Cold urticaria

Cold urticaria (ur-tih-KAR-e-uh) is a reaction that appears within minutes after skin is exposed to the cold. Itchy welts, also called hives, arise on affected skin.

Symptoms in people with cold urticaria can range from minor to serious. For some people with this condition, swimming in cold water could lead to low blood pressure, fainting or shock.

Cold urticaria occurs most often in young adults. If you think you have this condition, check in with your healthcare team. Treatment usually includes steps to keep cold urticaria from happening, such as taking antihistamines and staying away from cold air and water.

Cold urticaria symptoms may include:

• Temporary itchy welts, also called hives, on the area of skin exposed to cold.
• A response that worsens as the skin warms.
• Swelling of the hands while holding cold objects.
• Swelling of the lips from eating cold food or drinking cold beverages.

Serious responses may include:

• A whole-body reaction, also known as anaphylaxis. This can cause fainting, a racing heart, swelling of limbs or trunk, and shock.
• Swelling of the tongue and throat. This can make it hard to breathe.

Cold urticaria symptoms begin soon after the skin is exposed to a sudden drop in air temperature or cold water. Damp and windy conditions may cause symptoms to flare up. Each bout of symptoms may last for about two hours.

The worst reactions generally occur when all of the skin is exposed to cold, such as when swimming in cold water. These reactions could lead to fainting and drowning.

If you have skin reactions after being exposed to the cold, see your healthcare professional. Even if the reactions are mild, your healthcare professional will want to rule out other conditions that may be causing the symptoms.

Seek emergency care if your whole body is affected or you find it hard to breathe after suddenly being exposed to the cold.

No one knows what causes cold urticaria. You could have sensitive skin cells due to a virus or an illness or from a trait passed down in your genes. In the most common forms of this condition, cold causes the release of histamine and other chemicals into the blood. These chemicals cause itching, and they sometimes affect the whole body.

You're more likely to have cold urticaria if:

• You're a young adult. The most common type — primary acquired cold urticaria — occurs most often in young adults.
• You have another health condition. A less common type is secondary acquired cold urticaria. A condition such as hepatitis or cancer can cause it.
• You have certain traits. Rarely, cold urticaria is passed down to you in your genes. This type causes painful welts and flu-like symptoms after being exposed to cold.

The main possible complication of cold urticaria is a serious response that occurs after large areas of skin are exposed to the cold, such as when swimming in cold water.

These tips may help stop cold urticaria from happening:

• Take an antihistamine available without a prescription as directed before being exposed to the cold.
• Protect your skin from the cold or sudden changes in temperature. If you're going swimming, dip your hand in the water first to see if your skin responds.
• Stay away from ice-cold drinks and foods to keep your throat from swelling.
• If your healthcare professional prescribed an epinephrine autoinjector, keep it with you to help stop serious responses from happening.
• If you're scheduled for surgery, talk with your surgeon ahead of time about your cold urticaria. The surgical team can take steps to help keep symptoms caused by cold from happening in the operating room.