Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Cold rash—medically coined cold urticaria (hives)—is a rare disorder involving an immune response to cold exposure. When a person has cold urticaria, raised wheals or bumps called hives appear if the skin is exposed to cold temperatures.
Cold rash comprises approximately 3% of all cases of urticaria (hives). It is more prevalent in younger adults than in the elderly population and affects women and men equally.Treatment often includes employing preventative measures, such as avoiding exposure to cold (including cold air, icy cold drinks or food, and cold water).
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Types of Cold Rash
Cold rash can include two different forms, including:
Acquired (Essential Form)
Acquired (essential) form of cold rash involves symptoms that become obvious within two to five minutes of exposure to the cold. Symptoms last approximately one to two hours in a person with the essential form of cold urticaria.
Acquired cold urticaria is said to have several subcategories including:
Hereditary (Familial) Form
Hereditary (familial) form of cold rash involves symptoms that:
Cold Rash Symptoms
Common symptoms of cold rash include:
Severe Symptoms
Symptoms of cold rash often worsen as the skin warms up.
A severe reaction is possible and usually occurs when a person has full skin exposure (such as immersion in cold water).
Severe, systemic symptoms may include:
Severe reactions, such as anaphylaxis, are usually linked with full skin exposure, such as when swimming in cold water.
Although the exact cause of cold rash is not completely known, scientists have some clues about possible underlying contributing factors.
When the body reacts with any type of hives (including cold rash) it’s due to a cellular process called degranulation, in which mast cells release histamine into the dermis (skin).
Sometimes a person‘s skin reacts this way because of an inherited trait; it could also be due to a virus or an illness.
The cold temperature triggers the mast cells to release histamine and other chemicals into the blood; these chemicals (including histamine) are responsible for causing the symptoms of cold rash, including redness and itchiness, as well as a more severe and serious reaction calledanaphylaxis.
Genetic Causes
Scientists have identified a genetic mutation that causes the immune system to respond with allergic symptoms, such as those that occur in cold rash.
Autoimmune Disorders
Some forms of cold rash are also diseases of the autoimmune system.
Autoimmune disordersare caused when the body’s natural defenses against “foreign” or invading organisms (e.g., antibodies) begin to attack healthy tissue for unknown reasons.”
Underlying Diseases
When this is the case, you will need treatment for the underlying cause, in addition to implementing preventative measures to prevent recurring outbreaks of urticaria.
Risk factors
Although the exact cause of cold urticaria (cold rash) may not be well known, some risk factors make you more likely to have the condition, these include:
A raised discolored or red welt (hive) that appears after an application of ice is placed on the skin for approximately five minutes is considered a positive response to having cold rash. The hive may appear in the shape of the ice cube within around 10 minutes after the ice is removed.
Timing of Cold Rash DiagnosisWhen using the ice test, the hive formation occursafterthe skin begins to warm up and not during the coldest temperature exposure.
Timing of Cold Rash Diagnosis
When using the ice test, the hive formation occursafterthe skin begins to warm up and not during the coldest temperature exposure.
Sometimes there is a false positive to the ice test because in some instances it takes longer than five minutes for cold exposure to result in a skin reaction.
There is no cure for cold rash; treatment is primarily aimed at implementing preventative measures (such as avoiding cold exposure) andthe use of antihistamines.
Medications used as a preventative measure to treat symptoms before cold exposure include:
Omalizumab (Xolair) isan asthma medication that is sometimes used to treat cold rash when other medications are ineffective.
Prevention
Tips for preventing episodes of cold rash from recurring include:
Inform Your Healthcare TeamIf you are scheduled for an upcoming surgical procedure, be sure to discuss your condition with the surgeon before the procedure so measures can be taken to prevent cold-induced symptoms in the surgery suite.
Inform Your Healthcare Team
If you are scheduled for an upcoming surgical procedure, be sure to discuss your condition with the surgeon before the procedure so measures can be taken to prevent cold-induced symptoms in the surgery suite.
A Word From Verywell
At Verywell Health we know that having a condition such as cold rash is much more complex than simply breaking out in a rash. The adverse symptoms can be challenging or they could even cause serious life-threatening danger in certain circumstances.
Even though the symptoms may resolve on their own in a relatively short amount of time, it’s important to seek medical advice and consult with a healthcare professional about taking precautionary measures.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.NORD National Organization for Rare disorders (NORD).Urticaria, cold.Stepaniuk P, Vostretsova K, Kanani A.Review of cold-induced urticaria characteristics, diagnosis and management in a Western Canadian allergy practice.Allergy Asthma Clin Immunol. 2018;14(1):85. doi:10.1186/s13223-018-0310-5World Allergy Organization (WAO).Urticaria.NORD National Organization for Rare disorders (NORD).Urticaria, cold.National Institutes of Health.Researchers find cause of rare immune disease.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.NORD National Organization for Rare disorders (NORD).Urticaria, cold.Stepaniuk P, Vostretsova K, Kanani A.Review of cold-induced urticaria characteristics, diagnosis and management in a Western Canadian allergy practice.Allergy Asthma Clin Immunol. 2018;14(1):85. doi:10.1186/s13223-018-0310-5World Allergy Organization (WAO).Urticaria.NORD National Organization for Rare disorders (NORD).Urticaria, cold.National Institutes of Health.Researchers find cause of rare immune disease.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
NORD National Organization for Rare disorders (NORD).Urticaria, cold.Stepaniuk P, Vostretsova K, Kanani A.Review of cold-induced urticaria characteristics, diagnosis and management in a Western Canadian allergy practice.Allergy Asthma Clin Immunol. 2018;14(1):85. doi:10.1186/s13223-018-0310-5World Allergy Organization (WAO).Urticaria.NORD National Organization for Rare disorders (NORD).Urticaria, cold.National Institutes of Health.Researchers find cause of rare immune disease.
NORD National Organization for Rare disorders (NORD).Urticaria, cold.
Stepaniuk P, Vostretsova K, Kanani A.Review of cold-induced urticaria characteristics, diagnosis and management in a Western Canadian allergy practice.Allergy Asthma Clin Immunol. 2018;14(1):85. doi:10.1186/s13223-018-0310-5
World Allergy Organization (WAO).Urticaria.
National Institutes of Health.Researchers find cause of rare immune disease.
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