Woken up with unusually swollen lips? Lip swelling can occur for a number of reasons including injury, allergic reactions, minor skin issues, and inflammatory conditions.
Dr Roger Henderson looks at the most common causes and treatment options for swollen lips, plus when to seek urgent medical attention:
Why are my lips swollen?
Swollen lips are usually caused by a build up of fluid under the skin in the area, or from significant inflammation of the lips. The severity can range from very mild and needing no treatment to a potentially life-threatening medical emergency.
Is lip swelling a medical emergency?
Anaphylaxis is a severe and potentially life-threatening reaction to a trigger such as venom, food, medication or an allergy, that may present itself in lip swelling. Anaphylaxis often develops very quickly following exposure to something you're allergic to and usually requires urgent medical attention.
Symptoms of anaphylaxis include:
Experiencing difficulty breathing or wheezing
An increased heartbeat
Feeling faint or lightheaded
Confusion and distress
An itchy raised rash
Loss of consciousness
Feeling or being sick
Anaphylaxis is a medical emergency and can be very serious if not treated quickly, so if someone experiences the above symptoms call 999 for an ambulance immediately.
9 reasons why your lips might be swollen
If you've ruled out a medical emergency, the main causes for swollen lips include the following:
Your lips and the surrounding area is very sensitive to injury and trauma and so can swell quite significantly even with a relatively mild impact. The usual injuries that cause this are blunt force (such as being hit or punched), bites, cuts and burns.
The treatment of swollen lips due to injury depends on what has caused it:
If lip injury is due to trauma then applying a cold compress or an ice pack wrapped in a towel can help reduce the swelling and discomfort.
If your lips are cut this can also help but if the bleeding will not stop. If the cut is deep then seek medical attention.
Cuts and burns can also become infected and signs of this are heat, redness, worsening pain and tenderness, and swelling. Antibiotics may be required if this occurs so tell your doctor about it.
Allergies are a common cause of swollen lips, and an allergy is simply your body reacting against a certain substance you are allergic to. When this happens, your body releases a chemical caused histamine and this causes the classic symptoms of allergy such as itching, sneezing and inflammation. Many types of allergy exist, and lip swelling may occur with any of them. Common allergies include:
Many common allergies are easily treatable with over-the-counter medicine, so if you believe you might be experiencing an allergic reaction ask your local pharmacist for advice.
3. Food allergies
Food allergies are increasingly common, with around 5 per cent of the population estimated to have a food allergy or intolerance. Common triggers include shellfish, nuts, dairy and eggs. Lip swelling is often one of the first signs after eating something you are allergic to, and other symptoms can include wheezing and coughing, nausea, facial swelling and dizziness. Severe allergies can cause an anaphylactic reaction so urgent treatment may be required.
The most important treatment for a food allergy is to stop eating the foods that trigger your allergic reaction. Your doctor might prescribe medications including antihistamines – histamines are the chemicals that cause most allergy symptoms, and antihistamines block their effects – as well as epinephrine, which is used to treat anaphylaxis.
4. Insect bites
Insect bites can cause lip swelling, such as can occur after being stung. The most common insect bites in the UK are mosquitoes, midges, fleas, bedbugs, horseflies and ticks. Wasp and bee stings are acutely painful so you will usually know if you’re being stung.
For most people, insect bites are self-limiting and will settle over a few hours but a quick-acting antihistamine tablet can help reduce any swelling more quickly.
5. Drug allergies
A drug allergy is the abnormal reaction of your immune system to a certain medication and allergies to common medicines – such as penicillin and non-steroidal anti-inflammatory drugs – can cause swollen lips and other allergic symptoms.
The best treatment is to avoid further use of that medication and take an antihistamine tablet. If you have any concerns whatsoever about your medication, make an appointment with your GP.
6. Hay fever allergies
Hay fever is an allergic reaction to grass or tree pollen in the air that predominantly affects the upper airways. Symptoms typically include sneezing, a runny or itchy nose and watery or itchy eyes, but hay fever can present itself as lip swelling.
Allergies such as pollen or pet hair are treated by avoiding the allergen whenever possible, and taking anti-allergy medication regularly.
⚠️ If you experience breathing difficulties speak to a healthcare professional urgently or call 999 for an ambulance.
Angioedema is a condition that usually lasts 24-48 hours and causes swelling deep underneath the skin due to an allergic reaction. This can cause lip swelling as well as swollen hands, feet, genitals and around the eyes, and there is usually a raised, itchy rash (called urticaria) on the skin at the same time.
• Allergic angioedema
When due to an allergic response it is called allergic angioedema, and can be very significant. This can be triggered by an allergic reaction to a number of things including certain types of food (especially nuts and shellfish), some types of medicine (where it is called drug induced angiodema) including aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), blood-pressure lowering treatments such as ACE inhibitors, and also antibiotics, bites and stings and latex allergy.
• Hereditary angioedema
In some cases the condition may be inherited and caused by a genetic fault. This is known as hereditary angioedema and if this occurs there is a 50 per cent chance of passing it on to your children. In some other cases the cause can be difficult to identify but known triggers can include stress, minor infections, hot or cold temperatures and vigorous exercise.
• Angioedema anaphylaxis
A severe attack of angioedema is called anaphylaxis and this requires immediate treatment with adrenaline via an auto-injector such as an Epi-Pen which is administered at the start of an attack. If you carry one of these always make sure you have told your family, close friends and co-workers about it and how to administer it if you are unable to.
Decisions about treatment can be difficult when the onset of angioedema is so unpredictable, but avoiding any foods, drugs or activities that trigger symptoms can help to minimise the chances of an episode of swelling. Antihistamines can settle or minimise the attacks and the newer types are less sedative than the first generation ones like Piriton (chlorpheniramine). Specialist treatments are also available to treat inherited angioedema although it cannot be cured.
8. Cheilitis glandularis
Cheilitis glandularis is a rare inflammatory condition characterised by swelling of the lips. Although there may be a genetic susceptibility, no definitive cause has been established and medical experts aren’t sure what causes it. However it seems to be more common in men and associated with lip injuries, sun exposure and smoking.
The condition often doesn’t need treatment, but may require surgical excision by vermilionectomy (sometimes called a lip shave). Cheilitis glandularis can also make you more susceptible to bacterial infections, in which case antibiotics or corticosteroids may be prescribed by your doctor.
9. Melkersson-Rosenthal syndrome
Melkersson–Rosenthal syndrome (MRS) is a rare neurological disorder characterised by recurring facial paralysis and swelling of the face and lips. Most people only experience one or two symptoms at a time so if you suddenly have an onset of upper lip swelling it could be MRS. However no definitive cause has been established and medical experts agree MRS is likely genetic and extremely rare.
MRS is commonly treated with corticosteroids and NSAIDs to help reduce swelling. If you think you might have MRS or a family member is known to have it and you suspect you may be experiencing symptoms, make an urgent appointment with your GP.
Last updated: 17-03-2021
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