Angioedema and skin care: Navigating swelling and sensitive skin

Last updated Jan. 19, 2024, by Susie Strachan
Fact-checked by Patricia Silva, PhD

While angioedema swelling can happen suddenly, there are steps you can take to reduce swelling and care for your skin. Knowing how to help your skin recover can make you feel more in control of what can be an unsettling experience.

The swelling, which is caused by fluid buildup in the deeper layers of the skin, can irritate your skin and even be painful.

You may also notice other symptoms, such as rash, itchiness, fatigue, or abdominal pain. In some cases, angioedema can be life-threatening, especially when it affects the throat and breathing capacity.

While the condition is usually treated by an allergist or immunologist, a dermatologist can help you manage angioedema with skin care routines that protect your skin, such as finding right moisturizer to alleviate dryness. Medications and lifestyle changes can also aid your skin in recovering faster from swelling.

How angioedema affects skin

There are different types of angioedema: acute allergic angioedema, which happens suddenly from an allergic reaction, and nonallergic angioedema, which results from a reaction to certain types of medicines. Idiopathic, hereditary, and acquired angioedema are chronic disease forms, and many of these cases are thought to be associated with an underlying immune system issue.

Swelling commonly occurs on the lips, eyelids, mouth, or tongue, on extremities such as the hands or feet, and on the throat. It may also flare up in the mucosal linings of the respiratory and digestive tracts.

Angioedema attacks can cause swelling that is:

• smooth or raised in appearance
• red in color and warm to the touch, or a normal color
• accompanied by symptoms such as itchiness, hives, or pain.

Swelling in acute allergic cases often occurs rapidly, within minutes to hours. There may be a sensation of tightness or discomfort.

When angioedema affects your hands or feet, the swelling may impair your ability to perform daily tasks, such as using your fingers or even walking.

The visible swelling, especially when on your face, may make you feel self-conscious. Dealing with the unpredictability of swelling episodes can cause emotional stress and make you hesitant to take part in social activities.

Dermatologist Hamdan Abdullah Hamed, MD, who treats patients with angioedema-related skin problems, says it’s important to work with your healthcare team –– including immunologists, allergists, and, in cases where angioedema is associated with autoimmune disorders, a rheumatologist –– because a collaborative approach will enhance your health and quality of life.

“Regular checkups are important, as is mental health awareness,” says the Dubai-based dermatologist. “In many cases, patients have to undergo a drastic lifestyle change and see a visual difference in their body as time goes on. Living with angioedema can be challenging.”

Common triggers that cause swelling

An allergist or immunologist can help you to identify and manage triggers that contribute to angioedema.

The type of angioedema with which you have been diagnosed will determine the underlying triggers and the method of treatment.

For example, if you have acute allergic angioedema, exposure to allergens can prompt the release of histamine and other chemicals, leading to blood vessel leakage and subsequent swelling. You may also have itchiness, hives, and, in more severe cases, respiratory symptoms such as difficulty breathing, wheezing, or coughing.

Some common allergic angioedema triggers are:

• certain foods, like nuts, shellfish, and eggs
• insect venom from bee or wasp stings
• pollen or animal dander.

Allergic angioedema is treated with medications such as antihistamines or corticosteroids to control the allergy. You may also be advised to take preventive steps to limit future exposure to an allergen and to carry an epinephrine auto-injector, such as an EpiPen, in case of severe reactions.

Hereditary angioedema (HAE) is a genetic disorder usually caused by a deficiency or dysfunction of C1 esterase inhibitor, a protein involved in regulating part of the immune system.

Unlike allergic angioedema, HAE triggers can include:

• stress
• physical trauma
• surgery
• illness or infections
• hormonal fluctuations, such as during menstruation or pregnancy.

HAE causes an overproduction of the bradykinin protein, which regulates blood pressure and inflammation. When bradykinin is activated in the deep layers of the skin, fluid may flow from the bloodstream into nearby tissues.

HAE can be managed with preventive treatments.

Establishing a personalized skin care routine

Skin care for people with angioedema usually involves a consistent and allergen-free routine that includes using hypoallergenic products, avoiding potential triggers, and consulting with healthcare professionals for advice on managing their skin’s health during angioedema episodes.

When meeting with a patient who is living with angioedema, Hamed works with them to create a personal skin care plan that helps reduce swelling.

“A basic skin care plan would be formulated and can be changed as needed, adding or removing steps to minimize flare-ups,” he says.

He notes that as a person gets older, their skin tends to lose its elasticity, making it less firm and resilient. Older skin often becomes drier and more prone to dehydration.

Depending on the severity of angioedema swelling, older skin may not recover easily after being stretched.

“For some, episodes can be less threatening or frequent, while for others, it can be more aggressive as it progresses,” Hamed says. “However, it does have a stronger effect on aging skin, primarily because older skin is more susceptible.”

He recommends using safe skin care products for angioedema that are:

• hypoallergenic
• clinically tested
• maintain the skin’s natural pH balance
• do not contain ingredients that previously triggered swelling episodes.

While angioedema primarily affects the deeper layers of the skin, helping skin stay healthy means keeping it moisturized, taking medications to ease angioedema symptoms, and using dermatologist-recommended skin care products.

Some other tips for maintaining healthy skin with angioedema are:

• using gentle and fragrance-free products for sensitive skin
• using mild soaps, cleansers, and moisturizers
• avoiding harsh exfoliating products and scrubbing too hard, which can irritate skin
• bathing and showering in lukewarm water to reduce the likelihood of irritation
• trying over-the-counter anti-itch creams that contain ingredients like calamine or hydrocortisone to help with itchiness
• preventing further irritation or damage to the skin by not scratching the affected areas
• taking antihistamines as recommended by a healthcare professional
• applying cool compresses to the affected areas during a swelling episode.

Protecting skin from environmental factors

Environmental factors such as sunlight and extreme temperatures (both hot and cold) can trigger angioedema swelling.

Apply a sunscreen with a high SPF daily to protect your skin from sun exposure — a sunburn can trigger or make angioedema episodes worse. Consider wearing protective clothing and staying in the shade when outdoors.

The cumulative effects of sun exposure become more noticeable as you get older. Ultraviolet (UV) rays can accelerate the breakdown of collagen and elastin fibers, leading to premature aging and an increased risk of skin cancers.

Hydration and nutrition

Diet can play a role in angioedema skin care, particularly when there are underlying issues such as food allergies or sensitivities. Hydrated skin is generally healthier and more resilient, which is why it’s important to drink plenty of water and other fluids.

Some people may be sensitive to certain food additives, preservatives, or artificial colors. Reading food labels and minimizing the intake of processed foods with additives may be beneficial.

Hamed says taking skin supplements may help your skin bounce back from swelling episodes.

“Look for a combination that contains ingredients such as biotin for nail strength, vitamin E for the lipid layer in the skin, vitamins C, an antioxidant which reduces effect of sun’s rays on the skin, and vitamin B1, B6 and more, used for maintaining a healthy nervous system, which in turn aids in circulation,” he says.

Before making significant changes to your diet, consult with your primary healthcare provider or a registered dietitian.

Angioedema News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.