According to the MayoClinic.com, cold hives are essentially an allergy to cold temperatures. Dr.Greene.com states that cold hives are triggered by exposure to extremely cold temperatures, such as jumping in a cold pool or going outside during the winter months. The body's immune system reacts to the cold exposure in an abnormal way by releasing antibodies that trigger histamine in the blood, causing an allergic reaction that results in hives. Hives are local welts that are extremely itchy and appear red and elevated, according to the American Academy of Dermatology, or the AAD.
Avoidance
According to the AAD, avoidance is the best treatment for cold hives. Avoiding cold all together is not possible, but certain precautions can be implemented to ensure as little exposure to cold temperatures as possible. For example, moving to a warm climate, running the shower before entering it and carrying a sweater for air-conditioned environments will help prevent exposure to cold temperatures. The MayoClinic.com urges avoidance because in rare cases, a person with cold hives can experience life-threatening reactions that can lead to death.
Antihistamines
The American College of Allergy, Asthma and Immunology, or the ACAAI, states that antihistamines are the most common drugs used to treat cold hives. Antihistamines block the body from producing histamine in the blood, thereby avoiding the allergic reaction that causes a hives outbreak. The MayoClinic.com states that many antihistamines are available over-the-counter for prevention and treatment of cold hives.
A doctor will determine the type of antihistamine and length of use that is best for the individual's condition. A doctor may prescribe two to three different antihistamines to be taken together to get the skin under control and then recommend a nonsedative OTC antihistamine for continual treatment.
Doxepin
Doxepin is a drug commonly prescribed to treat anxiety and depression, but it is also used to treat cold hives. Doxepin is a strong drug that can affect a person's memory and can cause drowsiness, according to Drugs.com. A person taking doxepin should not drink alcohol and should contact the doctor if he notices common symptoms of an allergic reaction, such as lip swelling, wheezing and chest tightness. Drugs.com warns that doxepin impairs the ability to process information properly. Someone taking this drug should not engage in activities that require being alert. Common side effects of doxepin are dizziness, dry mouth, weight changes, increased sweating, nasal complications and nausea.
