Baby, it’s cold outside. Winter has arrived in many places, and for some, this comes with frosty and magical winter mornings. Unfortunately, for a few people, the mystical time can also bring a sense of pain – their bodies can experience more than just cold toes and fingers, but an allergic reaction to the freezing weather. This allergy has a name: cold urticaria [ur-tih-KAR-e-uh]. The most common symptom is itchy hives, redness, and swelling on the skin. This reaction often occurs when the skin has been cooled by either by swimming in cold water, a drop in the temperature, or even drinking or eating something frozen. There can be a range of reactions to this allergy; from non-threatening symptoms (hives, burning sensation while the skin warms up, headache, fatigue, anxiety, joint pain, swelling at exposure site) to more life-threatening symptoms (anaphylaxis, heart palpitations, drop in blood pressure, breathing problems, fainting, shock, swelling of tongue and throat). Who can get this condition? There are mainly two types of cold urticaria: Acquired or essential: The reaction can occur within 5-10 minutes after the initial exposure and can often last 1-2 hours. Hereditary or familial: The symptoms can appear 24-48 hours after exposure and last 24-48 hours. This condition is more common in females than males, with it being more common in young adults (although those of any age can experience it). Occasionally, the condition can appear suddenly but also resolves itself over time. What causes cold urticaria? The condition occurs when the cold causes mast cells to activate and histamine (along with other inflammatory mediators) to be released. Why the cold affects the mast cells is still a puzzle to scientists. How do you treat cold urticaria? There are a few preventative steps that can be taken for this condition. You can try and avoid the cold elements, like not swimming in cold water and avoiding drinking ice-cold drinks. For some people, high doses of non-sedating antihistamines may be required. For anaphylactic reactions, emergency adrenaline should be carried. How can this condition be tested? A medical doctor can help diagnose the condition. Often the medical profession will discuss symptoms, health history, physical exam, along with a few tests. One test is called the ice cube challenge test, where an ice cube is placed in a plastic bag, then placed on the body for a few minutes. The person would then be observed for any hives or other symptoms. What are the precautions for people who suffer from this condition? Activities that cause a rapid drop in body temperature should be avoided or monitored. Swimming and surfing should always be done under supervision in case of fainting. For people who undergo general anesthesia, medical professionals need to be made aware as the person would have to be kept warm and their body temperature monitored. Source
