Swelling of the lips, eyelids, hands or feet that comes on over hours and takes days to settle. About half of chronic urticaria patients get it at some point. Most episodes are uncomfortable rather than dangerous — but some are an emergency, and knowing the difference matters.
Call emergency services immediately for swelling of the tongue or throat, a change in your voice, difficulty breathing or swallowing, noisy breathing, dizziness or collapse. Airway swelling can progress quickly. Do not wait to see whether it improves, and do not drive yourself.
Angioedema is swelling in the deeper layers of the skin and the tissue beneath it, caused by fluid leaking from small blood vessels. Hives affect the surface of the skin; angioedema affects what lies underneath.
Hives are raised, red, very itchy and fade within 24 hours. Angioedema is usually skin-coloured, more painful or tight than itchy, and can take one to three days to resolve. The two frequently occur together.
Most often the lips, around the eyes, and the hands and feet. It can also affect the tongue, throat, genitals, and occasionally the gut lining, which causes abdominal pain and vomiting without any visible swelling.
Swelling builds over hours rather than minutes and lingers for days. Waking with a swollen lip or eyelid that was normal at bedtime is a typical pattern.
Angioedema alongside chronic hives usually shares the same underlying mechanism, and patients who get both tend to have a longer course. See chronic urticaria.
This distinction changes the treatment completely, so it is worth understanding.
The common type, occurring with hives, allergies or chronic urticaria. Itching is usually present. It responds to the standard urticaria treatments including antihistamines.
Certain blood-pressure medicines, particularly ACE inhibitors, can cause angioedema — sometimes after months or years of uneventful use, and often without any hives. If this applies to you, tell your doctor promptly; never stop a prescribed medicine on your own.
A rare inherited condition causing recurrent swelling without hives, often with a family history and attacks starting in childhood or the teens. It does not respond to antihistamines, steroids or adrenaline, and needs specific diagnosis and treatment. If you have swelling without hives, ask your doctor about testing for it.
Tongue or throat swelling, voice change, breathing or swallowing difficulty. Make sure your family knows them too, and carry any emergency medication your doctor has prescribed.
Review with your doctor whether anything you take, particularly blood-pressure medicines and anti-inflammatory painkillers, could be contributing.
These worsen swelling and hives in a significant minority of patients. Ask your doctor what is safe for you to use for pain or fever.
Swelling usually settles before an appointment. Dated photographs help your doctor judge the pattern and severity.
When angioedema occurs with chronic hives, controlling the underlying condition is what reduces the swelling episodes. See our treatment approach.
Speak with a Life Force homeopath about your history and get an honest assessment of your case. Online consultations worldwide.