A TikTok video revealing the little-known condition responsible for unbearably itchy legs after cold exposure has gone viral, with many people discovering they have cold urticaria.
In the clip, TikToker Danielle Olivia was seen incessantly scratching her legs over her leggings in a car park in the cold air. She captioned it: 'You are part of the minority who deals with the cold urticaria.' The post quickly reached 3 million views, with many realising this was the condition they've had all along.
What is cold urticaria?
'Cold urticaria is a rare condition in which exposure to cold temperatures triggers an allergic-type skin reaction,' pharmacist Thorrun Govind, former Chair of the Royal College of Pharmacy, told Metro.
This cold exposure could be due to eating or drinking something cold, putting ice on their skin, swimming or bathing in cold water, or even simply walking or running outdoors in cold weather or rain. Around 20% of people will struggle with urticaria at some point in their lives, although it's not known how many of these are induced by the cold, with some estimated at 0.05% of the population.
Some people with urticaria have other conditions, such as thyroid disease or other autoimmune disorders, according to the British Association of Dermatologists (BAD). 'It can affect anyone, but it's more commonly diagnosed in younger adults,' Thorrun adds. 'Usually it's acquired, meaning the cause is typically unknown. But, in extremely rare cases, it can be hereditary. Familial cold autoinflammatory syndrome is an exceptionally rare inherited inflammatory condition which can cause a rash, as well as joint pain.'
Symptoms and treatment
Cold urticaria is largely characterised by a skin rash which can affect a small patch of skin, or cover a large surface area. 'The giveaway is usually a combination of cold exposure followed by itching, redness and raised welts on the skin,' Thorrun says. But, for some, symptoms can be a little more severe, experiencing deeper swelling around the hands, lips or face. While many people only develop hives, some may have more serious whole-body symptoms like anaphylaxis, including dizziness, fainting, or changes in vision.
'That intense itching is down to histamine,' she explains. 'When someone with cold urticaria is exposed to cold, mast cells in the skin can release histamine. This stimulates the nerves responsible for that itch.'
Antihistamine medication is usually recommended for most cases of urticaria, according to the NHS. This can help with the symptoms of itching and swelling and can bring down the rash. Your pharmacist will likely recommend cetirizine because it doesn't make you drowsy. Some antihistamines like Chlorphenamine (also called Piriton) can cause sleepiness. BAD also recommends avoiding anything that may worsen urticaria like tight clothes and alcohol.
There is no specific cure for the condition, which is not classed as an allergy, so the focus is on suppressing the symptoms which can be done effectively for most patients with an antihistamine.
