The swelling is limited to the parts of the body that have been in contact with the stimulus. The symptoms are often worse after the exposed area is warmed. Holding of cold objects can cause swelling of the hand. Eating cold food may result in swelling of the lips, but swelling of the tongue and throat occurs less frequently. Generalised symptoms of flushing, headache, fainting and abdominal pain may occur if large areas are affected.
Patients typically experience symptoms while outside on cold, windy or rainy days.
Fatalities following swimming have been reported and those affected should be warned that swimming or having a cold bath could be dangerous. Place an ice cube on the patient's forearm for 4 minutes and observe the area for 10 minutes afterwards. If the patient has cold urticaria, the area will become itchy and then swell approximately 2 minutes after removing the ice cube. The most commonly form of cold urticaria seen in practise is idiopathic cold contact urticaria. There are other conditions in which exposure to cold results in whealing.