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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.

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