Allergy to cold

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1. Overview

Allergy to low temperatures or cold is characterized by redness, itching, hives and swelling of the skin that has been exposed to these temperatures.

People who suffer from allergy to cold should avoid both low temperatures and cold water. For example, swimming in cold water, which is the most common cause of severe reactions triggered by cold water can cause fainting, heat shock and even death.

If a person believes that he may suffer from allergy to cold should consult a specialist. Treatment may include antihistamines which will be given prior to exposure to cold.


1. Overview
2. Diagnosis
3. Symptoms
4. Severe reactions
5. When is time to seek medical advice?
6. Risk factors
7. Treatments and drugs

2. Diagnosis

Diagnosis of allergy or urticaria to cold is a test that involves placing an ice cube on the forearm. Cold object is left up to 10 minutes. If the test is positive, the area will swell in about 5 minutes after removing the ice cube.

Time of exposure to a cold object determines the severity of the disease: as soon as symptoms appear following exposure to cold, the allergy is more severe.

In some form of allergy to cold temperatures, the symptoms will not manifest in the test which involves applying ice cubes or these skin manifestations will be atypical. Among these are:

- Delayed cold urticaria – in this case symptoms occur 12 hours after exposure to cold. Ice cubes test may show a positive result to several hours after it was over.

- Cold-dependent dermographism – manifestations are present after friction or after pressure on the skin exposed to cold. In the test with ice cubes, skin may have the appearance of normal rashes if rubbed.

- Cold-induced cholinergic urticaria – symptoms occur at low temperatures. If events occur in hot environments is likely to suffer a cholinergic urticaria.

- Localized reflex cold urticaria – events occurring a few inches away from where it was applied the ice cube – away from direct exposure to the cold.

Once a person is diagnosed with cold urticaria may be necessary to detect underlying causes of the condition. These may include blood tests to see if there are autoimmune diseases, cancer or infection.

3. Symptoms

Symptoms of allergy to cold starts immediately after the skin is exposed to the cold air or water. Although manifestations are present during exposure to cold, they get worse when the skin warms.

The majority of cold urticaria reactions occur when the skin will be exposed to temperatures below 4 degrees Celsius (but in some people symptoms can occur even at higher temperatures). Humidity and wind may predispose to the occurrence of cold urticaria.

Signs and symptoms may include:
- Red rash, itchy skin when it was exposed to cold, which generally persist about half an hour
- Swelling of hands when they make contact with a cold object
- Swelling of the lips when eating cold food
- In rare cases, there is severe swelling of the tongue and throat that can obstruct breathing (pharyngeal edema).

4. Severe reactions

For people who suffer from cold urticaria, exposure to cold can be dangerous. In some cases reactions affect the whole body (systemic reaction). Signs and symptoms of a severe reaction include:
- Fainting
- Chills
- Accelerated heartbeat
- Swelling of the limbs or trunk.

The most serious reactions occur with complete exposure of the skin. Massive liberation of histamine and other chemicals by the immune system cause a sudden drop in blood pressure that can lead to fainting, shock and even death. If it swims in cold water drowning may be caused by loss of consciousness.

5. When is time to seek medical advice?

If a person has skin reactions after exposure to cold should consult a doctor. Even if symptoms are minor, the physician must determine whether there is any underlying condition that might cause the problem.

It will require emergency care if there is a severe reaction after severe exposure to cold:
- Shortness of breath
- Feeling of faint
- Inflammation of the throat or tongue.

6. Risk factors

Cold allergy can occur at all ages, both in women and men. Are prone to hives at low temperatures:

- Children and young adults – a type of urticaria called primary acquired urticaria occurs in children and young adults. This is the most common type of hives and disappears on its own within 2-3 years.

- People who have recently suffered a viral infection – mycoplasma pneumonia and mononucleosis were associated with cold urticaria.

- People who suffer from certain diseases such as rheumatoid arthritis, hepatitis and cancer. This type is called secondary acquired uritcaria.

- People with genetic predispositions – although quite rare, cold urticaria is associated with a condition called familial autoinflammatory syndrome triggered by cold.

7. Treatments and drugs

There is no cure for cold urticaria, but there are remedies that can relieve symptoms. Therapeutic measures include avoiding exposure to low temperatures and sudden temperature changes.

Medicines can help prevent and reduce the events. Some medicines used to treat allergy to cold include:

- Antihistamines – which blocks the release of histamine and prevent specific symptoms. Some of these may be available without a prescription, while others only after doctor’s recommendation.

- Cyproheptadine – This medication is an antihistamine which acts on nerve impulses that cause symptoms.

- Doxepin – in normal conditions this drug is used to treat anxiety and depression, but may also improve symptoms of urticaria caused by cold.

However, all these measures will not cure allergy to cold but will keep symptoms under control. If cold urticaria is caused by certain health problems may need other medicines or treatments for the underlying condition.



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