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Symptoms vary based on the cause of the condition, the type of Cold Urticaria and the environmental exposure.  Each page listed under Type in the menu explains in more detail based on the specific type.  However, this page will generically list possible symptoms associated specifically with Cold Urticaria, Angioedema, Anaphylaxis and Shock.

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Cold Urticaria

General Reactions

Hives (Wheals and/or Welts)
Itching Burning
Flushing Reddening of the skin

Systemic Reactions may be accompanied by (Not Anaphylactoid)

Fever Headache Anxiety Anaphylaxis
Tiredness Lethargy Fainting Shock
Palpitations Nausea Diarrhea Arthralgia
Acrocyanosis  Confusion  Hypoglycemia  Paleness

Immediate treatment with Epinephrine and follow up with a medical professional is recommended when three or more body systems are involved.

Symptoms not recorded in research, but reported by sufferers of Cold Urticaria (specific type unknown, but they generally experience systemic reactions) include a lowered body temperature (95 – 97 degrees Fahrenheit) and a lowered blood pressure, not just during a reaction, but at all times.

When the airway is involved (Not Anaphylactoid)

Wheezing Coughing

Symptoms following contact may begin to appear as soon as 30 minutes after exposure or while rewarming. Full body exposure to air conditioned rooms, bodies of water, wintery weather or windy environments can trigger reactions instantly or within just a couple of minutes while.  Reactions related to delayed cold urticaria usually appear within 9 – 18 hours.

Most reactions will resolve once the exposure area or body has been rewarmed, sometimes within 30 minutes or as long as 24 hours. Hives lasting more than 24 hours are usually identified with vascular reactions and can persist for up to 48 hours after exposure.

Systemic reactions can last for 24-48 hours following a reaction.

Appearance is very similar to hives except they are deep within the skin tissues.  Because there are no nerve endings in these areas, there are typically no symptoms if itching or burning.  The most common areas where Angioedema are found, the face, hands and feet tend to swell quite large and may disfigure the individual.  However, other areas of the body, the Angioedema can be flat with a mild swelling of the general area.  Angioedema usually lasts for 24 hours; however, there is usually a residual watermark type hive left behind in the tissues.  Angioedema can also occur in the digestive tract.  With Cold Urticaria, Angioedema can appear independent of hives or can appear after prolonged reactions where the hives become Angioedema.


  • Skin reactions, including hives along with itching, and flushed or pale skin (almost always present with anaphylaxis)
  • A feeling of warmth
  • The sensation of a lump in your throat
  • Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
  • A weak and rapid pulse
  • Nausea, vomiting or diarrhea
  • Dizziness or fainting

Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes, however, Anaphylaxis can occur a half-hour or longer after exposure. Anaphylactoid reactions can return upto 24 hours later.

Immediate treatment with Epinephrine and follow up with a medical professional is recommended following an Anaphylactoid reaction.

1 Comment

  1. November 8, 2015    

    Thank you for sharing!

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Nuggets of Wisdom

Yes, there is such a thing as having an allergic type reaction to temperatures. This is defined as a physical urticaria. Other physical urticarias include Solar, Aquagenic, Pressure, Vibration and Exercise.

Most reactions are pseudo-allergic. By definition, an allergy involves inhaling or consuming an allergen. Physical urticarias have no known allergen. Despite the terminology and medical definitions, systemic reactions can be life threatening.

Cold has an arbitrary definition based on an individual feeling. For a person with a cold urticaria, cold can be defined as any temperature cooler than their own body temperature.

You do not have to be cold to have a reaction to the cold; contact with cold can trigger a reaction.

You can have an allergic type reaction to both cold and heat simultaneously.

Most reactions considered anaphylactic are really anaphylactoid by definition.

Moving to a warmer climate as a treatment for Cold Urticaria is a myth. Warmer climates present their own issues for those with Cold Urticaria.

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