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What Are The Clinical Features Of Cold Urticaria

The Inside Story: Girl has rare allergy to cold

Symptoms of cold urticaria become evident within 25 minutes after exposure and last for 12 hours. They include:

  • Itchy weals and angioedema that may be localised or generalised .
  • In some cases, systemic symptoms may develop
  • Shortness of breath, wheezing
  • Abdominal pain, gastrointestinal ulcers
  • Rapid and irregular heartbeat
  • In very severe cases hypotension , shock, collapse and even death may occur.
  • Swimming in cold water is the most common cause of a severe cold urticarial reaction. Severe reactions may also arise in patients exposed to cold rooms or during surgery under general anaesthesia.

    Cold urticaria

    Diagnosing Chronic Hives Vs Cold Urticaria

    Cold urticaria can happen without a known cause, but it often runs in families, explains Dr. Jacob. It is diagnosed, in part, by observing the events that trigger it, such as:

    • Exposure to low seasonal temperatures
    • Swimming in or falling into cold water
    • Eating cold foods
    • Handling cold objects
    • Water evaporating off the skin

    Your doctor will typically use a cold stimulation time test to confirm the diagnosis. This involves placing an ice pack on an area of skin. If you have cold urticaria, the skin under and around the ice will become itchy and inflamed.

    How Do Doctors Diagnose Cold Allergy

    If you think you might have cold urticaria, make sure to see a doctor for diagnosis. They’ll perform something called “the ice cube test,” which involves a doctor holding an ice cube to a patch of bare skin, and then watching “for a hive swelling to develop as the skin starts rewarming” over the next five to 15 minutes, according to Dr. Palacios-Kibler.

    It’s important to get a doctor involved in your treatment. Not only can they give you tips on managing the allergy and use blood tests to rule out other causes for your hives they can also help you stay aware of the serious dangers cold urticaria can create. Folks with a severe version of the allergy can experience “systemic anaphylaxis, which is a severe allergic reaction due to hypotension, or low blood pressure” when they go out in extreme cold weather, or jump into a cold body of water. If you have a severe allergy to the cold and jump into a cold pool, for example, you can go into anaphylaxis and asphyxiate, Dr. Palacios-Kibler notes. So don’t try to handle this allergy on your own â it can be riskier than it sounds.

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    Yes You Really Can Be Allergic To Cold Weather

    University Hospitals Rainbow Babies & Children’s

    Dislike of frigid temperatures may have some of us declaring that we are allergic to the cold. But for some people, an allergy to the cold is real.

    The allergy is called cold urticaria, and those who have it experience itchy hives, redness and swelling when their skin is warmed after being exposed to cold temperatures below 39 degrees, says pediatric allergy and immunology specialist Eli Silver, MD.

    The exposure to cold sets them up to develop hives, Dr. Silver says. The hives begin when the skin is warmed.

    Man Almost Dies From An Allergic Reaction To Cold Air

    Meet Riley. She

    ByRachael Rettnerpublished 29 October 20

    The man developed the life-threatening reaction when he stepped out of a hot shower into a cold bathroom.

    Stepping out of a hot shower into a cold bathroom almost killed a Colorado man, who had developed a serious allergic reaction to cold temperatures.

    The 34-year-old old man collapsed after getting out of the shower, and his family found him on the floor, according to a report of the case published Oct. 27 in The Journal of Emergency Medicine. The man was struggling to breathe and his skin was covered in hives. He was experiencing a life-threatening, whole-body allergic reaction known as anaphylaxis.

    When paramedics arrived, his family told them that the man had a history of being “allergic to the cold weather,” according to the report. He had previously experienced hives as a reaction to the cold, but not anaphylaxis. These episodes started after he moved from Micronesia, which has a tropical climate, to Colorado, which sees colder temperatures, the report said.

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    Paramedics treated the man with epinephrine and oxygen, and rushed him to the emergency room. When he got to the hospital, he was sweating profusely and had hives all over his body.

    6 Winter Woes to Watch Out For

    Exactly how common the condition is overall is not known one study in Europe found a prevalence of 0.05%, according to the National Institutes of Health. Anaphylactic reactions are less common than hive-like reactions.

