Montreal Gazette

Allergy to extreme hot or cold a painful condition

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HEALTHING.CA

Straight talk on health, illness and recovery. Get better.

NICK BEARE

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, says the National Organizati­on for Rare Disorders (NORD).

The first and more common form, acquired cold urticaria, displays obvious symptoms within a couple of minutes of exposure to the trigger and can last for a couple of 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 of cold urticaria, 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, NORD says.

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 4C.

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 to 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 “weals” 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.

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