When the air starts to turn frosty, many people complain about cold weather and having to wrap up in jackets, scarves and gloves.
For some, however, the fall and winter seasons bring about extreme physical discomfort.
These people are actually allergic to the cold, an illness known as cold urticaria, or "cold-induced hives."
"It is usually an itchy, transient skin reaction caused by release of histamine and other substances in response to exposure to cold temperatures," said Dr. Fred Kam, medical director for Auburn University Medical Clinic.
Physically induced forms of urticaria are manifested when a person comes in contact with something in the environment, such as heat, sun, water or, in this case, cold.
According to a report done by the National Organization for Rare Disorders, "Cold urticaria may be diagnosed by placing an ice cube on the skin of the subject's forearm for about four or five minutes.
A positive response is indicated by the appearance of a 'hive' in the shape of the ice cube, within 10 minutes after the stimulus is removed.
Hirsh Komarow, a staff clinician in the laboratory of allergic diseases for the National Institute of Health, explained hives show up in the area of exposure. General symptoms include redness, some swelling and itchiness.
According to Mayo Clinic's Web site, the symptoms often worsen as the skin warms back up.
Cold urticaria is different from just getting the goose bumps.
"Goose bumps are caused by the contraction of little muscles at the base of hair follicles causing them to become erect," Kam said. "This can happen with exposure to a chilly environment. Cold urticaria is caused by release of chemicals such as histamine, similar to what happens in an allergic skin reaction."
Dr. Richard W. Honsinger of Los Alamos Medical Care Clinic Ltd. and clinical professor of the University Of New Mexico School of Medicine said the mast cells in the surface of membranes are full of tiny granules.
When those granules are disturbed or excited, the cells release some of the granules, including histamines.
Honsinger said the hives last as long as it takes the body to block the histamine. Simply moving to a warmer area or wrapping up in a blanket will not speed the reduction of the symptoms.
People who have cold urticaria should take great care to avoid cold temperatures, Komarow said.
"People that have it should stay away from jumping into cold water," Komarow said. "That could be life-threatening."
Cold urticaria is usually only external, Honsinger said, and those who suffer from it can still eat and drink cold things.
Hives could appear on their lips and other sensitive areas after being exposed to cold temperatures
Cold urticaria is typically treated with antihistamines. Over the counter antihistamines can help reduce the allergic reaction. Komarow said the antihistamines will only help as long as the person continues taking them.
They can be used as preventative treatment and can also lessen the symptoms for those in which the cold urticaria has already been manifested, meaning the symptoms are already physically present.
People with more severe symptoms may require additional medication.
Unfortunately, cold urticaria cannot be prevented, meaning a person cannot do anything to ensure they never get it, but the symptoms can be prevented through the use of antihistamines.
There are both acquired and genetic forms of urticaria.
For the majority of people who suffer from it, Komarow said, the illness will usually go away within five years.
For others, it can be a life-long struggle.
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