Cold allergy is a hypersensitivity reaction in response to exposure to low temperatures with the appearance of rashes on the skin like contact dermatitis, urticaria. The main symptoms are redness of open areas of the skin, the appearance of blisters and erosions, peeling, cracks, itching. Diagnostics includes the collection of anamnesis, clinical examination of the skin and mucous membranes, conducting an application test. Treatment involves warming the affected area of the body, using antihistamines, applying ointments and creams with anti-inflammatory and wound-healing effects to the skin, preventive use of protective cosmetics.
L50.2 Urticaria caused by exposure to low or high temperature
Cold allergy is a pseudoallergic reaction that occurs when the body is exposed to low temperatures and is characterized by the development of an inflammatory process on the skin and mucous membranes with an acute or chronic course. It is observed mainly in the autumn-winter period with frequent contact with cold water in open reservoirs and in everyday life, when cleaning rooms, ingesting ice water and soft drinks, ice cream. Clinical symptoms include manifestations of urticaria, dermatitis, rhinitis, conjunctivitis, bronchial asthma. According to statistics, cold allergy occurs in 10-20% of the population, women and children are more likely to suffer.
The true cause of the pathology has not been clarified. The main risk factors are:
- Hereditary predisposition. Cold allergy is more common in people with a hereditary predisposition to allergic diseases, as well as in the presence of relatives with hypersensitivity to the effects of cold.
- Vascular disorders. Violation of microcirculation, deterioration of blood circulation in the skin and subcutaneous tissue (on the face, in the distal parts of the upper and lower extremities) in vegetative-vascular dystonia, Raynaud’s disease, overweight and obesity.
- Chronic diseases. Chronic inflammatory process in the digestive tract (gastroduodenitis, enterocolitis), upper respiratory tract (sinusitis, tonsillitis).
- Endocrine disorders. Disorders of the thyroid gland, adrenal glands.
- Sensitive skin. Delicate sensitive skin, dry skin, the presence of concomitant diseases (neurodermatitis, eczema, psoriasis, etc.).
- Frequent contact with cold. Prolonged stay in cold weather with exposed parts of the body (face, hands), swimming in an open pond, visiting the pool with low resistance to low temperatures, contact with cold water in everyday life (cleaning rooms, washing dishes).
The pathological process in cold allergy is based on a pseudoallergic reaction, which is triggered due to the irritating effect of cold on mast cells and occurs as a result of a massive release of histamine. Inflammatory mediators circulating in the vessels increase the permeability of the vascular wall, cause local and widespread swelling of the skin and mucous membranes, have a damaging effect on cells. The inflammatory process may increase with the additional intake of products containing histamine into the body, as well as substances that stimulate its release by mast cells.
Symptoms of cold allergy
The disease is characterized by lesions of the skin on exposed parts of the body (face, hands), irritation of the mucous membranes of the upper respiratory tract (nasal passages, pharynx, trachea and bronchi), eyes, less often – the gastrointestinal tract.
- Cold urticaria. On the skin of the face, including on the eyelids, upper lip, as well as on other open areas of the body, there is hyperemia, swelling, rashes like urticaria (multiple itchy blisters, erythema), pronounced itching.
- Contact dermatitis. Redness and swelling in a limited area after contact with the cold factor. After 1-2 days, small bubbles filled with serous fluid are formed. After opening the bubbles, the formation of erosions is noted, then their coating with scab and scarring. If contact dermatitis acquires a chronic course, stagnant erythema develops, often accompanied by infiltration, maceration of the skin. There are long-term non-healing cracks, the skin flakes off.
- Meteorological heilitis. Redness, dryness, peeling, and a feeling of tightness appear on the red border of the lips. Patients with meteorological cheilitis often lick their lips to prevent unpleasant sensations.
- Defeat of the mucous membranes. There may be symptoms of conjunctivitis (redness, lacrimation, burning), vasomotor rhinitis (rhinorrhea, sneezing attacks), bronchospasm (feeling of lack of air, suffocation).
The diagnosis of cold allergy involves a thorough collection of anamnesis and identification of the relationship of emerging symptoms after cold exposure. A clinical examination of the patient by a dermatologist, allergist-immunologist, otolaryngologist and other specialists is required according to indications. To exclude a true allergy, standard laboratory tests used in practical allergology are carried out.
A cold prick test has diagnostic value, during which a piece of ice is placed on the skin of the upper limb for 1-3 minutes. The allergy test is considered positive when typical local clinical symptoms of cold allergy appear (hyperemia, swelling, the appearance of a blister, etc.).
Differential diagnosis is carried out:
- with other skin diseases (simple contact and seborrheic dermatitis, eczema, psoriasis, dermatomycosis, herpes simplex);
- with allergic reactions (atopic dermatitis, drug and food allergies, allergic rhinoconjunctivitis, bronchial asthma);
- with some infectious diseases.
Cold allergy treatment
The main principles of therapy for this disease are the cessation of contact with an irritating physical factor, the use of protective equipment, taking antihistamines, local treatment.
- Termination of contact with cold. It is necessary to warm the affected areas of the skin (go into a warm room, put on gloves, protect your face with a scarf, scarf, hat), stop bathing in an open pond or pool and dry yourself. It is useful to drink a cup of hot tea.
- Antihistamines. They allow to reduce the manifestations of dermatitis, urticaria: redness, itching, swelling. Facilitate the course of vasomotor rhinitis, conjunctivitis.
- Local treatment. It involves the use of ointments and creams with anti-allergic and anti-inflammatory effects. With severe exacerbation, short-term use of ointments with glucocorticosteroids is possible.
Prognosis and prevention
The prognosis of the disease in terms of recovery is favorable. To prevent cold allergies and prevent exacerbations, it is necessary to carry out certain preventive measures. Among them are the use of protective clothing and special winter cosmetics before going outside in cool weather, the use of warm water for household purposes, limiting the time spent outside in the autumn–winter period, hardening the body.