From the Guidelines
Lip swelling after emotional upset is likely a symptom of hereditary angioedema (HAE) or another form of angioedema, and patients should seek medical attention immediately if they experience difficulty breathing, throat tightness, or severe swelling. According to the study by 1, HAE is characterized by episodic swelling, often triggered by stress or trauma, and can involve the face, lips, and other areas of the body. The primary mediator of swelling in HAE is bradykinin, and the condition can be diagnosed based on laboratory findings, including low C1INH antigenic and functional levels.
Some key points to consider:
- HAE attacks can be preceded by a prodrome and typically worsen over 24 hours, peak, and then resolve over the next 48 hours 1
- Epinephrine, corticosteroids, and antihistamines are not recommended for the treatment of HAE, as they are not efficacious 1
- Fresh frozen plasma may be effective in abrogating HAE attacks, but caution is required due to the potential for acute exacerbation 1
- Management of HAE attacks can involve symptomatic treatment based on the region of body swelling, and patients should have access to an effective, on-demand HAE-specific agent 1
In terms of treatment, patients with HAE should have access to an effective, on-demand HAE-specific agent, such as C1INH concentrates, a plasma kallikrein inhibitor, or a bradykinin B2 receptor antagonist 1. Short-term prophylaxis can be achieved using fresh frozen plasma, C1INH replacement, or short-term, high-dose anabolic androgen therapy, while long-term prophylaxis may involve treatment with low-to-moderate doses of anabolic androgens or replacement plasma-derived C1INH 1.
It's worth noting that the study by 1 is not directly relevant to the question of lip swelling after emotional upset, as it focuses on the treatment of acne vulgaris. Therefore, this study does not influence the recommendation for patients experiencing lip swelling after emotional upset.
From the Research
Lip Swelling After Emotional Upset
- Lip swelling can be a symptom of various conditions, including systemic or local diseases 2
- There is no direct evidence in the provided studies to suggest that emotional upset is a common cause of lip swelling
- However, anaphylaxis, a potentially life-threatening allergic reaction, can cause swelling of the lips, face, and tongue, and can be triggered by emotional stress in some cases 3, 4, 5
- Angioedema, a condition characterized by swelling of the skin and mucous membranes, can also cause lip swelling, and can be triggered by various factors, including certain medications and emotional stress 6
Possible Causes of Lip Swelling
- Systemic diseases, such as Miescher syndrome, Melkersson-Rosenthal syndrome, and erythema multiforme 2
- Local diseases, such as lip hemangioma and mucous extravasation cyst 2
- Allergic reactions, such as anaphylaxis and angioedema 3, 4, 5, 6
Treatment of Lip Swelling
- Treatment of lip swelling depends on the underlying cause, and may include medications such as antihistamines, corticosteroids, and epinephrine 2, 3, 4, 5, 6
- In cases of anaphylaxis, epinephrine is the first-line treatment, and should be administered promptly 3, 4, 5
- In cases of angioedema, treatment may include antihistamines, corticosteroids, and other medications, but epinephrine should be used with caution due to the risk of adverse effects 6