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    What Are Cold Allergy Symptoms

    They vary by person, but typically include red hives on parts of the skin exposed to the cold air. In severe cases, people may experience low blood pressure, heart palpitations, difficulty breathing, or shock, according to the National Institutes of Health. The rash typically begins just minutes after exposure and lasts roughly two hours.

    Although this condition is particularly relevant during the winter season, some people may have problems eating cold foods, explains , MD, MPH and assistant professor of medicine at National Jewish Health in Denver.

    If you get red, itchy, and swollen skin five to 30 minutes after exposure to the cold, you may have cold urticaria. Other symptoms include swollen hands when holding a cold drink, or swollen lips or tongue when drinking a cold beverage, she tells Men’s Health.

    How cold is too cold? Typically, symptoms will be triggered when temperatures dip below 39 degrees Fahrenheit.

    How Can I Manage My Cold Urticaria

    Most people rely on lifestyle changes to avoid flare-ups of their condition. However it doesnt affect everyone in the same way.

    It can be helpful to get to know your common triggers and how the condition affects you personally. For example, can you tolerate moderately low temperatures without your skin reacting, or is your temperature threshold quite high?

    If you know youre going to be unavoidably exposed to the cold, consider taking your antihistamine in advance.

    As well as taking your medication as prescribed, avoid or take precautions with:

    • Visiting places with low ambient temperature e.g. cellars, ice rinks, supermarkets with refrigerated cabinets, etc.
    • Outdoor leisure activities e.g. swimming, watersports, snowsports, caves, and mountains
    • Household jobs e.g. window cleaning, defrosting the freezer
    • Cold cosmetic procedures
    • Chilled/frozen foods and drinks.

    Before any medical or dental procedure or childbirth, tell your healthcare team that you have cold urticaria so they can keep you warm during the procedure.

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    What Is An Allergic Reaction

    An allergic reaction is the way your body responds to the allergen. A chain of events occur that result in an allergic reaction.

    If you are prone to allergies, the first time youre exposed to a specific allergen , your body responds by producing allergic antibodies. The job of these antibodies is to find the allergens and help remove them from your system. As a result, a chemical called histamine is released and causes symptoms of allergies.

    How Are Hives Diagnosed

    Allergic to the cold

    Most of the time, a doctor can diagnose hives just by looking at the skin. To find the cause, you may be asked questions about your child’s , recent illnesses, medicines, exposure to allergens, and daily stressors.

    If your child has chronic hives, the doctor may ask you to keep a daily record of activities, such as what your child eats and drinks, and where the hives tend to show up on the body. Diagnostic tests such as blood tests, allergy tests, and tests to rule out conditions that can cause hives, such as thyroid disease or hepatitis might be done to find the exact cause of the hives.

    To check for physical hives, a doctor may put ice on your child’s skin to see how it reacts to cold or place a sandbag or other heavy object on the thighs to see if the pressure will cause hives.

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    Kids Allergic To The Cold

    Connor and Taylor Frankenfeld — allergic to the cold.

    While many people get sick in cold weather, a small number develop an allergic reaction to the cold – literally. Much as with food and pollen allergies, reactions can include rashes, hives that can extend almost to an inch, closing of the throat and general itchiness.

    Mike and Melissa Frankenfeld of Sterling, Colo., are all too familiar with this rare condition, called cold urticaria.

    Their battle started two years ago when they noticed a painful rash on their son, Connor, who was 3 years old at the time.

    “It was really weird,” Melissa Frankenfeld told “We saw this rash in the diaper area, and I thought ‘diaper rash,’ and I treated it with home remedies and it got worse. I tried changing detergents and soaps, and I took him to the doctor, because it wasn’t getting any better. They said it was diaper rash, and to let it air out.”

    The rash continued to worsen and even began to swell as the Frankenfelds made the rounds of several more doctors, none of whom could hit on the right treatment. The only thing that seemed to soothe Connor was warm baths.

    Lanting said cold urticaria was rare, affecting approximately one in 100,000 people.

    “I just feel my throat start to feel funny and it was feeling like it was getting bigger,” Taylor told ABC 7 in Denver. “I was really scared. I thought I was going to die.”

    Mike and Melissa Frankenfeld try to their best to maintain a normal life for their children.

    Does Cold Urticaria Go Away

    Some people who have cold urticaria see it go away on its own within a few weeks or months. About half the people who get cold urticaria will see it disappear within five years. Once this happens, most patients never get hives from the cold again.

