Cold urticaria: risk factors and prevention

Cold urticaria is a skin reaction that It occurs in a short period of time after being exposed to cold. When hives appear, itchy red bumps develop on the skin.

On the other hand, cold urticaria has a higher incidence in young adults. It is one of the 5 most frequent causes of chronic urticarias; It is included in the type of physical hives.

As we said, this skin condition appears after exposure to cold, but it can also arise by having been in contact with an object, air or a cold liquid.

Cold urticaria is also known as cold allergy, since its cutaneous manifestations occur 10-30 minutes after exposing the affected area. At other times, it may appear at the same time.

Symptoms of cold urticaria

Patients with cold urticaria have very different symptoms. Some of the signs are:

  • Urticaria: As the name implies, this will be the characteristic symptom. Temporary reddish welts appear that cause itching in areas of the skin that have been exposed to cold.
  • When the skin goes into heat, the reaction worsens.
  • Swelling in the hands when cold objects are caught.
  • Swelling of the lips when consuming cold food and drinks.

In other cases, the symptoms are not so mild. Fever, general malaise, and localized pain in the head, abdomen or joints may occur. Further, some patients suffer very serious symptoms that affect the oropharyngeal tract, that is, to the mouth, glottis and trachea.

In cases where exposure to cold is prolonged, as can happen with a cold water bath in a natural environment, the patient may suffer from anaphylaxis and drown. The reason for this is that the passage of air is interrupted due to the appearance of an oropharyngeal angioedema.

Causes and risk factors

Nowadays The exact causes of cold urticaria are not known. In some cases it seems that people have very sensitive cells, due to an inherited trait, a virus or a disease.

Normally, when a person suffers from this condition, the cold triggers the release of histamine, in addition to other substances. All of them are responsible for producing the symptoms seen in the previous section.

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On the other hand, there are a number of risk factors that favor the occurrence of urticaria. Among them we can mention:

  • Age: As we have seen, young adults are the most likely to suffer from it.
  • Undiagnosed condition: There is a secondary acquired cold urticaria that may be due to an undiagnosed health problem, such as hepatitis.
  • Heritage: Sometimes cold urticaria is hereditary.

How can it be prevented?

There are a number of measures that can be carried out in order to prevent a recurrent episode of cold urticaria. Among them, we recommend the following:

  • Check with the doctor about which antihistamine is the most effective for your specific case. According to what he prescribes, follow the treatment prescribed by the professional.
  • If you are going to expose yourself to the cold, protect yourself with appropriate clothes.
  • In the case where you go swimming, try your hand first to see if you have a skin reaction.
  • If the doctor has prescribed an epinephrine autoinjector, always carry it with you to prevent serious reactions.
  • Share with your doctor about your cold urticaria if you are going to have surgery.


Cold urticaria It is primarily treated with antihistamine drugs. They are medications that help relieve symptoms, but do not prevent them.

However, the use of this type of medication is not effective for all types of cold urticaria. Nonetheless, today there are other more specialized pharmacological treatments, which are applied according to the dermatologist's criteria.

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Another treatment measure is to direct the patient to increase cold tolerance. For it, your exposure to low temperatures gradually increases. It should always be done in the hospital and under medical supervision.

However, it is important to keep in mind that The best treatment is the adoption of preventive measures, avoiding exposure to cold.