Dr. M.J. Bazos, MD
Patient Handout
ANGIOEDEMA
About Your
Diagnosis
Angioedema is almost
identical to the common skin condition of urticaria or hives. In hives, raised,
red, itchy, irregular bumps appear on your skin, whereas in angioedema the same
thing is happening but deeper in the skin. You cannot see the raised, red bumps,
but you can feel a firm swelling pushing up your normal skin. Instead of
angioedema being itchy, it may be tender or painful. Angioedema can occur
anywhere on the body, but it more commonly involves the eyelids, lips, tongue,
and external genitalia. It can also occur inside the body. In the intestines it
can cause abdominal pain, and in the airways it can cause difficulty in
breathing, which can be fatal. Fortunately the most common occurrence of
angioedema is on the outside of our body, and although uncomfortable it is not
dangerous. Anyone can get angioedema. About 15% to 20% of all individuals will
have at least one episode of hives or angioedema in their lifetime. The swelling
of angioedema is usually present for only a day or two at any one spot. However,
it often will move from one location to another and last for several days.
Sometimes it can become chronic. Angioedema is an allergic reaction that somehow
has come into your body. It is not an infection, although infections can cause
an attack of angioedema. It is not contagious, although certain types are
hereditary, and you should check to see whether other family members have had a
similar problem. The usual causes of angioedema are a new drug, a new food, a
new perfume, etc. You may even have taken that drug or food in the past without
problem, but now you have developed an allergy to it. Although no cure exists
for angioedema, it can be treated and the symptoms controlled. The main
treatment is to prevent
recurrences.
Living With Your
Diagnosis
The diagnosis of angioedema
is made by the typical appearance of the swollen skin and its tendency to come
and go. There are some blood tests that can be done, but they are not always
helpful and do not affect treatment. A family history of angioedema is very
important; therefore family members should be asked about any episodes of
angioedema they have had, and you should tell your doctor about these. The
typical rash of angioedema is puffy or swollen skin that is firm and may be
painful. The rash
can occur anywhere but
usually involves the eyelids, lips, genitalia, tongue, hands, and/or feet. The
swelling can occur inside the body as well. You must contact your doctor
immediately if you are having any trouble breathing or are wheezing, or are
having abdominal pain. Angioedema often resolves in a day or two to a week, but
in some cases it can persist and may require long-term treatment. Chronic
angioedema, although uncomfortable and irritating, usually will not progress to
a more serious
disease.
Treatment
The
primary treatment for angioedema is removal of whatever is causing the allergy.
Unfortunately the exact cause of the angioedema is often not known, and even if
it is (e.g., pollen), it may be impossible to remove it. Therefore the main
treatment of active angioedema is to control the symptoms. Application of cold
compresses may provide local comfort. Lotions and creams are usually not helpful
because they don’t penetrate deep
enough
under the skin to reach the
angioedema. Oral antihistamines work well but must be taken in adequate amounts
on a regular basis. Failure to take antihistamines regularly may result in the
angioedema coming back. Antihistamines are well known for their tendency to make
individuals drowsy, as well as to cause other side effects such as dry mouth.
Newer antihistamines have fewer side effects. If antihistamines are not
controlling
your symptoms, see your doctor.
Your doctor can prescribe stronger medications such as steroids. The best
treatment is always prevention. You should carefully examine potential causes
for your angioedema. Note if you ate a new food, wore new clothes, took a new
drug, wore a new perfume, were exposed to a new smell, or have a new job.
Anything that you can think of which might have caused your angioedema is
helpful. Sometimes your doctor may need to perform tests to find out what the
allergic problem is. If you know what triggers your angioedema, the best
treatment is to avoid that
trigger.
The
DOs
• Do seek medical aid
immediately if you are having trouble breathing or are having chest
pain.
• Do use cold compresses on the
swollen areas.
• Do take
antihistamines in proper doses for the
swelling.
• Do note immediately any
possible causes for your angioedema (new food, drug, soap, perfume,
etc.).
• Do remove or stop any
possible cause of the swelling, such as new food, new soap, or new perfume. Ask
your doctor about any drugs you are taking.
The
Don’ts
• Don’t use heat on the
swelling
• Don’t use creams,
ointments, or lotions.
When to Call
Your Doctor
• If you are having
trouble breathing, having chest pain, or having abdominal pain, contact your
doctor immediately.
• If your
angioedema is not responding to antihistamine therapy after 2 or 3 days of
continuous treatment.
• If you are
having recurrent attacks of angioedema.