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Hives (Cold urticaria)

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Skin (Integumentary system)

Cold urticaria

Cold urticaria is a type of urticaria, also known as hives, that occurs in response to cold temperatures or exposure to cold objects or water. It is a relatively rare condition, affecting about 1 in 100,000 people.

The symptoms of cold urticaria typically include the sudden onset of red, itchy welts or hives on the skin after exposure to a cold. These hives can appear within minutes of exposure and may last for several hours. In severe cases, exposure to cold can also cause swelling and difficulty breathing, a condition known as anaphylaxis.

The exact cause of cold urticaria is not well understood, but it is believed to be related to the body's immune response to cold. Cold temperatures may trigger the release of histamine and other chemicals in the body, leading to the development of hives.

Treatment for cold urticaria typically involves avoiding exposure to cold temperatures or taking preventive measures, such as wearing warm clothing or taking antihistamines before exposure to cold. In severe cases, a doctor may recommend epinephrine, a medication used to treat severe allergic reactions, in case of anaphylaxis.

While cold urticaria can be a chronic and uncomfortable condition, it is usually not life-threatening and can be effectively managed with appropriate treatment and preventive measures.

Research Papers

Disease Signs and Symptoms

Itching
Swollen arms or hands
Swollen lip

Disease Causes

Cold urticaria

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

Disease Prevents

Cold urticaria

The following tips may help prevent a recurrent episode of cold urticaria:

Take an over-the-counter antihistamine before cold exposure.
Take medications as prescribed.
Protect your skin from the cold or sudden changes in temperature. 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.
If your doctor prescribed an epinephrine autoinjector (EpiPen, Auvi-Q, others), keep it with you to help prevent serious reactions.
If you're scheduled for surgery, talk with your surgeon beforehand about your cold urticaria. The surgical team can take steps to help prevent cold-induced symptoms in the operating room.

Disease Treatments

Cold urticaria

In some people, cold urticaria goes away on its own after weeks or months. In others, it lasts longer. There is no cure for the condition, but treatment and preventive steps can help.

Your doctor may recommend you try to prevent or reduce symptoms with home remedies, such as using over-the-counter antihistamines and avoiding cold exposure. If that doesn't help, you may need prescription medication.

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 (Claritin) and desloratadine (Clarinex).
Omalizumab (Xolair). 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. If you have a history of systemic reaction, your doctor may prescribe an epinephrine autoinjector that you'll need to carry with you.