IS We’ve all gone out without gloves and come home with red hands and one strong feeling of tight skin. This is a normal skin reaction to low temperatures, but the cold can trigger a stronger reaction which we mere mortals call allergy, even if from a medical point of view it is not correct to define it that way.
It’s hives, not allergies
“IS misleading to talk about allergies from cold, but certainly in some people there is an autoimmune and autoallergic component, so low temperatures favor the appearance of urticaria on the skin», explains Dr. Paola Facheris, dermatologist of theIrccs Humanitas Clinical Institute of Milan. In simpler words, it is not the cold itself that is the direct cause of the “allergy”, but the frost induces the skin production of particular molecules calls self-antigenswhich in turn induce the histamine releasethe substance responsible for urticaria.
What happens to the skin
As in some types of allergies and in any urticaria, the symptoms of cold allergies are mainly cutaneous. «On the skin they can many wheals appeari.e. raised lesions of reddish color, which are very itchy», explains Dr. Paola Facheris. The most common sensation is that of itching. It’s hard to resist the temptation to scratch the wheals that can appear in various parts of the body, not just on the hands and face. They can remain visible up to about 24 hours after being in the cold. “In many cases these wheals come and go. They appear not only if you have been outside in very low temperatures. It is also sufficient to drink or eat something cold, or come into contact with freezing or almost freezing surfaces» clarifies Dr. Paola Facheris, dermatologist also at Humanitas medical care.
Other ailments also appear
Cold urticaria, even if it’s not a real allergy, can cause some more general ailments, which don’t just affect the skin. «Fatigue, hypotension (ed, blood pressure lower than normal), headache, difficulty breathing or breath with a hiss are some of the symptoms that can accompany wheals on the skin» explains Dr. Paola Facheris. If cold urticaria becomes chronic i symptoms can last longer than six weeks. And not only that, this type of urticaria can be associated with others, such as idiopathic urticaria, the one whose cause is not known exactly.
At what temperature does hives start?
Everyone who works in an “open space” knows this. While the colleague wraps up yet another scarf, the desk neighbor fans herself from morning to night, begging to turn down the radiator… if you really can’t open the window a little. This is a practical example of how the perception of heat and cold is very subjective. Consequently there is no temperature that can favor the onset of the reaction of the skin that cannot be defined as an allergy, as the cold does not penetrate the skin as allergenic substances do, but simply induces the skin to react. Badly we add. «In general, it can be said that cold urticaria is triggered when the person who is predisposed to it comes into contact with temperatures around 4°Cbut there is a lot of variability from case to case, some go wild even below 20°C» explains Dr. Paola Facheris.
Dr. Paola Facheris is a dermatologist at the Irccs Istituto Clinico Humanitas in Milan.
Who is more exposed to cold urticaria
Guess this riddle which of the men or women is most likely to get a whealed face just because she went skiing without wearing an alpine burqua? You guessed right: it is women who most often have allergic reactions to low temperatures. Particularly women between 20 and 40 years old they are the ones most likely to experience cold urticaria. It is not yet clear why scientifically women, especially young women, are more at risk of suffering from cold urticaria» explains the doctor Paola Facheris expert in this type of skin diseases. «What is known with certainty is that, except in very rare cases, there is no familiarity in this problem. Moreover, even stress can make it worse» concludes the dermatologist.
Itching due to the cold can also appear in parts of the body that are always covered. Getty Images
To prevent it, just listen to grandma…
To avoid finding yourself full of reddish wheals after a nice walk outdoors, the only way is to cover yourself well, trying to leave as few areas of the body as possible exposed to the cold. In practice, gloves, scarf and hat always worn. «Avoidance is the first prevention strategy against all types of urticaria, including this one. Not only that, reducing the time of exposure to the cold can also be useful» explains Dr. Paola Facheris. «In those who suffer from it, even being in the cold for just five minutes can be dangerous, as can eating something fresh or drinking an ice-cold drink.» concludes Dr. Paola Facheris.
… to treat it, however, it is better to consult a dermatologist
Anyone who thinks they have this kind of problem should first keep a diary. Yes, a daily diary of the disease, where you write every time you have an episode of urticaria, how long it lasted, what you were doing or had done shortly before the onset. «Having the history of the disease is essential to understand how to intervene from a therapeutic point of view. For this reason, the dermatologist before making a diagnosis of allergy or urticaria tries to know the patient’s medical history. And a diary is very useful to frame the problem well» explains Dr. Paola Facheris. “Once you’ve made sure it’s really cold urticaria, you can treat this problem with medications second generation antihistamines. These drugs can be modulated on the needs and characteristics of each individual patient, but require specific skills for prescription» explains the doctor. For this reason, a visit to the general practitioner is often not enough. IS need to see a dermatologistwhich before making a diagnosis of cold urticaria will also rule out other causes for those wheals, which make winter really itchy.
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