A rare condition called cold urticaria can cause hives, swelling and, in severe cases, a potentially life-threatening allergic reaction after exposure to cold.
The condition was highlighted in a recent personal account by Shauna Castaner, a California woman who told The Guardian that her symptoms first appeared in 2012, when her fingers became swollen and red after she held iced drinks or handled chilled food. Her symptoms later included swelling inside her mouth after eating ice-cream.
Castaner said an allergist diagnosed her with severe cold urticaria in 2014. She was prescribed epinephrine auto-injectors and advised that antihistamines could help manage symptoms, although they were not always effective for her.
According to Mayo Clinic, cold urticaria is a reaction that usually appears within minutes after skin is exposed to cold. Symptoms can include itchy welts, swelling of the hands after holding cold objects, and swelling of the lips after consuming cold food or drinks. Severe reactions can involve anaphylaxis, including breathing difficulties, fainting or shock.
For Castaner, the condition affects everyday activities as well as her work and family life. She told The Guardian that she monitors temperatures closely, avoids chilled food and drinks, and has difficulty spending time outdoors during the colder months in Sacramento. She also said the condition contributed to her decision to leave her career as a photographer and become a stay-at-home parent.
Cold urticaria can vary significantly from person to person. Mayo Clinic says diagnosis can involve a cold-contact or ice-cube test, while treatment commonly focuses on avoiding cold exposure and controlling symptoms with medicines such as antihistamines. People with a history of severe whole-body reactions may be prescribed an epinephrine auto-injector.
The Guardian account also describes the practical precautions Castaner takes at home and when going outside. Despite the restrictions, she said warmer days have taken on a new significance because of how rarely she can comfortably spend time outdoors.
Medical note: Cold urticaria can be serious. Anyone who develops widespread symptoms, swelling of the tongue or throat, breathing difficulty, fainting or other signs of anaphylaxis after cold exposure should seek emergency medical care. This article is for general information and is not a substitute for medical advice.
