Allergy to cold weather: Is this possible?

Is there such a thing as an allergy to cold weather? When exposed to cold temperatures, the skin on my face, neck and hands gets red and itchy.

- Pauline / Connecticut

Mayo Clinic asthma and allergy specialist James Li, M.D., and colleagues answer select questions from readers.

Answer

As strange as it sounds, it is possible to have an allergy to cold temperatures. Doctors refer to this as cold hives (urticaria).

In some people, skin exposure to cold temperatures triggers the release of histamine and other chemicals into the skin. This results in skin redness, itching, swelling and hives. Although symptoms may begin during the cold exposure, they're often worse during rewarming of the exposed skin.

The cause of cold urticaria isn't clear. But certain people appear to have overly sensitive histamine-containing skin cells.

As much as possible, people with cold urticaria should avoid exposure to cold air as well as cold water. For example, swimming in cold water is the most common cause of a severe, whole-body reaction — leading to fainting, shock and even death.

If you think you have cold urticaria, consult your doctor. Treatment may include antihistamines taken before cold exposure. Cyproheptadine (Periactin) may be especially useful for treatment of cold urticaria. Rarely, cold urticaria is associated with an inherited condition called familial cold autoinflammatory syndrome.