Dr Xand van Tulleken, a regular on BBC Morning Live, has warned that a condition known as cold urticaria could catch some people in the UK by surprise this winter, creating what he described as a "perfect storm of problems" for those affected. Speaking on the show on Tuesday, November 10, he said the condition, sometimes called the "winter itch," affects thousands of people across the country.
Cold urticaria (ur-tih-KAR-e-uh) is a reaction that appears after skin is exposed to the cold, causing itchy welts, also called hives. Dr Xand noted that while it is classed as "rare," it is in fact "not that rare and it does affect thousands of people in the UK." Symptoms can include swelling in the hands and lips, and in serious cases, swelling of the tongue and throat.
A Reaction to Cold
"You can almost think of it as an allergy to cold," Dr Xand explained, adding that the immune system responds "very strongly to cold and you get a severe itch." He said the condition is "worth talking about for a couple of reasons," noting that it can be a really "dismal symptom and one that gets almost no attention."
"We all recognise pain is a big problem, but itching is still something we often don’t take seriously enough," he said, "and it can really drive you bananas." He urged anyone experiencing symptoms to discuss them with their GP, particularly those with eczema.
Advice for People With Eczema
Dr Xand cautioned that for people with eczema, "winter is a difficult time." As the season changes, several environmental factors shift, including lower humidity that dries out the skin, reduced oil production making skin prone to cracking, longer hot baths or showers that wash away natural oils, less UV light, and a higher likelihood of illness that puts stress on the immune system.
These factors, he said, create a "perfect storm of problems heading into the winter with dry air, cold weather, changes in behaviour and even changes in clothing because we wear more wool, which can irritate your skin."
Treating the Winter Itch
While pain medication can act rapidly, Dr Xand noted that "the same is not true for itch," which requires a long-term approach. Speaking about his 11-month-old daughter, he said she receives ointment twice a day and wears mitts at night to prevent scratching, and he advised adults to adopt a similar routine.
"Treating yourself like a small baby in terms of the attention and preparation you give yourself is really valuable," he explained, especially during the winter months when eczema may flare up. He recommended avoiding scratching, avoiding triggers, wearing non-irritating materials, having lukewarm baths, using steroid creams carefully, and always moisturising.
The exact cause of cold urticaria is unknown, according to the Mayo Clinic. It may be linked to overly sensitive skin cells, sometimes triggered by a virus or illness, or it may run in families. In the most common types, exposure to cold prompts the body to release histamine and other chemicals into the bloodstream, leading to itching and, in some cases, symptoms that affect the whole body.
Dr Xand directed BBC viewers to the British Association of Dermatologists (BAD), whose website notes several "things that can irritate the skin," including allergens such as pollen and dust, soaps, detergents and other chemicals. Other triggers may include food allergies or stress.
Symptoms and When to Seek Help
Symptoms of cold urticaria can range from mild to severe. For some people, swimming in cold water can trigger a serious reaction, including a drop in blood pressure, fainting or even shock. The Mayo Clinic lists temporary itchy welts on skin exposed to cold, a response that worsens as the skin warms, swelling of the hands from holding cold objects, and swelling of the lips from cold food or drinks as common symptoms.
Serious responses may include anaphylaxis, which can cause fainting, a racing heart, swelling of limbs or trunk, and shock, as well as swelling of the tongue and throat that can make breathing difficult. The clinic states that symptoms begin soon after skin is exposed to a sudden drop in air temperature or cold water, and each bout may last about two hours. "The worst reactions generally occur when all of the skin is exposed to cold, such as when swimming in cold water. These reactions could lead to fainting and drowning."
The Mayo Clinic stresses that anyone whose skin reacts after exposure to cold should speak to a healthcare professional, even if the reaction seems mild, to rule out other causes. Emergency help should be sought if symptoms affect the whole body or if breathing becomes difficult after sudden exposure to cold.
