Cold urticaria

An ice cube is placed on your skin for five minutes to diagnose cold urticaria. If you have cold urticaria, a raised bump, also called a hive, will form a few minutes after the ice cube is taken away. This is called the ice cube or cold contact test.

In some cases, another condition, such as an infection or cancer, causes cold urticaria. This condition affects your immune system. If your healthcare professional thinks you have another condition that could be causing cold urticaria, you may need other tests.

In some people, cold urticaria goes away on its own after weeks or months. In others, it lasts longer. While there is no cure for the condition, treatment and taking steps to avoid cold urticaria can help.

Your healthcare professional may recommend that you try to keep symptoms from happening or reduce those symptoms using home remedies. These remedies include antihistamines available without a prescription and staying away from the cold. If these treatments don't help, you may need prescription medicine.

Medicines used to treat cold urticaria include:

• Nondrowsy antihistamines. If you know you're going to be exposed to the cold, take an antihistamine ahead of time to help keep a response from happening. Examples include loratadine (Claritin, Alavert, others), cetirizine (Zyrtec Allergy, Zerviate, others), and desloratadine (Clarinex, Clarinex D 12-Hour, others). Some of these medicines are available without a prescription, while others require prescriptions.
• Omalizumab (Xolair). This prescription medicine, which is typically for people with asthma, has been used successfully to treat cold urticaria that doesn't respond to other medicines.

If you have cold urticaria because of another condition, you may need medicines or treatments for that condition as well. If you have a history of responses that affect your whole body, your healthcare professional may prescribe an epinephrine autoinjector (EpiPen, Auvi-Q, others) that you'll need to carry with you.

Antihistamines block the release of histamine that causes symptoms. These medicines can be used to treat mild symptoms of cold urticaria or to keep a response from happening. Medicines available without a prescription include forms of loratadine and cetirizine.

You'll probably see your primary care professional first. You also may need to see a healthcare professional who specializes in skin diseases, known as a dermatologist. Or you may need to see an allergy specialist, called an allergist-immunologist.

Preparing a list of questions for your healthcare professional will help you make the most of your time together. For cold urticaria, some questions to ask include:

• What's most likely causing my symptoms?
• What are other possible causes for my symptoms?
• How long will the hives last?
• What kinds of tests do I need? How do I get ready for these tests?
• What treatments do you recommend?
• Do these treatments have any side effects?
• Is there a generic alternative to the medicine you're prescribing?
• Will the recommended treatments affect the other conditions I have?
• Do you have any brochures or other printed material I can take with me? What websites do you recommend?

What to expect from your doctor

Your healthcare professional will likely ask you questions such as:

• When did you begin having symptoms?
• Have you recently been ill?
• Do others in your family have similar symptoms?
• Have you taken any new medicines recently?
• Have you tried any new foods?
• Have you traveled to any new places?
• Does anything seem to make your symptoms better or worse?

Preparing and expecting questions will help you make the most of your time.

What you can do in the meantime

If you're having mild hives, these tips may ease your symptoms:

• Protect affected areas from getting irritated.
• Stay away from whatever you think may have caused your response, such as facing into a cold wind or swimming in cold water.
• Reduce vigorous activity, which can irritate your skin more.
• Use antihistamines available without a prescription to help with itching.