This rare condition is caused by an allergic reaction to cold temperatures. In most cases, cold urticaria is characterized by a rash or hives after exposure to cold air, water, food, or drink. However, symptoms can be more severe. Sometimes, it is associated with an infectious disease or blood cancer.
Histamines are chemicals made by your immune system in response to an allergen, but it is unclear what causes cold urticaria.
It is possible that cold urticaria is a symptom of autoimmune disorders. Autoimmune disorders occur when the body's immune system attacks healthy cells or tissues without knowing why.
There are two types of cold urticaria: inherited and acquired. Inherited cold urticaria occurs in families and symptoms may take longer to occur and last longer than acquired cold urticaria. People with no family history of cold urticaria are likely to develop the disease and symptoms usually appear shortly after being exposed to the cold and disappear within an hour or two.
Cold urticaria symptoms vary from person to person. They can be mild to severe. They can affect a small area of your skin or your entire body. The main symptom is a skin rash.
Other symptoms may include:
Itching, burning, swelling or redness of the skin.
Blisters or welts that may ooze or bleed.
Headache, dizziness, fainting or low blood pressure.
Difficulty breathing, wheezing, chest tightness or throat swelling.
Nausea, vomiting, diarrhea or abdominal pain.
In rare cases, cold urticaria can cause a life-threatening reaction called anaphylaxis. Anaphylaxis is a medical emergency that requires immediate treatment. Signs of anaphylaxis include:
Severe swelling of the face, lips, tongue or throat.
Difficulty breathing or swallowing.
Rapid heartbeat, shock or loss of consciousness.
When an ice cube is placed on the skin for five minutes, a raised bump (hive) will appear a few minutes later if you have cold urticaria.
If your doctor suspects you have an underlying condition that affects your immune system, such as an infection or cancer, you may need blood tests or other diagnostic tests.
Cold urticaria may go away on its own after a few weeks or months, but it may persist for a long time. There is no cure for cold urticaria, but treatment and prevention may help.
If home remedies don't help, you may need prescription medication. Your doctor may suggest using over-the-counter antihistamines and avoiding cold exposure.
Prescription medications used to treat cold urticaria include:
Nondrowsy antihistamines. If you know you’re going to be exposed to the cold, take an antihistamine beforehand to help prevent a reaction. Examples include loratadine and desloratadine.
Omalizumab. Normally prescribed to treat asthma, this drug has been used successfully to treat people with cold urticaria who didn’t respond to other medications.
If you have cold urticaria because of an underlying health problem, you may need medications or other treatment for that condition as well.
You may need to carry an epinephrine autoinjector with you if you have a history of systemic reactions. Epinephrine can reverse the symptoms of anaphylaxis.
The best way to prevent cold urticaria is to avoid exposure to cold temperatures or sudden changes in temperature. Some tips to prevent or reduce symptoms include:
Dress warmly and cover your skin when going outside in cold weather.
Wear gloves, a scarf and a hat to protect your hands, face and ears.
Avoid swimming or bathing in cold water. If you’re going swimming, dip your hand in the water first and see if you experience a skin reaction.
Avoid ice-cold drinks and food to prevent swelling of your throat.
Keep a warm blanket or jacket handy in case you get cold.
Inform your doctor, dentist and other health care providers about your condition before any procedures that may involve cold exposure.
