Surviving Winter's Itch: The AAAAI Offers Advice On Cold-Induced Urticaria (Hives)

December 9, 2002

MILWAUKEE (AAAAI) -- With winter weather upon us, allergy sufferers often believe the worst to be over. But for many, winter's chilly temperatures mean another trigger for allergy symptoms and a condition that often goes undiagnosed - cold-induced urticaria.

What is urticaria?

Urticaria, characterized by an outbreak of hives, is a condition that 25% of the U.S. population will experience at least once in their lifetime, according to the American Academy of Allergy, Asthma and Immunology. In cold-induced urticaria, the primary trigger for the hives is a rapid change in temperature, which is why winter, with its fluctuating temperatures, is the prime season for this condition.

Hives are pale, red swellings on the skin that occur in groupings, most likely in the area that was exposed and can itch, burn and sting. They are the result of histamine, a chemical found in the upper layers of the skin responsible for many of the allergic reaction symptoms.

Symptoms of cold-induced urticaria

When a person with cold-induced urticaria is exposed to a rapid change in temperature, their skin starts to itch, turn red and swell within minutes. Hives occur when the skin is exposed to cold temperatures, and also when the skin is warmed after exposure to the cold. If a large area of the body is exposed to cold for a prolonged time, histamine is produced in larger amounts and may result in wheezing, flushing, and even fainting.

Treatment

The AAAAI recommends seeing an allergist/immunologist if you suspect you have cold-induced urticaria. The allergist/immunologist can help identify the cause of the hives by taking a thorough medical history and complete physical examination. Antihistamines may be prescribed to alleviate discomfort. Staying educated about your condition and knowing how to properly manage your symptoms are key to avoiding a severe reaction.

"People of all ages need to be aware of the effects cold-induced urticaria can have on an individual. The intensity of the itch associated with hives can completely disrupt an urticaria sufferer's normal activities," said Roger W. Fox, MD, Chair of the AAAAI's Urticaria and Angioedema Committee. "Appropriate precautions and daily antihistamines will provide relief for the majority of patients with this physical urticaria,"

In addition to extreme cold temperature, urticaria can be caused by the immune system's overreaction to foods, drugs, infection, insect stings, blood transfusions or other substances. Foods such as eggs, nuts and shellfish, and drugs such as penicillin are common causes of urticaria. If the cause can be identified, the best treatment is to avoid the substance that causes the urticaria.

To find an allergist/immunologist in your area or to find additional information on allergic skin conditions, call the AAAAI's Physician Referral and Information Line at (800) 822-2762.