Cold weather allergies
Most people tormented by allergies start crossing their fingers and refreshing their medication the minute they get one whiff of spring's bounty of grasses, trees and flowers.
But once cooler weather hits, there's another segment of the population that prepares itself for Mother Nature's mischief. The mayhem surprisingly can happen indoors too - as people escape the frigid temperatures outside. Take a look at some of these cold-weather culprits.
Cold Facts: Some people get rosy cheeks in the cold weather. For others, plummeting temperatures cause a breakout of cold-induced urticaria, also known as "cold-induced hives," says Dr. Marjorie Slankard, a board-certified allergist and immunologist and clinical professor of medicine at Columbia University in New York. These welts - they're a reaction to cold weather or cold water and are often itchy - can be as large as a half-dollar, may appear suddenly and may reoccur chronically with exposure to cold.
Remedy: The appearance of cold-weather hives requires a visit to a medical doctor who'll test for abnormal proteins in the blood, called cryoglobulins, that are activated by exposure to the cold, says Slankard, who's also in clinical practice at ColumbiaDoctors Eastside, in New York. If cryoglobulins are present, further evaluation is needed to check for underlying causes, including hepatitis C.
Other precautions to take include keeping the body as covered up as possible and taking an OTC nondrowsy antihistamine before going out in the cold or into cold water. If OTC medication doesn't help, a physician may suggest Periactin, a prescription drug with the active ingredient cyproheptadine, which has side effects such as drowsiness and possible weight gain.
Cold Facts: Cold-induced angiodema - swelling in the deeper tissues - is often associated with cold-induced urticaria. However, says Slankard, swelling is potentially a more dangerous response because it may precipitate a drop in blood pressure. This, in turn, may lead to light-headedness or more serious symptoms. In contrast with the itching of hives, cold-induced angioedema typically causes burning or pain.
Remedy: If taking an OTC nondrowsy antihistamine before going outdoors doesn't help, following the pharmaceutical protocol for cold-induced urticaria may provide relief.
Cold Facts: In some individuals, exposure of the hands and feet to the cold may lead to severe constriction of the blood vessels. The result, says Slankard, is decreased oxygen to those areas, which causes the skin to go white and become painful. As the skin warms up, the affected body parts often turn a rainbow of colors - blue followed by red. When Raynaud's becomes chronic, the skin, tissue under the skin and even muscles may atrophy. Fingernails may become brittle and marked by longitudinal ridges.
Remedy: It's important to seek additional medical attention to rule out Raynaud's syndrome, also known as secondary Raynaud's. Secondary Raynaud's may be associated with systemic lupus erythematosus (SLE), other immune disorders and even medications such as beta blockers, says Slankard. In extreme cases, the fingertips may be so adversely affected that skin ulcerations or gangrene may result.
Protective clothing, especially for the extremities, is a must. If SLE has been ruled out but the patient still experiences severe symptoms, Slankard suggests a visit to a vascular specialist for further evaluation.
Cold Facts: For some individuals, simply breathing cold air into the lungs is all it takes to bring on an asthma attack, with shortness of breath and constriction of the airways. Cold dry air is sometimes a more potent trigger than the cold moist variety, says Slankard. Cold winds can also fuel an attack, and typical winter-weather flu and colds can worsen asthma symptoms.
Remedy: To keep your mouth and nose warm and help ensure that you're breathing warm air, generously cover these body parts with protective outerwear, says Slankard. Carry a rescue inhaler, such as albuterol or levalbuterol, at all times, and use it before exposure to the cold. If necessary, avoid exercising outdoors in frigid temperatures or even in unheated indoor facilities.
Cold Facts: Although it's technically not an allergy, vasomotor rhinitis - the common runny nose - nevertheless behaves like an allergy. Symptoms of this condition - continuously runny noses, sneezing, nasal congestion and post-nasal drip can all be part of the mix - may suddenly erupt in cold-sensitive people after they do nothing more than set their feet down on a cold floor, says Slankard.
Remedy: Antihistamines typically provide no relief for this condition. However, she says, prescription nasal sprays - including nasal antihistamines, nasal cholinergic inhibitors (ipratropium), or nasal steroids - may provide relief.
Cold Facts: It's far more comfy watching snow, sleet and bundled-up neighbors when you're ensconced on a plush sofa or pillowed up in bed on a soft mattress. But you may have company. House dust mites, which allergists often refer to as HDM, also like to
burrow - in upholstery, bedding and linens, says Dr. Sakina Bajowala, a board-certified allergist and immunologist in private practice in North Aurora, Ill.
These microscopic critters have quite an appetite, gobbling up skin that humans regularly shed. As they dine, says Bajowala, the mites secrete digestive enzymes, especially proteases, which wind up in their fecal matter. These substances - as well as the mites' external structure - may trigger allergic symptoms that include runny noses, wheezing, congestion, headaches, itching and asthma. Fortunately, blocking the activities of Dermatophagoides farinae and other dust mite brethren is relatively easy.
Remedy: Dust mite covers do a great job keeping these at a safe distance. That's because the weave of these special fabrics is very tight - typically less than 10 microns - which helps ensure that mites can't squirm their way in and out of your possessions, she says. As a precaution, wash bedding at least once a week in very hot water. If family members are dust mite-sensitive, keep fabrics in the home to a minimum by eliminating drapes and opting for blinds or other window treatments.
Cold Facts: Bringing nature indoors is one way to fuel the winter-holiday spirit. Unfortunately, says Bajowala, decking your home with evergreen trees, wreaths or garlands may also heighten allergies. That's because evergreens may harbor naturally forming mold on their needles and fruits.
Remedy: Some holiday tree farms put their trees into a "shaker" with an eye towards dislodging the mold. But if your tree still provokes allergic reactions, try an OTC nondrowsy or long acting antihistamine, says Bajowala, who notes that an artificial tree may be the most trouble-free solution of all.
Cold Facts: With an onslaught of cold weather, most people start insulating by layering their clothing. Trouble is, some winter fabrics, such as wool, contain short and rigid fibers that can provoke skin itching. The people most susceptible are often those who have thinner skin or existing skin conditions, such as eczema.
Remedy: To cut down the scratchiness quotient, make sure the first-layer garment touching your skin is made of 100 percent cotton, says Bajowala. Once that cotton layer is in place, consider experimenting with synthetic fabrics, especially garments that athletes wear in the cold weather. Read clothing labels carefully, and stay away from garments that have been coated with resins or other chemicals. And, because dry skin is more susceptible to irritation from fabrics, moisturizing your skin is a must, she says.
Cold Facts: One tasty antidote to cold weather is the variety of food that becomes available as holiday time approaches. However, there are seldom labels of ingredients on the pot-luck offerings from family and friends or the food served at catered events or office parties. For people who are food-sensitive or allergic to certain foods, the season presents the problem of having less control over what's being served, says Bajowala.
Remedy: Good communication is key. Ask if these foods - fruit cakes, eggnog and casseroles are often red flags - contain ingredients on your "do not eat" list, especially nuts. Be vigilant and, if necessary, abstain from eating potentially appetizing but harmful dishes. If you have already been diagnosed with a food allergy, she says, be sure to carry your emergency medication with you at all times.