014;30:38.
- Abajian M, et al. Physical urticarias and cholinergic urticaria. Immunology & Allergy Clinics of North America. 2014;34:73.
- Lang DM, et al. Contemporary approaches to the diagnosis and management of physical urticaria. Annals of Allergy, Asthma & Immunology. 2013;111:235.