Awareness * Advocacy * Research

Where Reactions Occur (triggers):

Cold weather: Exposure to temperatures below each individual’s threshold may trigger a reaction. For more severe cases, temperatures colder than the individual’s body temp. could trigger a reaction.

Some reactions may occur instantly and others take hours.  Duration of exposure is not always a determining factor in how quickly someone may become reactive.  For some individuals, each circumstance can be different than the one before.  Sufferers don’t always react in the same amount of time or last for the same duration or with the same severity.

Environmental:  Humidity and air circulation both can trigger reactions and may increase the likelyhood of a reaction and its severity.  Transfering from one environment to another with a striking difference between temperatures will also increase the liklyhood of a reaction.

Avoidance of exposure when possible; or, if not possible preparation are the two best measurers for avoiding reactions based on these triggers.

• Evaporative: Reactions are known to trigger on warm days or following exertion while sweat evaporates from the skin.

As air passes over the skin, cooling occurs and triggers a reaction. Drying off and wearing moisture wicking clothing reduces the number of reactions from evaporation.

Medical Fluids, Tools and Theaters: Syringes, intravenous fluids (IV’s), refrigerated serums for injection or testing, ice packs, metal scales (for babies), metal X-Ray tables, sonogram fluid, creme’s and lotions are all concerns and some life threatening.  Doctor’s offices and Surgical theaters are cooled at very low temperatures to inhibit the spread of germs.

Dialogue with your doctor, nurses and anestesiologist about your condition and the need for these items to be warmed.  Room temperatures can be increased; serum, fluids, cremes and lotions can be warmed prior to use; and, heated blankets and IVs can be used in surgery.

Anestesiologists should be made aware of the risk for Anaphylaxis and Hypotension and that in some cases, patients with Cold Urticaria also have a propensity for chronically low blood pressure and body temperatures.

Water Immersion: Bathing and swimming can be especially dangerous as the body enters the water all at once combined with the onset of hives can lead to Anaphylaxis, shock and immediate death.

Though swimming is not recommended for someone with Cold Urticaria, some individuals with less severe cases or appropriate accommodations choose to participate regardless.

Children should never be left alone during their time of bathing and/or swimming. Children could easily fall asleep and drown in the bathtub.  Though it is not always appropriate to be in the bathroom with an older child that can be left alone to bathe.  In situations like this, a baby monitor without video could be used to monitor the older child’s safety.

Adults and children should be dry off immediately following departure from the tub or pool.  A second towel should be available to dry hair.  Dryer heated towels could be transported in a dry insulated food cooler when away from home.  Towels will stay hot for several hours.

Responsible steps and close monitoring must occur when swimming in a pool, lake or ocean, regardless of size.  When entrusting your child into someone elses care, it would be beneficial to make the individual aware of the condition and necessary precautions and supplied with medications.  Ask if the individual is comfortable with caring for your child.  In the event you do not know the individual such as being at a birthday party, remain at the party.

Air Conditioning: It does not matter if you live in an area which is cold most of the year or warm most of the year.  Individuals with Cold Urticaria suffer from this condition year round in all areas around the globe.  In warmer climates, the number one trigger is air conditioning.

Office and School buildings, places of worship, grocery stores, medical providers, entertainment areas, and vehicles are all cooled and in some cases at very low temperatues during a summer. Exposure can lead to not just the burning and itchy hives, but also trouble breathing the cool air, mental confusion, reactive hypoglycemia, headaches, hypothermia and fatigue. Individuals with systemic reactions can become Anaphylactic or go into shock, even without anyother signs such as the hives and itching.

Consumption: Refrigerated or iced/frozen food and drinks may trigger a reaction.  Not everyone with Cold Urticaria has an issue with consuming cold items, but some do.

Some individuals will consume drinks at room temperature, or if they are reactive and choose to consume cold products often consume very little at a time.  Waiting until warm food has been consumed prior to having an iced drink can reduce and / or prevent a reaction.

Signs that a reaction will occur can be swelling of the tongue, hands, mouth and/or face are possible following handling of cold stuff.  Reactions are not only external, but some are internal  as they can occur in the digestive tract.  If this occurs, the only signs that will draw attention or nausea, vomiting and diarrhea, tiredness and lethargy.

Handling and preparation of refrigerated and frozen items can trigger a reaction.

Cool/Cold Surfaces: Both indoor and outdoor structures and objects which retain cool temperatures well can illicit a reaction.  Concrete, metal, glass, ceramic, wood flooring will result in hives.

Avoidance is the most appropriate action to prevent a reaction. Using blankets or stadium seats can be used when sitting on concrete, wearing gloves to prevent direct contact with poles, mailboxes, wearing socks around the house can all be supportive in preventing reactions.

Circulation: The reduction of blood flow can reduced the temperature of the area where circulation is diminished.

Avoid sitting on legs or leaning on arms for prolonged periods.  Avoid restrictive clothing and shoes.  Get up and walk around after sitting for long stretches.

Ailments: Dehydration and fevers related to an ailment can lead to full body reactions.

Most people don’t drink enough fluids each day as it is.  Everyone with Cold Urticaria should be sure to get their full supply of fluids each day.  Avoid drinks that can increase dehydration.  Full body reactions can also lead to dehydration as fluid leaks from blood vessels into the skin.  Always add more fluids to your daily regimen follow a systemic reaction or a course of frequent reactions.

Fevers are nature’s way of helping the body get well during an ailment.  Unfortunately for someone with Cold Urticaria, fevers also lead to evaporative cooling of the body, even when sweating is not involved.  Keep in mind that the lack of sweating can mean the body is dehydrated.  Always drink more fluids when sick.

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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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