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How to manage cold allergy of the skin?

Q: I am 50 year old. Since the past 9 years I have been experiencing severe allergy on the skin, whenever my skin is exposed to anything cold. It may be rain, cold wind, cold water, ice, or even the coolness in an air conditioned room. My skin gets severe itching, becomes reddish and there is swelling on the skin. After some time when I am away from the cold, this will subside with out any medicine. This is causing lots of problems when I ride a bike in the morning. Even the parts protected by the cloth start to itch. I have to dress like an astronaut to avoid this. Is there any cure for it?

A:It sounds as if you have cold urticaria, or nettle rash. This is a recognised example of a physical urticaria, which may be prevented by pre-treatment with an anti-histamine, such as loratadine, cetirizine, acrivastine or fexofenadine. If it is widespread, such as after swimming in cold water, it can even lead to loss of consciousness. It sometimes runs in families, and sometimes gets better spontaneously. The diagnostic test is to apply an ice cube to the skin of the forearm for 5 minutes, and then see if a weal develops over the next few minutes.


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