Facial Swelling: Allergies or Other Underlying Issues?

Facial edema

Hello Dr.
Zhao,
About a week ago, my face started to swell.
It happened right after I had dinner at an Italian restaurant, so the doctor suspected it was a food allergy.
After taking Prednisone for three days, the swelling is not as severe as it was initially, but there is still some edema in my face.
I then consulted a second doctor who believes it might be an allergy to environmental substances (like pollen) and recommended that I take antihistamines.
Although the swelling is not as bad as it was a week ago, it is still present.
I also noticed that after eating or making larger movements with my face, the swelling temporarily increases but then subsides after a while.
Aside from the facial swelling, I do not have any other noticeable symptoms (my neck is normal, with no enlargement, and I do not have a fever).
Could you please advise if this is indeed an allergy or if there might be another issue? I do not have any other medical conditions, but I have a family history of liver cancer and lung cancer.
Thank you!

Bebe, 30~39 year old female. Ask Date: 2005/08/28

Dr. Zhao Chongliang reply Internal Medicine

Hello! Your symptoms sound like angioedema (also known as angioneurotic edema or Quincke's edema).
It is a type of allergic reaction caused by a deficiency of C1 esterase inhibitor, leading to the release of histamine and other chemicals into the bloodstream after exposure to certain substances, physical, or psychological stimuli.
This results in well-defined subcutaneous edema, particularly on the face, especially around the eyes, lips, and conjunctiva.
In some cases, it can cause laryngeal edema, which may lead to life-threatening respiratory difficulties.
It can be hereditary.
Treatment involves avoiding triggers and administering medications such as epinephrine, corticosteroids, sedatives, and antihistamines to reduce the allergic response.
Therefore, it is important for you to avoid known allergenic foods, and the treatment approach you are following is appropriate.

Reply Date: 2005/08/28

More Info

Hello! Thank you for reaching out with your concerns about facial swelling. Based on your description, it seems like you are experiencing a complex situation that could indeed be related to allergies, but there are other factors to consider as well.

Facial swelling, or edema, can occur for various reasons, and allergies are one of the most common causes. When you mentioned that the swelling began after dining at an Italian restaurant, it’s reasonable to suspect a food allergy, particularly if the meal contained common allergens such as shellfish, nuts, or dairy. The fact that you were prescribed Prednisone, a corticosteroid, suggests that your doctor was addressing a significant inflammatory response, which is typical in allergic reactions.

The subsequent recommendation to take antihistamines indicates that your healthcare provider is considering environmental allergens, such as pollen or dust mites, as potential triggers for your symptoms. Antihistamines are effective in managing allergic reactions by blocking the action of histamine, a substance in the body that causes allergic symptoms.

You mentioned that the swelling has decreased but persists, and that it temporarily worsens after eating or making facial movements. This could suggest that while allergies are a contributing factor, there may be other underlying issues at play. For instance, conditions such as angioedema, which is a deeper swelling of the skin often associated with allergic reactions, can cause prolonged swelling. Additionally, certain foods or additives can cause delayed allergic reactions, leading to ongoing symptoms even after the initial exposure.

Another possibility to consider is the role of fluid retention, which can be influenced by dietary factors (such as high salt intake), hormonal changes, or even stress. If you have been under stress or have made changes to your diet recently, these could also contribute to facial swelling.

Given your family history of serious illnesses like liver and lung cancer, it’s understandable to be concerned about any unusual symptoms. While your current symptoms are likely related to allergies or inflammation, it’s always prudent to monitor any changes closely. If the swelling persists or worsens, or if you develop new symptoms such as difficulty breathing, hives, or gastrointestinal issues, it would be wise to seek further evaluation from a healthcare professional.

In conclusion, while your symptoms are likely related to allergies, it’s essential to consider other potential causes and to continue monitoring your condition. If you haven’t already, keeping a symptom diary could be beneficial. Note when the swelling occurs, any foods or environmental factors that coincide with the symptoms, and how long the swelling lasts. This information can be invaluable for your healthcare provider in determining the best course of action.

If you have any further questions or concerns, please don’t hesitate to reach out. Your health and well-being are important, and it’s crucial to address any ongoing issues with a qualified healthcare professional.

Similar Q&A

Understanding Facial Redness and Swelling: Possible Causes and Solutions

Hello Doctor: I go back to my hometown about once a week, and every time I return, I notice that my skin in the room becomes red and swollen, resembling the size of acne, and it keeps increasing. I initially thought it was due to poor air circulation in the room causing an allerg...

Dr. Wu Yuxin reply Dermatology
Without actually seeing the lesion, it is impossible to determine the issue. If it is very concerning, please seek medical attention as soon as possible. A proper examination is necessary to understand the problem and to determine the appropriate course of action.

Understanding Facial Swelling: Allergies or Acne Complications?

Hello, doctor. My nose tip is swollen (it doesn't hurt but feels hard to the touch), and the sides of my nose are also swollen (it doesn't hurt but feels like there's a pimple under the skin). Additionally, my cheeks look swollen from below the eye bags, and they f...

Dr. Li Yufen reply Dermatology
Hello: Based solely on the textual description, it is not possible to accurately diagnose skin diseases. Allergies affecting the nose can potentially cause puffiness under the eyes and dark circles, as symptoms may include difficulty breathing, frequent insomnia, and the presence...

Understanding Redness and Swelling: Skin Conditions of the Face and Body

Hello Doctor, about seven months ago, I experienced inflammation on my face. The dermatologist prescribed me doxycycline 100mg to take twice a day and Metronidazole topical cream 0.75%. I also took an allergy medication, Loratadine 10mg. Two months ago, my condition improved, but...

Dr. Huang Ruiyun reply Dermatology
Hello: I’m sorry, but even with the photos you provided, I am unable to make a diagnosis due to regulations. Since you have already had a biopsy, you should continue with follow-up care (there should be some blood tests as well, right?). Providing you with possible differential d...

Should You See a Rheumatologist for Persistent Allergy Symptoms?

Two weeks ago, on Monday night, I stayed up late and woke up the next morning to find that my lower eyelid was swollen, extending to my cheekbone. I confirmed there was no external trauma and thought it might be due to allergies and fatigue, expecting the swelling to subside. By ...

Dr. Zeng Guosen reply Internal Medicine
Hello, based on your situation, it may be angioedema, which can have many causes, with allergies being just one of them. I recommend that you visit a dermatologist or an immunology/rheumatology specialist for further evaluation and treatment. Thank you for your question.