Urticaria - Wind-Cold Pattern

TCM differentiation and treatment for urticaria with

Urticaria · Wind-Cold Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Skin


Pattern Overview

Wind-Cold is a common pattern in urticaria, characterized by

**cold-induced mast cell degranulation, wheals triggered by cold

exposure, intense itching, and winter exacerbation**. The core

pathogenesis is invasion of Wind-Cold pathogens into the exterior,

causing cold-induced mast cell degranulation, histamine release, and

wheal formation.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

exposure, winter exacerbation |

Associated Symptoms

or pale wheals |

Tongue and Pulse

floating and tense pulse |

Pathogenesis Wind-Cold pathogens binding the exterior
Etiology

cold urticaria |


Acupuncture Point Prescription

Point Location Function
Fengchi (GB20)

sternocleidomastoid and trapezius | Disperses Wind and releases the

exterior |

Hegu (LI4)

metacarpals | Disperses Wind and releases the exterior |

Lieque (LU7)

depression between the tendons | Diffuses the Lung and disperses

Wind-Cold |

Quchi (LI11) Lateral end of the elbow crease

and stops itching |

Xuehai (SP10) On the medial thigh, 2 cun above the patella

Cools Blood and stops itching |

Clinical Recommendation: Filament needle, reducing method;

moxibustion may be added to disperse Cold.


Herbal Formula

Base Formula: Gui Zhi Ma Huang Ge Ban Tang (桂枝麻黄各半汤) or Jing

Fang Bai Du San (荆防败毒散)

Composition:

Cinnamon Twig (Gui Zhi), Ephedra (Ma Huang), Schizonepeta (Jing Jie),

Saposhnikovia (Fang Feng), Notopterygium (Qiang Huo), White Peony (Bai

Shao), Ginger (Sheng Jiang), Licorice (Gan Cao)

Action: Disperses Wind-Cold, releases the exterior, and stops

itching.

Modifications

Associated Symptoms Additions/Subtractions
Intense itching Add Bai Xian Pi, Ku Shen to stop itching
No sweating Add Ma Huang, Gui Zhi to release the exterior
Chills Add Fu Zi, Xi Xin to warm and disperse Cold
Pale wheals Add Gui Zhi, Sheng Jiang to warm the meridians

Western Mechanism Reference

Cold-induced mast cell degranulation and histamine release, with cold

urticaria and TRPA1 channel activation. Wind-Cold corresponds to cold

urticaria, where cold exposure activates TRPA1 channels inducing mast

cell degranulation and histamine release.


References

1. Dermatology of TCM - Urticaria with Wind-Cold.

2. Zang-Fu Pattern Differentiation: Wind-Cold Binding the Exterior →

Clearing Pathway.

3. WHO. (2023). Skin health. World Health Organization.


Explore More

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Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.