Symptoms of Angioedema

Angioedema is swelling under the skin that often happens as an allergic reaction. Symptoms of angioedema include swelling of the eyes, lips, hands, feet, legs, or genitals. Other common angioedema symptoms include:

• Dizziness
• Patchy welts
• Rash
• Redness
• Upset stomach 

Less common angioedema symptoms include: 

• Breathing difficulties
• Burning sensation on the skin
• Itching
• Tingling
• Trouble chewing or swallowing
• Diarrhea

Angioedema symptoms come on suddenly and range in severity but are rarely life-threatening. This article discusses angioedema symptoms, possible complications, and when you should see a healthcare provider.

Common Symptoms of Angioedema

Symptoms of angioedema can appear alongside other allergy symptoms, such as hives. This may happen if the trigger is something you're allergic to, such as food, medications, clothing, cosmetics, or an insect bite. In cases of allergy, angioedema progresses rapidly within a few hours and can resolve as quickly as it started, particularly if appropriate treatment is given.

At other times, angioedema symptoms may begin without an identifiable reason. If you have hereditary angioedema, symptoms can occur spontaneously without a specific trigger, or they may occur in times of stress like during or after surgery or illness. In these cases, angioedema symptoms can develop more slowly over a couple of days.

The most common symptoms of angioedema include:

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• Swelling: The hallmark of angioedema is swelling and puffiness of the eyes or lips. It may also affect the hands, feet or legs, and less often may involve genitalia. Swelling can develop in the throat and tongue as well, and this can affect breathing or eating due to physical obstruction of the airway and food pipe. Swelling is not pitting, meaning that you cannot produce an indentation in the puffy area by pressing on it.
• Redness: Redness can accompany the swelling or may appear on its own. It can appear as numerous small spots or as patchy areas and can be raised or flat. It may appear anywhere on the body, including areas that are not swollen, but often affects swollen areas or appears at the edges of the swollen areas. Redness is often blanching, which means that it briefly becomes pale when you press on it, but then returns to red again within a few minutes.
• Rash: A rash, which may appear as small bumps or flat areas clustered together, can develop anywhere on the skin and is usually reddish.
• Patchy welts: You can develop patches of slightly raised skin, usually reddish or pink in color. These patches are often described as welts. 
• Dizziness: A sense of mild to moderate lightheadedness can accompany the skin changes of angioedema.
• Stomach upset: You may experience stomach discomfort or nausea in association with angioedema. Sometimes this occurs together with other symptoms of allergy or hereditary angioedema; other times it occurs in isolation without other symptoms.

Less Common Symptoms of Angioedema

Less common symptoms of angioedema include sensory changes of the skin, GI problems, and trouble breathing. For example:

• Itching: Occasional itching may accompany the redness and swelling with angioedema, but usually, itching is a sign of other conditions such as contact dermatitis.
• Tingling: Tingling or another non-painful sensation can accompany the swelling of angioedema.
• Burning: A mildly painful burning sensation may occur with angioedema, particularly on the swollen areas of the body.
• Diarrhea: Occurring less often than most symptoms, mild diarrhea can accompany angioedema. This occurs as a result of swelling of the digestive system. It is especially rare for diarrhea to be the only symptom of angioedema, although this can happen.
• Trouble eating: If your tongue and throat become swollen due to angioedema, the swelling may physically interfere with your ability to chew and swallow food. This can increase your chances of choking.
• Breathing difficulties: Swelling does not usually involve the throat and tongue, but when it does, breathing difficulties may occur as a result of physical obstruction of your airway.

Complications

Generally, angioedema resolves on its own or with treatment. However, while it is not common, angioedema can cause serious, or even life threatening, complications.

Complications of angioedema include:

• Breathing obstruction: If the swelling in your throat and tongue is extensive, this can impair breathing, preventing air from getting through efficiently. In rare instances, this is a medical emergency, requiring medical or surgical intervention to clear your airway.
• Shortness of breath: Shortness of breath may occur with angioedema. This is different than the breathing difficulty that occurs due to tongue and throat swelling. In some instances, angioedema can induce actual changes in your respiratory abilities, which requires urgent medical attention.
• Respiratory arrest: If you have angioedema, your immune system can overreact to such an extent that breathing suddenly stops. This is a life-threatening situation requiring emergency medical assistance.

When to See a Doctor

It is not possible to predict whether your symptoms will become worse, especially if you have not had angioedema before. And, because the symptoms of angioedema are so sudden and often vague, it is hard to know what is happening. If you experience any of the following symptoms, you should seek medical attention:

• Shortness of breath: If you experience shortness of breath or feel that you cannot breathe, this could get worse very quickly. You should call for emergency help. If your child or someone else becomes short of breath, you should call for emergency help as well.
• Faintness, dizziness, or lightheadedness: This could be a sign that you are having a severe reaction that may not quickly resolve on its own.
• Swelling of your throat or tongue: As with shortness of breath, things can progress rapidly. Even if you are fully conscious, the swelling may quickly block your airway.
• A strong allergic reaction: If you have had a serious, life-threatening reaction to an allergen before, you could have the same response upon repeated exposure to the allergen. This includes shortness of breath, loss of consciousness, tongue swelling, or heart symptoms. If you have a tendency to have a severe reaction to a particular allergen, you likely will need to carry an epinephrine auto-injector (e.g. EpiPen) at all times so that you can use it whenever symptoms start to occur. Ask your physician for evaluation if you think you need a prescription for one.