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Cold-Induced Urticaria: Can you be allergic to the cold?

Some people can have an adverse reaction to the cold on a summer day after eating ice cream, walking into a cool building, or grasping a cold bottle of water.


Our skin is sensitive to the cold. Dry skin and rosy cheeks are the symptoms most people experience when being exposed to the cold in the winter.


But some people can have an adverse reaction to the cold on a summer day after eating ice cream, walking into a cool building, or grasping a cold bottle of water. Their skin starts to break out into itchy hives within minutes after coming into contact with a cold stimulus. People who react in such a manner may be allergic to the cold.


Cold-induced urticaria, also known as cold-induced hives, is a condition where raised red welts (hives) appear on the skin in response to cold stimuli. The welts are usually itchy and appear in the exact area where the skin was exposed; they commonly occur on the face, neck, hands, legs, and feet. Some welts may join and form large swollen areas on the skin. If you press the welt, it turns white.


The symptoms can appear in a few minutes to half an hour after exposure and disappear a few hours after the skin has become warmer.


Hives develop because of an allergic reaction. The immune system releases histamine that makes fluid from the blood leak through blood vessels and accumulates around the site of injury, resulting in rashes.


Swimming in cold water is the most common cause of a severe cold urticarial reaction, since the whole body is exposed to the cold. This can cause a drop in blood pressure, loss of consciousness and even anaphylactic shock, which can be fatal.


Drinking ice-cold water or eating ice cream may be followed by swelling in the throat, making it difficult to breathe.


Cold-induced urticaria affects mostly children and young adults.


In most cases, its underlying causes remain unknown, but the risk could be higher if cold-induced urticaria runs in the family, or a person has some other health problems, such as hepatitis or cancer.


Cold-induced urticaria can go away on its own within 5-6 years. It’s also possible to have it for life.


If you think you might have cold-induced urticaria, make sure to see an allergist. The ice cube test is usually done to confirm the diagnosis. A bag filled with ice cubes is placed on bare skin to see how it reacts to cold. Most people who have cold-induced urticaria develop welts on their skin after the bag is removed.


If the diagnosis is confirmed, in most cases the symptoms can be kept at bay with precautionary measures, as well as taking antihistamines.

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