    Its also possible to have cold urticaria for life.

    Related AAD resources

    ImagesImage 1: Used with permission of Journal of the American Academy of Dermatology: J Am Acad Dermatol. 2002 47:608-10.

    ReferencesAbajian M, Curto-Barredo L, et al. Rupatadine 20 mg and 40 mg are effective in reducing the symptoms of chronic cold urticaria. Acta Derm Venereol. 2016 96:56-9.

    Alba Marin JC, Martorell Aragones A, et al. Treatment of severe cold-induced urticaria in a child with omalizumab. J Investig Allergol Clin Immunol. 2015 25:303-4.

    Deza G, Brasileiro A, et al. Acquired cold urticaria: Clinical features, particular phenotypes, and disease course in a tertiary care center cohort. J Am Acad Dermatol. 2016 75:918-24.

    Hochstadter EF and Ben-Shoshan M. Cold-induced urticaria: challenges in diagnosis and management. BMJ Case Rep. 2013 Jul 8:2013.

    Ik S, Arkan-Ayyldz Z, et al. Idiopathic cold urticaria and anaphylaxis. Pediatr Emerg Care. 2014 30:38-9.

    Jain SV, Mullins RJ. Cold urticaria: A 20-year follow-up study. J Eur Acad Dermatol Venereol. 2016 30:2066-71.

    Kim G. Primary cold urticaria and cholinergic urticaria. Dermatol Online J. 2004 10:13.

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    How Do You Treat A Cold Allergy

    If you’ve been diagnosed with cold urticaria, you may be wondering how exactly you’re supposed to cope â move to the equator? Spend all summer out on the sidewalk, eating lukewarm soup? Luckily, if you’re suffering from cold allergies, the symptoms can generally be kept in check with antihistamines, as well as precautionary measures like making sure all parts of your body are covered before you go outdoors in the winter.

    And in the summer, Dr. Dr. Palacios-Kibler cautions, make sure to be careful around water ” your feet little by little…in a body of water, instead of diving into a pool.” This will allow you to see if your body is having a reaction while you’re still in shallow water. By contrast, if you just cannonball in instead, you run the risk of experiencing anaphylaxis in the water, which has led to drowning deaths among cold urticaria sufferers.

    If you think you might have cold urticaria, you might be pretty danged bummed about now. But with solid prevention and treatment, you can still live a comfortable, welt-free life. And even if you have cold urticaria today, you may not be stuck with it forever â according to the National Institute of Health, in roughly 50% of cases, the allergy improves or disappears completely within six years.

    The most important thing to remember, however, is that you’re not doomed. There’s help available, so there’s no reason for you to be miserable every winter .

    This article was originally published on Dec. 9, 2015

    What Is Allergic Rhinitis

    How To Tell The Difference Between Allergies And Cold ...

    Nasal allergy symptoms and hay fever are referred to as allergic rhinitis. Seasonal allergic rhinitis is nasal allergies that change with the seasons because of pollen from plants . Seasonal symptoms arise during the pollinating seasons for particular plants. Because you can be allergic to more than one thing, your symptoms may get worse at different times throughout the year, or may be constant.

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    What Are Colds And Allergies

    They have different causes. You get a cold when a tiny living thing called a virus gets into your body. There are hundreds of different types that can get you sick.

    Once a cold virus gets inside you, your immune system, the body’s defense against germs, launches a counter-attack. It’s this response that brings on the classic symptoms like a cough or stuffed up nose.

    The viruses that cause colds are contagious. You can pick them up when someone who’s infected sneezes, coughs, or shakes hands with you. After a couple of weeks, at the most, your immune system fights off the illness and you should stop having symptoms.

    It’s a different story with allergies. They’re caused by an overactive immune system. For some reason, your body mistakes harmless things, such as dust or pollen, for germs and mounts an attack on them.

    When that happens, your body releases chemicals such as histamine, just as it does when fighting a cold. This can cause a swelling in the passageways of your nose, and you’ll start sneezing and coughing.

    Unlike colds, allergies aren’t contagious, though some people may inherit a tendency to get them.

