Cold allergy (cold urticaria): when the skin plays crazy in the cold
The so-called cold allergy is not an allergy in the medical sense, but a special form of the Nesselucht – the unpleasant consequences for the affected does not change this however.
Normally, allergies are triggered by substances that elicit an immunological antigen-antibody reaction. The cold urticaria belongs to the so-called physically triggered allergies, or to the pseudoallergies. This also includes, for example, skin deposits which are caused by mechanical pressure, sunlight or heat. In this case, a colic acid dissolves the release of histamine (a corporeal mediator substance) at the place where the cold acts on the skin. Within a short period of time, there are very itchy wheezes, as if one were caught in torches (hence the name Nettleucht or urticaria).
The skin reddens, begins to burn and often triggers a violent itching. Bumps that are called angioedema also develop in the lower layers of the hay. Usually the hands and face are affected, which includes mucous membranes in the mouth and throat area. Cold air, water, cool objects, ice-creams, but also cold drinks or meals, evaporated sweat and body temperature can be the cause of the suddenly occurring wheezing.
In the case of cold urticaria, contact with cold objects or even cold water or wind releases the release of histamine at the place where the cold acts on the skin. Within minutes, redness, swelling and severe itching occur. The coldness of the symptoms is very different from person to person. For some, it is a matter of temperature changes when they go from warm to cold, others have the outside temperature fall below a certain value, and others get the symptoms already when they drink something cold or eat ice.
At the beginning of the skin reaction, the itching redness and swelling of the skin are still relatively small and limited, but they can spread considerably. As a rule, these haemorrhages are unpleasant, but not dangerous. However, if large areas of skin are exposed to the cold, Eg in the event of a jump into the cold water, correspondingly large amounts of histamine are released, which can then reach the bloodstream within one minute into other body regions. The consequences are increased pulse, blood pressure drop, piercing headache, shortness of breath and a circulatory shock – in the worst case possible in the form of an anaphylactic shock with potentially fatal outcome.
Important: As a rule, pseudo-allergic reactions are clinically similar to allergic reactions, i. the same symptoms occur. The difference is that the immunological hypersensitivity (sensitization) phenomena characteristic of an allergic reaction are not detectable. Thus the term “cold allergy” is not only misleading, but also wrong: there is no allergy to cold at all. An allergy is due to the formation of antibodies against an allergen. An allergen is a harmless substance from our environment, occasionally a substance present in the body. The allergic reaction then arises on contact with the allergen. Since antibodies can not be formed against cold, there can also be no cold allergy.
Since the cold urticaria is not an antigen-antibody reaction, it is not possible (and necessary) to perform a blood test to diagnose. The cold urticaria is determined by the allergologist using a simple test. Several ice cubes are placed on the lower arm and removed at different times. If, after the ice cubes are removed, the typical skin symptoms appear, the diagnosis is established. However, this method makes it impossible to determine the exact and individual temperature at which a patient reacts with a whey.
Since recently, there is the possibility of a so-called temptest. This is carried out with a special cold tester, which is able to determine precisely within the temperature range from zero to 45 degrees, at which temperature the cold urticaria is triggered in the patient.
Causes and therapy
Among the physical urticaria forms, the cold urticaria is not uncommon with about 15%. In cold countries (Scandinavia) it occurs more frequently, in warm ones somewhat less. Women are affected twice as often as men, both sexes usually in young adulthood. The cold urticaria, however, is almost always chronic and lasts an average of 5-7 years.
The causes are infections, including gels, measles, chickenpox, respiratory and HIV infections, as well as parasitoses (root diseases). Frequently, the nutrient stress occurs together with food allergies and stress-dependent asthma.
Sometimes, other allergens or stimuli can also trigger the same symptoms in patients with cold urticaria. Food additives (e.g., colorants), medicaments, plants, animal hair, injected fruit and vegetables, insect bites, pressure on the skin, physical exertion). These stimuli can, as you see, be very diverse, so that the search for a triggering stimulus can prove very difficult.
In a German study, good treatment results were obtained with antibiotics in cold urticaria (disappearance or improvement of the symptoms by as much as 70%). This is now also easily explained: since infectious diseases often occur together with the cold energy and this seems to be maintained no wonder why the cold urticaria disappears in many patients when they take antibiotics. The doctor may also prescribe so-called antihistamines. These drugs prevent the skin from reacting and forming swelling and wheezing.
As medicament-free therapy possibilities, they are called so-called hardening therapy, as well as treatment with UV rays. In the Hardening Therapy (cold sensitization), the patients are repeatedly exposed to cold temperatures and baths, so they should get used to cold. How much success this therapy promises is still unclear. The therapy with UV rays should be more pleasant for patients.
We recommend warm, dense and skin-friendly clothing: gloves, socks and warm shoes. Free spots on the face and other unprotected parts such as hands must be treated with a fatty cream. In order to protect the life of patients from life-threatening swelling in the throat area (caused by cold food and drinks), there is an emergency set. Well-equipped are those who carry a liquid cortisone preparation and an antihistamine.
Avoid cold (cold water, metal, cold steering wheel, …) as well as possible.
Pack yourself: gloves, scarf, cap – because the more skin parts are protected from direct cold, the less effect.
If the discomfort quickly disappears, you can dispense with medication. In case of severe or persistent symptoms, a drug therapy can save you a lot of pain.
Always wear an antiallergic ointment to quickly alleviate the symptoms in an emergency.
Be careful when bathing in cold water! There are some, albeit few reports of death due to an anaphylactic shock caused by a cold allergy.
– Cold: stress for the skin (care tips)
– What to do with itching?
– Skin care in winter
– Urticaria Network
– The online encyclopedia of dermatology: pseudoallergic reactions