Cold urticaria is a form of inducible hives in which exposure to cold air, water, objects or sudden temperature changes triggers itchy raised welts or swelling. It is not the same as feeling unusually sensitive to cold.
Symptoms
Symptoms can include hives, itching, redness or swelling in skin exposed to cold. Hands may swell after holding cold objects, and lips may swell after cold food or drinks. Symptoms can become more severe when a large area of the body is cooled.
When to Get Emergency Help
Call your local emergency number for breathing difficulty, swelling of the tongue or throat, severe dizziness, fainting or collapse. Cold water swimming can cause a widespread reaction and loss of consciousness, so it should be avoided until a healthcare professional has assessed the condition.
Diagnosis
A healthcare professional will review the symptoms and possible triggers. A supervised cold stimulation test may be used. Testing should not be attempted at home because extensive cold exposure can cause a serious reaction.
Management
Reduce sudden cold exposure, protect skin in cold weather and discuss safe swimming and medical procedures involving cold temperatures. A clinician may recommend an antihistamine that is less likely to cause drowsiness. People with previous severe reactions may need an adrenaline auto-injector and an emergency plan.
Tell healthcare professionals about cold urticaria before surgery, infusions or procedures that may cool the body.
Sources
Reviewed 28 August 2026.