Cold reaction

[Ssup5568]

I'm 43 years old. Heathy and fit. I've had an allergic reaction to the cold since I was a child. It varies all the time some years worse than others. I break out in hive or develop a rash up my arms or my eyes or lips swell up. It is winter time now and I've noticed I am having a very hard time taking a deep breath. Not all the time, it seems to get really bad when I'm cold. Could this now be a new reaction I'm getting. I take Allegra now when I'm cold it controls my hives but, it doesn't seem to help my breathing.

[David Tinkelman, M.D.]

You have provided a good description of Cold Urticaria (“Hives”).  It is tempting to suggest that you are now experiencing shortness of breath secondary to cold-air induced bronchial constriction but your description specifically states, “I am having a very hard time taking a deep breath” and that implies that you are having a problem breathing air into your lungs, rather than trouble breathing air out of your lungs (characteristic of asthma).  If that truly is the case, it would suggest that the cause of your breathing problem might reside in some part of your upper airways, rather than in the lower respiratory tract, as occurs with asthma.  In this regard, it is noteworthy that the lesions of cold urticaria can localize in the pharynx and upper airway, including the pharynx, larynx and vocal cords and, can be precipitated not only by cold air but by cold drinks.  I mention this so that you might ask your doctors about this possibility, so that it might be considered along with the diagnosis of cold air induced asthma.  In this regard, direct examination of your pharynx, larynx and cords (with a fiberoptic laryngoscope)  and/or pulmonary function tests (with special attention to the inspiratory flow-volume loop) at a time when you are having difficulty taking a deep breath, might be most informative.

Specialists capable of shedding light on what is going on would include Allergists, Pulmonary (lung) or ENT specialists.

I strongly suspect that yours is a very treatable condition, although the treatment might require the avoidance of cold and/or you’re your wearing a Cold Weather Mask.

Good luck

[AllergyPA]

There is a skin condition you are describing associated with the cold weather.  A second geberation antihistamine, like Allegra, helps control one part of the allergic skin reaction.  A prescription medicine, Singulair acts on another part of the allergic reaction.  You may want to ask your doctor about it.   This forum is not a substitute for a medical examination, but you may have asthma.  Asthma causes your airways to spasm causing breathing problems and could be triggered by cold weather. You may also consider getting tested for allergies, as the trigger for your breathing problems.