Cold Sensitivity (Cold Urticaria) in Children: Signs, Causes, and Treatment

Cold sensitivity, also known as cold urticaria, is a common condition in children that may concern parents due to their still-developing immune systems. Children can have an abnormal or exaggerated immune response to cold exposure, triggering symptoms ranging from mild to severe.

According to Healthline, here’s what you need to know about the signs, symptoms, causes, and treatment of cold urticaria in children, and how to differentiate it from a common cold.

Signs and Symptoms of Cold Sensitivity in Children

Cold urticaria usually presents with red, itchy hives or rashes on the skin. In more severe cases, additional symptoms may include:

• Swelling (angioedema) under the skin after exposure to cold

• Difficulty breathing or wheezing

• Stomach pain

• Heart palpitations or irregular heartbeat

• Headaches

• Swelling of lips or throat

• Burning sensation on the skin

Symptoms typically appear 2–5 minutes after exposure to cold air or water and can last 1–2 hours.

Severe reactions may include:

• Low blood pressure

• Shock

• Fainting

These can be life-threatening, so immediate medical attention is essential.

Cold Sensitivity vs. Common Cold

Distinguishing between a cold and cold urticaria can be tricky. Key differences include:

• Duration: Colds typically last 1–2 weeks, while cold urticaria symptoms may persist longer or recur with cold exposure.

• Trigger: Cold urticaria occurs specifically after contact with cold air, water, or objects.

• Pattern: Allergic reactions tend to be immediate, whereas cold-related colds develop gradually.

Causes of Cold Sensitivity in Children

The exact cause of cold urticaria is unknown. Possible factors include:

• Overly sensitive skin cells

• Genetic predisposition

• Viral infections or other illnesses

Symptoms usually appear after exposure to cold air, water, or objects. In some cases, children may inherit a tendency to develop this sensitivity.

Diagnosing Cold Sensitivity in Children

If you suspect your child has cold urticaria, a dermatologist can confirm the diagnosis. Diagnosis usually involves:

1. Medical History: Detailing symptoms, triggers, and timing

2. Skin Examination: Observing reactions after controlled cold exposure

3. Ice Cube Test: Placing a plastic bag with ice on the skin to trigger and observe reactions

Treatment and Management

Cold urticaria may resolve on its own over weeks or months. Some children may outgrow it within five years, while others may require ongoing management. Treatment focuses on relieving symptoms and preventing reactions.

Practical Management Tips:

1. Avoid Triggers:

   • Keep your child warm; avoid cold water or air exposure

   • Dress in long sleeves, pants, and use blankets when necessary

2. Medications:

   • Antihistamines: Prevent or reduce skin reactions and itching

   • Stronger medications may be prescribed if antihistamines are insufficient

   • Epinephrine (adrenaline) injection may be needed for severe reactions

3. Emergency Preparedness:

   • Parents can be trained to administer an epinephrine injection

   • Ensure your child’s comfort and warmth to reduce triggers

4. Monitor for Severe Symptoms:

   • Difficulty breathing, swelling of the throat, or extreme reactions require immediate medical attention

5. Preventive Measures:

   • Avoid air-conditioned areas that are too cold

   • Minimize contact with cold surfaces or objects

   • Keep your child dressed warmly during colder weather

Summary: Cold urticaria in children ranges from mild skin reactions to severe allergic responses. Early recognition, avoidance of triggers, and appropriate medical care are crucial to prevent serious complications. Always consult a doctor for diagnosis and guidance on treatment.