Several weeks ago, our Friday Funny Chair comedian Damon Williams shared that his wife is allergic to cold temperatures — like, literally breaks out in hives.
Even though it’s late March, we wanted to talk about cold urticaria (ur-tih-kar-e-uh) because it doesn’t only happen during cold winter months. It is a rare disease and many people only become aware of it when someone they know gets affected by it.
WHAT IS COLD URTICARIA?
Cold urticaria is an allergic reaction to cold temperatures. Also known as cold hives, the condition causes redness, itching and swelling after exposure to the cold.
There is something called primary acquired cold urticaria, and another category of individuals who have secondary acquired cold urticaria. Patients with secondary acquired cold urticaria may be related to an underlying condition, like an infection. It affects patients of all ages, from infants to the elderly. In some cases it can occur spontaneously, and in some cases it can go away in a few years.
You can live your whole life in a cold weather climate and it can be triggered by a change in your immune system after recently having a fever or being sick.
WHAT CAN TRIGGER IT?
Cold urticaria is caused by exposure to cold, causing welts to develop after being exposed to cold, cold water, and cold objects. Pretty much any contact with cold; a cold drink, a cold swimming pool, exposure to cold outdoor temperatures.
WHAT ARE SOME OF THE SYMPTOMS?
Cold urticaria (ur-tih-KAR-e-uh) is a skin reaction to cold that appears within minutes after cold exposure. Affected skin develops reddish, itchy welts (hives). People with cold urticaria experience widely different symptoms. Some have minor reactions to the cold, while others have severe reactions. For some people with this condition, swimming in cold water could lead to very low blood pressure, fainting or shock.
Cold urticaria signs and symptoms may 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 while holding cold objects
- Swelling of lips from 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
ARE THERE ANY SEVERE CONCERNS TO BE AWARE OF?
Cold urticaria symptoms begin soon after the skin is exposed to a sudden drop in air temperature or to cold water. Damp and windy conditions may make a flare of symptoms more likely. Each episode may persist for about two hours. 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.
WHO IS THE MOST SUSCEPTIBLE?
Cold urticaria occurs most frequently in young adults. If you think you have this condition, consult your doctor. Treatment usually includes preventive steps such as taking antihistamines and avoiding cold air and water.
WHEN SHOULD YOU SEE A DOCTOR?
If you have skin reactions after cold exposure, see your 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 experience a whole-body response (anaphylaxis) or difficulty breathing. The hives aren’t like normal hives, the welts can be really painful and actually burn, almost like a really bad sunburn will start to burn. The reactions can last from an hour last up to a day
Dr. Heidleberg-Barnwell answers your “Text Tom” dermatology questions on the next page.
What can Black men do about razor bumps?
”Razor bumps” is Pseudofolliculitis Barbae (PFB). Because of how the hair curls, when it is shaved close it grows back into the skin causing irritation. To only way to cure PFB is to grow a beard. Otherwise, optimizing shaving techniques will help .
Hello, Dr., please tell me how to get rid of dark acne marks on my face. I have tried everything.
Your acne must be controlled and stay controlled before the dark spots will go away. Once your acne is controlled, there are many ways to get rid of dark spots which include topical bleaching medications, chemical peels and other procedures.
I have confluent reticulated papillomatosis. Is there a permanent cure?
Confluent and Reticulated Papillomatosis (CARP) is frustrating because it often eventually recurs after treatment . At this time there is not a permanent cure.
I have extremely dark pigmentation on my shoulders from bra straps. Is there anything that can be used to get rid of it?
To get rid of dark areas on your shoulders related to your bra, you must first make sure that your bra fits correctly. A bra that doesn’t fit correctly constantly rubs and irritates the skin which will make it dark. Once that is corrected, lightning medications can help to remove the dark spots.
I have a 2-year-old girl with eczema on her cheeks. Nothing seems to work, she’s constantly rubbing her face. Is there anything we can do?
I would assume that you have tried everything over the counter. I would make an appointment with your local dermatologist. There are great medications on the market for eczema.
What are some keloid treatments specifically for people of color?
There is a higher prevalence of keloids in people of color. The first line of treatment for keloids is Intralesional steroids .
I’m having a reaction on my neck. It comes and goes. At first, we thought it was some type of fungus, I was treated for than it came back. What are signs of eczema?
An essential feature of eczema is itching. Scratching the skin exacerbates the rash. The neck is a common area for eczema.
Great morning, How can my 20-year-old daughter get rid of acne spots?
Her acne must be controlled and stay controlled before the spots will go away. Once her acne is controlled there are many ways to get rid of the spots which include topical bleaching medications, chemical peels and other procedures.
Can you tell me why I have been getting boils under my breast for the last couple of months. I have never had this happen until the last two months. I do extra things to keep the area under my breast really clean and dry but I get them when it’s time for my period.
I would suggest that you see your local dermatologist to evaluate your skin and give you some recommendations. There are several entities that can cause boils under your breasts.
I am older now and starting to develop skin issues like dermatitis. Dark circle patches over my body that itch like crazy. Is this something I will have to live with or is it my diet?
It sounds like something that can be easily treated. See your local dermatologist. You should NOT have to live with itching all over your body.
I recently started using hydroquinone and tretinoin on my face for acne and pigmentation issues. I’ve also started using a new concealer and liquid foundation (I used to only wear powder foundation). For some reason, my eyelids and the skin under my eyes burns when I put on eye cream (CeraVe or L”Oreal Revitalift).
I stopped using everything until I can figure out what’s causing the burning. I’ve developed, however, what looks like a chemical burn around my eyes. What can I use to soothe the skin around my eyes without making things worse?
You may be using too much tretinoin on your skin. It is easy to do! Contact your dermatologist and make sure you are using the medication correctly and you can be prescribed a medication that can resolve the issue.
When the season changes, my son’s eyes get really big. It looks like he have a sty, but it only do it when the seasons change. Where should I start to figure out what’s going on?
If his eyes are itchy and he is rubbing them, I would see a dermatologist.
Can the dermatologist get rid of facial hair? I don’t want to keep shaving my chin because I’,m afraid to get a keloid on my face.
Yes, a dermatologist can get rid of facial hair. There are lasers that work very well for hair removal. Make sure your dermatologist has a laser that is safe for your skin type.
I have developed a molted skin rash on my left leg that looks like Livedo Retcularis over this winter season. My dr took labs and a DVT all came back normal. Now she’s referred me to a dermatologist to get a biopsy. My leg swells from time to time but it’s only the left leg with the rash. Are you familiar with this?
I am familiar with Livedo Reticularis and it sounds like you are doing all the right things to further evaluate the situation.
Dr. Karen Heidleberg-Barnwell, best known as “Dr. Karen” is a board-certified dermatologist, with a successful practice in Detroit, Michigan. She received her medical degree from the Howard University College of Medicine and completed her internship in internal medicine at George Washington University Hospital. At Heidelberg Dermatology, Dr.Karen is the managing partner and chief physician.
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