Cold water urticaria

Welts may appear on hands, feet, arms, the face, or any area touched by cold water. Symptoms can follow a shower, rain, washing, or contact with a cold wet surface. The larger the exposed area, the more important it is to take symptoms seriously. Facial or deeper swelling can be angioedema. A rash after water is not enough to identify the cause without considering temperature, timing, and other exposures.

Avoid cold-water swimming and sudden immersion until a clinician has assessed you. Use comfortably warm water, dry off promptly, and protect the skin from wind afterwards. Keep a record of water temperature as warm or cold, the body area exposed, onset, and associated symptoms. A clinician may discuss an oral antihistamine treatment and a personal plan for bathing and activities.

Get emergency help for trouble breathing, throat or tongue swelling, faintness, confusion, severe weakness, or rapidly spreading hives after cold-water exposure. If someone reacts in water, move them to safety without putting another person at risk and seek urgent help. Repeated water-triggered reactions need medical assessment.

Ask whether bathing, rain, or swimming should be restricted, whether testing is appropriate, which medicine plan fits you, and how to respond if a water reaction affects your breathing or alertness.