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Cold Urticaria – I’m allergic to the cold

Winter is bearing down on most of the U.S. with snow drifts and cold chills. Winter jackets, gloves, and hats are important, but did you know that the cold could be life threatening to those with an allergic reaction to cold temperatures? Cold Urticaria, or hives from being exposed to cold temperatures or feeling cold, is a real allergy and a problem that affects my son.

The familial form of cold urticaria has been traced to the long arm of chromosome one (1q40). Chromosomes are found in the nucleus of all body cells. They carry the genetic characteristics of each individual. Some forms of cold urticaria are also diseases of the autoimmune system. Autoimmune disorders are caused when the body's natural defenses against "foreign" or invading organisms (e.g., antibodies) begin to attack healthy tissue for unknown reasons.

Last year was particularly difficult. He missed over 25 days of school. He would wake up, get dressed for school, and head out the door. By the time he was in his first period, he was covered head to toe with large raised hives. They were incredibly itchy and embarrassing, and students would ask about his face. He would head to the nurse who would then call me. Some allergy medicines no longer work for him, as he has developed resistance to most. On one occasion, we did have to take him to the emergency room when his throat and lips started to swell. Luckily, he happened to be playing at a friend’s house whose mom is an ER nurse. She noticed the swelling and immediately alerted us to the problem.

So this year, when asked what he was expecting from middle school, his response was that he expected to be sick a lot. As a parent, this was my wakeup call, and I started to prepare for winter way back in August. How do you prevent the hives? What should we do to keep him in school?

So here is what I have found that works for us. First, I drive him to school to prevent the delay of standing for the bus in cold weather. Secondly, he layers up with cotton shirts and flannel lined jeans and has a really awesome winter jacket. But here is what has really worked for us - to turn off the receptors in his system, we give him two medications twice a day when this starts. First, he takes a simple over the counter non-drowsy allergy medicine that is working for him at this time. Secondly, we give him an ant-acid medication to turn off the receptors in his stomach. This was given to him for a few days, and it seems to have warded off most of the hives for now.

Now you might say, why not move to Florida where the weather is warm? Well, the hives also appear when he goes swimming and gets out of the water and is chilled. That’s right, 95 degrees outside, cold water, and hives appear in the middle of summer as well.

Another piece of good advice that we’ve discovered is that the human body will respond to heat in a way that shuts off the receptors of itchiness. In other words, if the skin is exposed to very hot water, it will shut off the itchy response. This works great at home, even though 30 minute showers can be expensive, but it’s not really convenient when he is at school.

So, if your school nurse suggests your child might be allergic to cold weather, they might just be on to something! After dozens of blood tests, skin tests, and prodding and poking, this is our conclusion. To our knowledge there is no cure for this, we just manage the symptoms.

For more information about hives.