foreign certified allergist I'm going to teach you everything that you need to know about cold induced hives also known as cold induced urticaria so we don't know why this happens but some people develop a chronic condition where when they are outside and exposed to cold temperatures typically below 57 degrees Fahrenheit their skin gets hives and potentially swelling that's due to abnormal Mast Cell Activation where histamine is being released in response to cold temperatures and that allows blood vessels at the top layer of your skin to open up fluid leaks out you get redness around the area and it itches intensely in very rare situations if that swelling occurs around your neck because it's been exposed to the cold that could actually make it difficult for you to breathe and that could be a life-threatening situation that would require epinephrine for treatment treatment mainly involves avoiding cold temperatures as much as you can so bundling up very well when you go outside wearing a wetsuit if you decide to go swim in a cold pool things of that nature you may need to take antihistamines on a regular basis to block the effects of histamine there are some other medications that may be used as well and in certain situations mainly my practice because I live in a mainly cold area in the winter time I will prescribe epinephrine as a safety measure just in case there's swelling around the neck that could occur in rare situations fortunately for the majority of people who have this it's typically outgrown on average about half of people outgrow it by about five to six years after diagnosis if you learn something from this content and find it helpful feel free to give me a follow to learn more