Cold Urticaria – What it is, Symptoms and Treatments

Cold Urticaria – What it is, Symptoms and Drug Treatments. Also, Cold Urticaria (ur-tih-KAR-e-uh) is a skin reaction to cold. Skin that has been in contact with the cold develops reddened, choreic welts ( urticaria ). The severity of Cold Urticaria symptoms varies greatly. Some people have minor reactions to the cold, while others have severe reactions. Swimming in cold water is the most common cause of a systemic (whole body) reaction. This could lead to very low blood pressure , fainting, shock and even death.

Cold Urticaria occurs most often in young adults. And it usually clears up within a few years. If you think you have this condition, see your doctor. Treatment for Cold Urticaria usually includes taking antihistamines and avoiding cold air and water.

Causes of Cold Urticaria:  No one knows exactly what causes Cold Urticaria . Certain people seem to have very sensitive skin cells, due to an inherited trait, a virus, or a disease. In the most common forms of this condition, the cold triggers the release of histamine and other chemicals into the bloodstream . These chemicals cause redness, itching, and sometimes a whole-body (systemic) reaction.

Symptoms of Cold Urticaria:  The signs and symptoms of Cold Urticaria include:

  • Itchy, reddened temporary herring (hives) in the area of ​​skin that has been exposed to the cold
  • A worsening of the reaction as the skin heats up
  • Hand swelling when holding cold objects
  • Swelling of lips and throat when consuming cold food or drink

Serious reactions can include:

  • A whole-body response (anaphylaxis), which can cause fainting, a racing heart, swelling of the limbs or torso, and shock
  • Swelling of the tongue and throat , which makes breathing difficult

Cold urticaria symptoms begin soon after the skin is exposed to a sudden drop in air temperature or cold water. Most Cold Urticaria reactions occur when the skin is exposed to temperatures below 39°F (4°C). But some people may have reactions to warmer temperatures. Wet and windy conditions can make Cold Urticaria more likely.

The worst reactions usually occur with full exposure to the skin, such as swimming in cold water. Such a reaction can lead to loss of consciousness and drowning. In some people, cold hives go away on their own after weeks or months. In others, it lasts longer.

When to See a Doctor:  If you experience skin reactions after exposure to cold, consult a physician. Even if the reactions are mild, your doctor will want to rule out underlying conditions that could be causing the problem. Seek emergency care if after sudden exposure to the cold you:

  • Feel dizzy
  • have trouble breathing
  • Feel your tongue or throat  swelling

Cold Urticaria Risk Factors:  Anyone can develop Cold Urticaria . You are more likely to have this condition if:

  • You are a child or a young adult. The most common type— primary acquired cold urticaria —occurs in children and young adults. It usually gets better on its own within a few years.
  • You have recently had an infection. For example, pneumonia has been associated with Cold Urticaria .
  • You have an underlying health condition. A less common type – secondary acquired dry hives – can be caused by an underlying health problem, such as hepatitis or cancer.
  • You have certain inherited traits. Rarely, Cold Urticaria is inherited. This familiar type causes painful aches and flu-like symptoms after exposure to cold.

Complications of Cold Urticaria:  The main possible complication of Cold Urticaria is a severe reaction that occurs after exposing large areas of skin to the cold, for example by swimming in cold water.

Cold Urticaria Tests and Diagnosis: Cold  Urticaria can be diagnosed by placing an ice cube on the skin for 5 minutes. If you have Cold Urticaria , a red bump (hive) will increase a few minutes after the ice cube is removed. Most cases of Cold Urticaria occur in young adults and do not have an apparent underlying cause.

It usually gets better on its own within a few years. In some cases,  cold hives are caused by an underlying condition that affects the immune system, such as hepatitis or cancer. If your doctor suspects you have an underlying condition, you may need blood tests or other tests.

Cold Urticaria Treatments:  There is no cure for Cold Urticaria , but treatment can help. Your doctor may recommend that you try to prevent or reduce symptoms with home remedies, such as over-the-counter antihistamines. If self-care steps don’t help, talk to your doctor about finding a prescription drug or drug combination that’s best for you. Medications prescribed to treat Cold Urticaria include:

  • Antihistamines. These medications block the release of histamine producing symptoms. Examples include fexofenadine (Allegra) and desloratadine (Clarinex).
  • Cyproheptadine. This medication is an antihistamine that also affects the nerve impulses that lead to symptoms.
  • Doxepin (Silenor). Typically used to treat anxiety and depression, this medication can also reduce the symptoms of Cold Urticaria .
  • Omalizumab (Xolair). Typically used to treat asthma, this drug has been used successfully to treat a small number of people with Cold Urticaria who have not responded to other medications.

If you have cold urticaria because of an underlying health problem, you also need medication or other treatment for that condition.

Lifestyle and Home Remedies:  The following precautions can help soothe recurring cold urticaria skin reactions :

  • Antihistamines. These medications block the release of histamine producing symptoms. Over-the-counter (OTC) products include loratadine (Claritin), fexofenadine (Allegra), cetirizine (Zyrtec), and levocetirizine (Xyzal).
  • Avoid sudden changes in temperature. Take special care to protect your skin from the cold.

Preventing Cold Urticaria:  You can help prevent a recurring episode of Cold Urticaria with these practices:

  • Take an over-the-counter antihistamine before cold exposure.
  • Take medications as prescribed.
  • Protect your skin from cold or sudden changes in temperature. For example, wear a wetsuit when swimming in cold water. Some people have had success with this method, but it’s not proven.
  • Avoid cold drinks and foods to prevent throat swelling .
  • If your doctor has prescribed an epinephrine auto-injector (Epipen, Auvi-Q, others), keep it with you to help prevent serious reactions.

If you are scheduled for surgery, speak to your surgeon beforehand about your Cold Urticaria . The surgical team can take steps to help prevent cold-induced symptoms in the operating room.

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