Averting Cold Weather Crises

The hallmark complication of sickle cell disease (SCD) is acute pain. Episodes of acute pain can occur at any time and are often caused by certain triggers. One of these triggers is cold weather.

Try to limit exposure to snow and cold temperatures, and stay hydrated and well-rested in the winter. If you spend time outside in the cold, dress warmly and participate in activities in short intervals. Also, take steps to prevent getting the flu and other infections.

Cold temperatures and sickle cell pain

Even if you have not experienced an acute pain episode in years, exposure to cold temperatures can trigger a crisis. People with SCD often report acute pain within hours after exposure to cold temperatures.¹

Large studies have shown a link between cold temperatures and sickle cell-related pain. We do not yet understand how all of the factors contribute to this, but some of the possible reasons include:^1-3

Colder temperatures cause blood vessels in the hands, feet, nose, and ears to narrow. This effect is larger when it is windier or when your skin is wet.
People usually drink less water when it is colder outside
Viral infections like the flu are more common in the winter
The holiday season often comes with higher stress, excitement, and more activities than normal

These factors can increase the chances of red blood cells becoming sickled and sticking to blood vessel walls. This can block blood flow and oxygen delivery, causing an acute pain episode.^1,4

Tips to avoid sickle cell crises in cold weather

There are several steps you can take to avoid sickle cell crises in cold weather.

Dress warmly with layers

Wear a warm jacket in cold weather, but try to >dress in layers so you can remove clothing if you get too hot. This can keep you from experiencing large changes in body temperature. For example, one option is to wear a thermal shirt underneath a sweater, with a jacket on top.⁵

Also, make sure to bring a hat, gloves, and scarf when you go outside. Wear warm socks, and use hand warmers inside gloves or foot warmers inside your shoes.¹

Stay dry

Wet skin can make the effect of cold temperatures worse, especially if it is windy. Try to limit your exposure to snow. Wear waterproof gloves and clothes, and bring an extra pair of dry socks with you.¹

Stay hydrated

People tend to drink less water in the winter than in the summer. Drink plenty of water when you go out into the cold. Hot beverages are also helpful. Hot chocolate, hot water, or hot tea can keep you warm and hydrated. Try not to drink too much caffeinated drinks because they can lead to dehydration.^1,6

Participate in winter activities in short intervals

Try to avoid continuous or long exposure to cold, wind, or snow. If you want to participate in winter activities, do them in short intervals of 20 tp 30 minutes. In between intervals, rest and hydrate yourself.¹

Get plenty of sleep and rest

Fatigue and stress are also linked to acute pain. Winter is often a busy and stressful time because of the holiday season. Try to minimize stress and fatigue by getting plenty of sleep. Also, know your body’s limits and take time for yourself to relax.¹

Take steps to prevent infections

The flu and other infections can be dangerous for people with SCD. These are more common in the winter because people spend more time indoors and in close contact with others. Here are some steps to help prevent infections:^1,7

• Wash your hands often with soap and water, especially before eating and after touching people or things that can carry germs
• Bring hand sanitizer with you, and use it often
• Shop online to avoid crowds in stores
• Try not to visit people who have a cold or any symptoms of an infection
• Wash vegetables and fruit before eating them
• Cook meat and eggs fully
• Make sure your vaccinations are up to date

Have pain medicines ready

Bring pain medicines such as NSAIDs with you so you can take them early if a pain crisis starts. Make sure you tell people how they can help if this happens.¹