Teena Mackenzie
Education Lead, British Dermatological Nursing Group
Jodie Newman
Education Nurse, British Dermatological Nursing Group
Urticaria (sometimes known as hives or weals) is a common skin condition affecting one in five people at any given point in their lives.
Urticaria presents as a red, raised itchy rash that can be either acute (lasting up to 24 hours) or chronic (lasting over 6 weeks).1 The rash can appear anywhere on the body and may be pink or red. It may present with raised bumps in different shapes and sizes.
Symptoms and what triggers urticaria
People with urticaria tend to experience symptoms of itchy skin and sensations of stinging and burning. 2 Urticaria eruptions can be triggered by a range of different factors including food, environmental exposures and climate. In some instances, it can be idiopathic — meaning no specific cause has been identified.
However, with winter lurking and different weather extremes approaching, those suffering from cold urticaria may find the next few months challenging. People who suffer from cold urticaria often experience a flare of their hives when exposed to cold weather, swimming in cold water or even ingesting cold food and drink.
With winter lurking and different weather extremes
approaching, those suffering from cold urticaria
may find the next few months challenging.
Two types of cold urticaria
Acquired cold urticaria is when a person has symptoms that appear within a few minutes after cold exposure. The symptoms often resolve after an hour or two, and there is no familial history. The second type of cold urticaria is known as familial or hereditary, meaning it has been passed down in families and often causes prolonged symptoms; although, these cases are rare.
Cold urticaria occurs when the body releases histamines in reaction to the cold. The immune system makes histamine, which is a chemical made in response to an allergen. Autoimmune disorders may also cause cold urticaria.3
A diagnosis is usually made by placing an ice cube on the skin. If positive, a red or enlarging hive can appear. People with a diagnosis can learn to protect their bodies from sudden temperature drops; for example, wearing a wet suit and hat when cold water swimming can help.
Treatment approaches for urticaria
Most cases of urticaria don’t need treatment as symptoms are usually mild and resolve quickly. If the itch is causing distress and the symptoms are lasting longer, a pharmacist may be able to help with a course of antihistamines.
A pharmacist can advise on the most appropriate treatment if needed. If symptoms persist, then a GP appointment may be required to rule out any underlying condition or further management.2
[1] National Institute for Health and Care Excellence. Urticaria. NICE. 2023. Urticaria. Available at: https://cks.nice.org.uk/topics/urticaria/
[last accessed 25 October 2023]
[2] NHS. Hives. Available at: https://www.nhs.uk/conditions/hives/
[last accessed 25 October 2023]
[3] DermNet. Urticaria- an overview. Available at: https://cks.nice.org.uk/topics/urticaria/
[last accessed 25 October 2023]
