Shine On

Allergic to the cold? Some people actually are

Some people have an actual allergy to the cold that can cause rashes and hives. (Thinkstock)Allergies have long been used as a facetious excuse to avoid unpleasant tasks — "But mom, I'm allergic to homework" or "Sweetie, you know I'm allergic to doing the dishes." As winter sets in, you've likely heard a whiny workmate or spouse complain that they are "allergic to cold."

Yet, for some people, this is actually true.

It's called cold urticaria, and those who have the condition develop typical allergy symptoms when exposed to the cold. Reactions can include hives, rashes, itchiness, and even anaphylactic shock.

"It's certainly well-known in the fields of allergy and immunology," says Anne Ellis, an associate professor of medicine and chair of the Division of Allergy and Immunology at Queen's University in Kingston, Ontario.

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Ellis says that while cold urticaria is rare, allergy and immunology specialists are well acquainted with the condition.

A recent ABC story described the cases of two siblings with cold urticaria, and who suffer rashes and hives when exposed to cold. The eldest, Taylor, almost went into anaphylactic shock after being exposed to the air conditioning system at her school.

Ellis says the severity of symptoms range widely, and the most effective strategy to combat the condition is avoidance of cold triggers. Patients are advised to stay away from ice and other cold materials -- even a cool floor or chair can cause a reaction.

"Swimming can be a real challenge," says Ellis, as jumping into a cold body of water can easily induce anaphylactic shock.

"It ranges from mild up to life threatening. I have two patients right now at the extreme end, and it has a significant impact on their quality of life."

According to Allergy Canada, 96 per cent of cases have no known cause, although the condition has been well-documented in association with systemic inflammatory disease,  hematologic disease, thyroid disease, infections with certain viruses, and with the use of certain medications like birth control pills and immunotherapy agents.

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Diagnosis can be quite simple.

"An ice cube is placed in plastic bag and applied to skin — usually the forearm — for 20 minutes," explains Dr. Mark Greenwald, an allergy specialist with Allergy Canada. A diagnosis can be made if a wheal — a welting allergic reaction on the skin — appears upon rewarming.

Greenwald says that the condition can resolve over time with treatment of the underlying condition.

In Harris's clinical experience, though, cold urticaria tends to be a long-standing condition.

"Right now I have about five patients with this, and in general, it's viewed as a life-long problem."

She advises anyone who suspects they may suffer from the condition consult with an allergy or immunology specialist to get an accurate diagnosis and optimal treatment.    

Watch the video below about how some Christmas trees have mould that can cause allergies.  

 

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