For most people, winter simply means wearing a few extra layers and enjoying a hot cup of tea to stay warm. But did you know? For a rare few, cold weather can be deadly. Cold urticaria commonly known as "cold allergy," might sound like a joke, but it's a rare and dangerous condition. Patients often find themselves unable to lead normal lives, which is truly heartbreaking. When their bodies come into contact with cold air, cold water, or even something as simple as touching a cold drink, it can trigger a severe allergic reaction.
Cold urticaria is like the body's "temperature alarm system" going haywire. The moment the skin senses cold, it frantically presses the alarm button, causing the body to go into overdrive. Imagine stepping outside on a winter day-what feels like a refreshing breeze to most people feels like a swarm of tiny ants crawling all over the skin for these patients. The result? Instantaneous redness, swelling, and itching, as if their skin were being devoured by an army of tiny insects. But this is just the beginning. If the cold exposure continues, the situation escalates quickly. The face, lips, and even the area around the eyes can swell up like inflated balloons, while the airways feel as though they're bound by icy "chains," constricting the throat like gulping down a mouthful of ice water, making it hard to breathe. In severe cases, the entire body feels "hijacked" by the cold blood pressure plummets like a runaway roller coaster, potentially becoming life-threatening. It's like being trapped in a freezing vortex, with no way out.
Lilian is a typical case. After contracting COVID-19, she suddenly developed a severe reaction to the cold. At first, it was just a few small rashes after swimming, but later, even a sip of cold water triggered throat itching and, in some cases, difficulty breathing. This drastic change completely upended her life. The outdoor activities she once loved have now become an unattainable luxury.
The onset of cold urticaria is like the immune system mistakenly identifying the cold as an "enemy invasion," triggering an unnecessary alarm. When cold air, cold water, or an icy drink enters the body, the skin's "soldiers" — mast cells— immediately go on high alert, releasing histamines like "chemical bombs" in an attempt to fend off a threat that doesn't exist. Unfortunately, this defensive manoeuvre backfires, leaving the "battlefield"— the skin— in chaos, resulting in redness, itching, and blood vessel dilation. It's like igniting a string of tiny "fireworks" on the skin, leaving behind a burning, itchy sensation. Worse still, if the histamine "firepower" spirals out of control, the body may go into full "emergency mode," potentially leading to anaphylactic shock, where the throat feels like it's being squeezed by an invisible hand, making it difficult to breathe. For patients, winter feels like entering a "danger zone," where they must remain on high alert for the next sudden attack.
While cold urticaria may seem like a persistent "winter ghost" that's impossible to shake off, there are ways to minimize the risks through small lifestyle adjustments and timely medication. Staying warm is key-like putting on a suit of "armour." Scarves, hats, and gloves become essential "protective charms" when stepping outside in winter, ensuring that no cold air sneaks in through any gaps. Summer requires vigilance to avoid staying in cold water for extended periods while swimming, and use warm water instead of cold water when bathing to keep the body within a "safe temperature zone." Even if you love cold drinks, your health comes first- resist the temptation of ice cream and other chilled treats to prevent the body from experiencing sudden "temperature shifts." Patients should always carry an epinephrine pen (EpiPen), ready to press the "emergency button" and inject immediately in case of a severe reaction.
For patients, learning to coexist with the cold is essential. Just like Lilian's journey, although cold urticaria has changed her life, she can still live a life filled with hope and warmth.
