Can you be allergic to extreme temperatures?

For people with urticaria, extreme heat or cold can be painful, and even life-threatening.

Nick Beare 3 minute read December 3, 2021
Meteorology thermometers. Heat and cold weather vector illustration. Cartoon characters in summer and winter season.

You should visit your doctor if you have any kind of skin reaction to either the hot or cold. GETTY

Extreme temperatures do funny things to the human body. We’re all aware of heat exhaustion and frostbite — and experiencing extreme hot or cold can be anything from uncomfortable to excruciatingly painful.

But can you be allergic to extreme temperatures?
In short: yes. Urticaria, the medical term for hives, can appear as a reaction to either heat or the cold.

Cold urticaria
Cold urticaria is a skin disorder that occurs as a reaction to the cold. There are two different forms of cold urticaria, according to the National Organization for Rare Disorders (NORD).

The first and more common form, acquired cold urticaria, displays obvious symptoms within a couple minutes of exposure to the trigger and can last for a couple hours. With the other variety, familial (hereditary) cold urticaria, symptoms take 24 to 48 hours to appear and take about 24 to 48 hours to go away.

For either type, symptoms appear after exposure to either cold weather or cold water, with the affected areas turning red and itchy. Welts also appear on the skin and can be accompanied by fever, headache, anxiety, tiredness and in some instances, fainting, according to NORD. The Mayo Clinic lists swelling of the tongue or throat and anaphylaxis as severe symptoms.

Symptoms can vary widely from person to person, with some people experiencing very mild reactions while other peoples’ are quite severe, and they can appear at any time once the temperature dips below about 4 degrees.

Cold urticaria tends to occur more often in younger people, but there are no known causes. People with weakened skin cells due to underlying conditions such as cancer could be more prone to cold urticaria.

Treatment of cold urticaria will depend on the reason it developed. For people with the hereditary variety, an over-the-counter antihistamine could be taken to try and limit symptoms before you’re exposed to the cold. For people who get the acute or acquired version, treatment will likely focus on managing symptoms with hormone treatment or antibiotics depending on the severity of the specific case.

Cholinergic (hot) urticaria
While cholinergic urticaria is rarer than its colder counterpart, it is a similar condition. Cholinergic urticaria is caused by increased body temperature with the most common causes being exercise, strong emotions, hot temperatures, spicy foods and bathing in hot water.

Like cold urticaria, cholinergic urticaria symptoms include red bumps or ‘wheals’ on the skin that are itchy and tingly as well as nausea, vomiting, diarrhea and anaphylaxis in rare cases. Symptoms often subside in a matter of hours, if not much sooner. Anyone can get cholinergic urticaria, but it is more common in younger men.

Treatments are similar to cold urticaria in that they depend on the severity of the case but will often include medication such as antibiotics or antihistamines. Avoiding triggers is the best way to prevent cholinergic urticaria, and you should visit your doctor if you have any kind of skin reaction to either the hot or cold.

Nick Beare is a Toronto-based freelance writer. He can be reached here

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