    Dust Mite Allergy Management And Treatment

    Make changes to your home and to your routine:

    • Remove wall-to-wall carpets, curtains, and drapes particularly in the bedroom.
    • Keep pets out of the bedroom, and preferably out of the house.
    • Minimize household humidity.
    • Use mite-proof cases on mattresses and pillows wash bed linens frequently in hot water.
    • Wear a mask when cleaning
    • Keep the relative humidity in your home less than 50%

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    Symptoms Could Be Caused By Allergy Related To Snowy Weather

    Dear Mayo Clinic:

    Is it possible to be allergic to snow? I have no allergies or problems in spring, summer or fall, but once snow starts falling, my eyes itch and I sneeze repeatedly. Why does this happen?


    In allergies, almost anything is possible. So you could be allergic to snow. But that would be very unusual. Much more likely, your symptoms are caused by another condition or a different allergy that’s related to the snowy weather.

    The most common cold-weather condition that can result in allergy symptoms is cold urticaria . In people who have this disorder, cold weather or low temperatures cause redness, itching, swelling and hives on the skin. These symptoms result from a histamine release in the body.

    Histamine is a natural compound the body produces that’s found in certain types of cells. Most histamine is contained within packets in these cells and is usually not released into the body.However, when an allergic response develops, histamine can be released from the packets. That release can cause a wide variety of symptoms, such as itching, skin welts, nasal congestion and, in some cases, even anaphylactic shock.

    Using the results of an allergy test, along with a review of your medical history and a physical exam, an allergist likely can help you find out if you have an allergy or other condition that may be triggered when the snow flies.

    James Li, M.D., Ph.D., Allergic Diseases, Mayo Clinic, Rochester, Minn.

    What Are The Types Of Allergies And How Are They Treated

    Cold or Allergy?

    You can be allergic to a wide variety of substances including pollen, animal dander, mold and dust mites.


    Seasonal allergic rhinitis, or hay fever, is an allergic response to pollen. It causes inflammation and swelling of the lining of your nose and of the protective tissue of your eyes .

    Symptoms include sneezing, congestion , and itchy, watery eyes, nose and mouth. Treatment options include over-the-counter and prescription oral antihistamines, anti-leukotrienes, nasal steroids, nasal antihistamines, and nasal cromolyn. In some people, allergic asthma symptoms can be caused by exposure to pollen.

    Your symptoms can be reduced by avoiding pollen. Stay indoors when pollen counts are high, close your windows, and use air conditioning. Ask your healthcare provider about immunotherapy to treat pollen allergy.

    Dust mites

    Dust mites are tiny organisms that live in dust and in the fibers of household objects, such as pillows, mattresses, carpet, and upholstery. Dust mites grow in warm, humid areas.

    The symptoms of dust mite allergy are similar to those of pollen allergy. To help manage dust mite allergies, try using dust mite encasements over pillows, mattresses, and box springs. Also, remove carpet, or vacuum frequently with a high-efficiency filter vacuum cleaner. Treatment may include medications to control your nasal/eye and chest symptoms. Immunotherapy may be recommended if your symptoms are not adequately controlled with avoidance methods and medications.


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    Allergic To The Cold: Living With Cold Urticaria

    A brutal winter has caused many frustrated Americans to exclaim their hatred for the cold. Winter might not be the favorite season of many Americans but for people with cold urticaria, such as 20-year-old Cara Yacino, from Douglas, Mass., the feeling goes beyond a longing for 4th of July barbecues and the beach filled days of summer.

    In June 2013, Yacino was diagnosed with the condition after a trip to Boston began with a Dunkin Donuts iced mocha and an engorged hand.

    I was holding , and I realize my hand that was holding the iced mocha started swelling up and was really painful, Yacino told It was kind of itchy, and it looked different comparing my two hands.

    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, according to the Mayo Clinic.

    My mom told me to stop drinking because might have been something in the coffee, like maybe hazelnuts, explained Yacino.

    Yacino promptly stopped drinking the coffee on her way to the New England Aquarium in Boston. But the visit to a touch tank proved her condition was more than a hazelnut allergy.

    They had a touch tank a shark and ray touch tank and I stuck my arm in, like everyone else, so that the rays could swim by and touch my hand, she said. I was in the tank for maybe like 10 minutes. I pulled my arm out and within five minutes that arm was covered in hives.


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