Angioedema is a rapid swelling of the deep layers below the surface of the skin or mucosa. Hives may accompany the swelling, and both angioedema and hives can result from an allergic reaction.
Angioedema mainly affects areas of loose skin, such as around the genitals, face, or under the neck. The swelling is the result of a buildup of fluid.
When angioedema occurs around the throat, it can become life threatening. Angioedema often occurs with hives, but they may not always appear together.
In this article, we explore the link between angioedema and hives. We look at the symptoms and causes of the two conditions and the potential treatments and complications.
Hives, known medically as urticaria, are raised, itchy areas that appear on the skin and come on suddenly and without warning. They are often red, range in size, and typically appear in groups.
About 25% of people in the United States may develop hives in their lifetime.
Angioedema can appear at the same time as, or independent of, hives. While hives involve swelling on the skin’s surface, angioedema causes swelling in the deeper layers of skin and under the fat.
Angioedema can be severe when the swelling occurs around the throat and neck. According to a 2014 study, hospitals reported 5,785 deaths between 1979–2010, indicating that deaths from angioedema are rare.
The primary symptom of angioedema is swelling in nearly any body area, but it is also associated with hives and other symptoms.
The following are possible symptoms a person may experience due to angioedema:
Sudden or rapid swelling under the skin is the
Swelling may also appear around the hands, feet, or genitalia.
Life threatening swelling
A more severe reaction can cause swelling around the airways and changes in blood pressure. Rapid-acting medications can help prevent severe complications and death.
Symptoms to watch for that
- voice changes
- throat or tongue swelling
- severe and sudden trouble breathing
- feeling faint
- stridor (a harsh, vibrating noise when breathing)
Hives often accompany angioedema. Hives are an itchy, raised rash that is usually red.
In addition to swelling and hives, angioedema may cause other symptoms not relating to the skin, such as:
- abdominal pain
- shortness of breath
The most common cause of angioedema is allergies. When allergies cause angioedema, a person may also experience hives along with swelling. Hyperthyroid conditions, such as Hashimoto’s or Graves’ disease, may also
In addition to allergies, a person may experience a nonallergic reaction to a medication. One of the
Another possible cause is hereditary. In this case, certain enzymes in the immune system are insufficient or have damage.
Acquired angioedema occurs due to autoimmune disease or infections. Although rare, it may also be the result of cancers such as lymphoma.
In some cases, doctors may not know the cause of the angioedema.
When might someone have angioedema with no hives?
A person is most likely to experience angioedema with hives due to allergies and thyroid disease.
Other causes of angioedema, such as reactions to medications, will not usually cause hives.
Risk factors for angioedema may include:
- being Hispanic
- a cardiopulmonary disease
- a history of smoking
- ACE-I medication
Additionally, previous angioedema puts a person at a higher risk of developing it again. Living with allergies can also put a person at higher risk of angioedema.
Often, angioedema with or without hives starts suddenly and goes away quickly without treatment.
A doctor may recommend steroids or antihistamines to help symptoms improve faster. In life threatening or severe cases, a person may need epinephrine, an injectable medication.
With or without treatment, angioedema recurrence is
Lifestyle and home remedies
People can try to make lifestyle changes for preventative medicine. By avoiding known triggers, a person may prevent angioedema from occurring frequently or at all.
When swelling occurs, a person can use cool, wet wraps to provide some relief. They may also find that wearing loose-fitting clothing helps.
In most cases, angioedema and hives are self-limiting, meaning they will go away on their own.
A person can take steps to prevent angioedema from occurring by avoiding known allergens. Avoiding medications or other substances that trigger a response may also help.
Some common allergens include:
- mold or mildew
- insect bites
- poison ivy or other plants
A person may consider seeing an allergist to help determine potential allergens to avoid.
Diagnosing angioedema and hives can vary depending on the suspected cause.
Allergens cause the majority of angioedema and hives cases. Part of the diagnosis may involve an allergist who can help identify allergens that trigger a response and recommend preventative treatment.
For suspected hereditary causes, a doctor will order blood tests.
Most cases of angioedema improve either on their own or with the use of medication. Most people will experience a full recovery.
Although a person could die from a severe angioedema reaction, this is rare and typically only happens when the swelling affects the airways.
Angioedema and hives frequently occur together. The most common cause of angioedema is allergens. Other causes include certain medications, genes, and other conditions and diseases.
A person may not require treatment, but treatments may consist of antihistamines, steroids, or injections. A person should always talk with their doctor to receive a proper diagnosis of the condition.