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Unfortunately, for many cases of cold urticaria, a cause cannot be determined.
Your allergist will likely do some testing, to include possibly placing a cold object on a portion of your skin. Additional studies may be indicated, based on your personal and family history.
Avoidance of cold exposures and non-sedating anti-H1 antihistamines are generally the first treatments for cold urticaria. If these strategies are ineffective, higher antihistamine dosages may be tried, or other agents may be attempted. You should discuss your symptoms, an evaluation tailored to you, and potential strategies for managing symptoms with your allergist.