It’s safe to say that most people don’t love the cold weather. It’s uncomfortable, you need to wear layers, and the bite in the air can physically hurt. But for some people, cold weather could actually kill them.
There’s a real medical condition behind that sentence, and it’s called cold urticaria. It’s a rare disorder where exposure to cold temperatures causes the immune system to misfire. Instead of adapting to a temperature drop, the body reacts as if it’s under attack. Skin can erupt into hives. Swelling can spread across the whole body. Blood pressure can drop. In severe cases, the reaction escalates into anaphylaxis.
Cold urticaria has been documented for centuries. It was first described in 1792 by German physician Johann Peter Frank, though it took much longer to understand what was happening inside the body. Today, researchers know the condition affects about six out of every 10,000 people and appears nearly twice as often in women as in men. Symptoms usually begin in early adulthood, but children and older adults can develop the condition too.
The problem starts with mast cells. These are immune cells that act as early warning systems in the skin and other tissues. Under normal circumstances, they release histamine to help deal with infections or injuries. In people with cold urticaria, cold exposure triggers that release without a real threat present. Histamine makes blood vessels widen and become leakier, which causes swelling, redness, and itching. In extreme reactions, that same process can disrupt blood pressure and breathing.
It’s not just winter weather that people with cold urticaria need to be careful about. Swimming in cold water is one of the most dangerous scenarios, especially because a large area of skin is exposed at once. Cold drinks, frozen foods, metal surfaces, and air-conditioned spaces can also set off symptoms. Some people react immediately. Others notice symptoms as the skin warms back up.
Doctors diagnose the condition using controlled cold exposure, usually placing an ice cube on the forearm and monitoring the reaction. This test has to be done under medical supervision. About 20 percent of patients experience systemic reactions during testing, including anaphylaxis, which makes do-it-yourself experiments a very bad idea.
There are two main forms. Primary cold urticaria accounts for roughly 95 percent of cases and has no clear underlying cause. Secondary cases are linked to infections or conditions such as Epstein-Barr virus, hepatitis C, HIV, or certain blood cancers. Treatment usually starts with antihistamines, sometimes at higher doses than standard allergy treatment. About 60 percent of patients respond well. Severe cases could require biologic medications like omalizumab. Some people gradually improve over time, and a portion eventually see symptoms fade completely.
Most people complain about the cold. A smaller group has to plan their lives around it, because their lives literally depend on it.
The post Some People Are Allergic to the Cold, and It Can Be Deadly appeared first on VICE.
