Angioedema

Angioedema is a condition in which swelling of the skin occurs due to an allergic reaction. It is similar to hives, but affects the deeper skin tissues (subcutaneous tissue, mucosa and submucosa tissues).

It commonly affects areas of the face such as the eyes and lips, and typically causes large, firm welts to appear. In some cases, the welts may obstruct vision.After the initial contact with an allergen, an allergic reaction can take anywhere from minutes to hours to develop. In most cases, swelling caused by angioedema will go away on its own after a few days.

The condition is generally harmless, unless it affects your throat or tongue, causing it to swell up, blocking air passages and restricting breathing. Internal organs can also be involved. Seek immediate medical attention if you feel your throat swelling or have trouble breathing.

Common features of angioedema include:

  • Thick welts that turn pale and swollen
  • A feeling of warmth and discomfort in the affected area
  • In severe cases, there may be difficulty swallowing or breathing, gastro-intestinal symptoms as well as cardiac side effects

Angioedema is caused by an allergic reaction that results in the release of histamine and histamine-like substances from cells called “mast cells” in the dermis.

These cells have multiple receptors that, when activated, permit the discharge of the products contained in tiny packages in the skin. Substances that are released into the bloodstream, such as histamine, allow blood vessels in the dermis to dilate, creating a red appearance and also causing water to leak into the skin, which produces swelling.

The exact cause of hives is often not fully understood, and it may be triggered by a variety of factors such as foods, medications, infections, or illness. In some cases there is a genetic aspect to this, which produces an enzyme deficiency (c1 esterase inhibitor or coagulation factor 12 gene defect).

General skin care is important for you in general. Because of the sensitive and inflammatory nature of this condition, take great care when choosing skincare products.

Avoid soaps, especially bar soaps, as they will dry the skin and may damage the skin barrier. Instead, opt for mild soap-free cleansers, preferably in liquid form. These cleansers will gently remove dirt, excess oil, bacteria and cosmetics without damaging the skin barrier.Be careful to limit contact with hot water, as this can actually dry out the skin further.

Moisturizers help restore and maintain the skin’s natural moisture levels. Look for a moisturizer specially designed for sensitive skin that is free of fragrance, dye or other allergens that may irritate the skin. Frequent application of moisturizers can help soothe dry and itchy spots.If you are experiencing severe itching, do not scratch the affected area, as it can lead to scarring, increased pigmentation (darkening of the skin), thickening of the skin, or infection. Instead, gently pat the skin, or apply a damp compress for relief.

Overall, the best course of action to prevent angioedema is to be able to identify and avoid the specific factors causing the reaction.

OTC
Taking an oral antihistamine can often help reduce the symptoms of angioedema. They can block the histamine receptors in the skin, which produce the symptoms of angioedema. Diphenhydramine (Benadryl) is considered one of the most effective medications for treating angioedema, but can cause drowsiness. A doctor may suggest non-sedating antihistamines such as Cetirizine (Zyrtec), Fexofenadine (Allegra) or Loratadine (Claritin)

Prescription
If the cause of the allergic reaction is known, a doctor may prescribe oral corticosteroids to help relieve swelling, redness and itching. There are a number of prescription antihistamines that are helpful. Some of them can be sedating, which at least can give the patient relief from intense itching and discomfort.