Swelling Around the Nose: Allergies or Other Issues?

Swelling above the nasal wings on both sides of the nasal bridge?

Hello, doctor.
I have suffered from allergic rhinitis since childhood, experiencing daily sneezing and frequent nasal congestion.
Over the past year, I have noticed occasional swelling on both sides of my nasal bridge and above my nostrils.
Additionally, the inner side of my upper lip (the area that flips up, located at the philtrum) also shows signs of swelling.
The frequency of these episodes is about every few weeks, or sometimes just once every couple of months.
The swollen areas on my nose are not painful to the touch, and their shape and edges are not distinct; they feel like cartilage—neither hard nor soft.
Sometimes only one side swells, while other times both sides are affected, making my nose appear flatter and my nostrils wider.
The swelling on my lip is not visually prominent, and it is also not painful or itchy when pressed.
However, the swollen area slightly elevates the nasal portion, making the tip of my nose point upwards.
I experience a mild tingling sensation from my upper lip to the tip of my nose, but it is not to the extent of numbness.
The swelling of the lip and nose occurs together, often with one swelling first, followed by the other, without a fixed order.
After about a day, the swelling resolves on its own, and my nose returns to normal without leaving any traces.
My nasal discharge is clear, and I do not experience any other discomfort outside of my mouth and nose.
I have not taken any medications or vitamins, nor have I used nasal sprays, and my diet remains normal without any changes (the last time I had a cold was at least six months ago).

Doctor, could this be simply an allergy or inflammation, or is it something else? Thank you!

W, 10~19 year old female. Ask Date: 2017/09/19

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on your current description, it is most likely a "nasolabial cyst" associated with recurrent infections that require further examination.
If necessary, a CT scan or even surgical intervention may be needed if symptoms persist.
It is advisable to consult an otolaryngologist for evaluation.
Wishing you peace and good health.
Sincerely, Dr.
Chi Chao-Yun, Head of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2017/09/19

More Info

Based on your description, it sounds like you are experiencing episodes of localized swelling around your nose and upper lip, which could be related to your history of allergic rhinitis. Given that you have a known history of allergies, it is plausible that these episodes are indeed allergic reactions, but there are other potential causes that should be considered as well.

Possible Causes of Swelling Around the Nose
1. Allergic Reactions: Your symptoms align with allergic responses, particularly since you have a history of allergic rhinitis. Allergies can cause localized swelling due to histamine release, which leads to inflammation and fluid accumulation in the tissues. Common allergens include pollen, dust mites, pet dander, and certain foods. The swelling you describe, especially if it occurs suddenly and resolves quickly, could be a form of angioedema, which is a deeper swelling often associated with allergic reactions.

2. Angioedema: This condition involves swelling in the deeper layers of the skin and can occur in response to allergens, medications, or even stress. The fact that the swelling is soft and not painful aligns with angioedema. It can affect the face, including the lips and nose, and may occur in episodes.

3. Infections: Although less likely given your symptom pattern, localized infections or sinusitis can cause swelling around the nasal area. However, these typically present with pain, redness, and possibly fever, which you have not mentioned.

4. Vascular Issues: Conditions affecting blood vessels, such as vasculitis, can lead to swelling. However, these are usually accompanied by other systemic symptoms.

5. Other Dermatological Conditions: Conditions such as dermatitis or eczema can cause localized swelling and might be triggered by irritants or allergens. However, these would typically present with additional symptoms like redness, itching, or scaling.

Recommendations
1. Allergy Testing: Since you have a history of allergic rhinitis, consider seeing an allergist for testing. Identifying specific allergens can help you avoid triggers and manage your symptoms more effectively.

2. Antihistamines: Over-the-counter antihistamines may help alleviate your symptoms during episodes. These medications can reduce the histamine response and help with swelling.

3. Avoidance of Triggers: Pay attention to any potential triggers that coincide with the onset of your symptoms. Keeping a diary of your symptoms and any environmental changes may help identify patterns.

4. Consultation with a Specialist: If the episodes persist or worsen, it may be beneficial to consult with an ear, nose, and throat (ENT) specialist or an allergist. They can provide a thorough examination and may recommend imaging studies or further tests to rule out other conditions.

5. Monitoring Symptoms: Keep track of the frequency and duration of your episodes. If you notice any changes in the pattern, such as increased frequency or additional symptoms, seek medical attention promptly.

In conclusion, while your symptoms are likely related to allergies, it is essential to consider other potential causes. A thorough evaluation by a healthcare professional can help clarify the diagnosis and guide appropriate management strategies.

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