What is cold induced urticaria?

Cold induced urticaria, or cold induced hives, is a condition characterized by a rapid onset of itching, redness and swelling after exposure to cold. The hives (urticaria) and swelling typically develop on the areas exposed to the cold, and usually develops as the area warms after the exposure.

What cause cold induced urticaria?

Following cold exposure, people with cold induced urticaria release chemical mediators, such as histamine from cells in the skin. The mediators (histamine, etc.) react in the tissues of the skin to create hives and swelling. In most individuals, this swelling is on the surface of the skin, although in rare instances it can cause swelling in the throat or airway.

Is cold induced urticaria serious?

Yes. Cold induced urticaria can be very serious in some instances. In cases where the whole body is exposed to cold, like swimming, a massive amount of histamine can be released into the blood stream all at once causing blood pressure to drop to dangerously low levels. If this happens while swimming one could drown or go into shock. Therefore, it is recommended that people with cold induced urticaria test the effects of the cold water on lower extremities to determine if the temperature causes any skin irritations or hives.

Can I be tested for cold induced urticaria?

Your provider may perform an ice‐cube test to reproduce the symptoms in the office. A bag of ice is placed on the forearm of the patient for 5‐10 minutes. It is then removed and the area is observed for another 5‐10 minutes to see if any swelling or hives develops. Your provider may also order blood tests
to rule out an underlying medical condition that may be cause for your symptoms. Most causes of cold induced urticaria are “idiopathic”, meaning of no known cause.

Will I outgrow cold induced urticaria?

Cold induced urticaria can develop in either gender, at any age, and can last for varying lengths of time. Some people will have this condition all their lives while others only for a short period of time. Follow‐up with your provider is necessary to monitor the condition.

Can I take medication to prevent cold induced urticaria?

Your provider may prescribe an allergy medication such as an antihistamine to help prevent the symptoms of cold induced urticaria. These medications are not always 100% effective, so preventative measures are necessary to avoid complications.

What else can I do to protect myself?

In addition to medication, avoidance and precautionary measures are ways to protect yourself from hives. Avoid cold showers, avoid holding cold drinks with bare hands, don’t gulp cold drinks, cover exposed body parts when out in the cold weather or in air conditioned environments, and avoid swimming in cold water. If you decide to swim, avoid quick changes in temperature i.e. do not jump into water or go from warm to cool water quickly. Hot tubs in cold outdoor environments are potentially dangerous. Never swim alone; always have someone with you who is aware of your condition and can call for help if needed.