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Online clinic on skin conditions - Sep 2017

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talkhealth > Clinics > Online Clinics Index > Online clinic on skin conditions - Sep 2017 > Other Skin Conditions

Other Skin Conditions

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Cold urticaria

Postby fredaz123 on Wed Sep 13, 2017 6:41 am

Four weeks ago I started getting cold urticaria. I have poor circulation so it could have been t shirt weather and warm, but I still developed the red dotty rash on the backs of my hands and on my feet. As the weather is getting colder my rash is becoming more frequent and more widespread and dense, covering my arms and legs and becoming itchy if I'm outside for any length of time.

Is there a reason why I would suddenly develop this? I also have problems with my sinuses so perhaps I have started developing allergies.

Is there any medication I can take to manage it before the rash appears? I have a public facing job and I don't want people to think I have something contagious.

Thanks for you help.
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Joined: Wed Sep 13, 2017 6:28 am

Re: Cold urticaria

Postby Dr Anton Alexandroff on Wed Sep 13, 2017 10:35 pm


Thank you very much for your question. We do not know why cold urticaria starts. I am afraid it can be difficult to treat. Antihistamines such as fexofenadine or levocetirizine can be used in licensed dose (1 tablet a day) or in difficult to treat cases up to 4 tablets a day off license providing it does not make you drowsy.
The next step would be to add ranitidine and/or montelucast medication off license. The next step would be ti add omalizumab monthly injections (can be prescribed by a dermatologist). After this there is a option of using very potent medicines such as cyclosporin and methotrexate (chemotherapy like drugs) - these need to be used under a close supervision of a dermatologist and require regular monitoring blood tests. Eventually cold urticaria resolves.

I hope this is helpful.
With Best Wishes,

Dr Anton Alexandroff FRCP(UK) PhD CCT(Derm) FRSM FAAD
Consultant Dermatologist and Honorary Senior Lecturer
Member of the British Association of Dermatologists
The British Skin Foundation Spokesperson
London, Cambridge, Leicester and Bedford

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Dr Anton Alexandroff
Consultant Dermatologist, Honorary Senior Lecturer & BSF spokesperson - FRCP, CCT (Derm), PhD, FRSM, FAAD

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Dr Anton Alexandroff
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