Woken up with a massively swollen face - what do you think has caused it?

[GreenAlien]

I'm away for work this week, arrived Sunday night and fly back Thursday.

I do get hayfever normally and have a history of having allergic reactions in spring because of grass pollen but never in winter.

Yesterday my face was a bit red and swollen but only on my cheeks and I thought maybe it was a bit of rosacea. I haven't been diagnosed with it but it runs in my family and I'm doing a fair amount of public speaking so that made my face flush and I thought that was it.

I've gone to bed last night and woken up with my eyes swollen and puffy, my face is absolutely bright red from my forehead down to my chin and I have a red rash (not hives) on my chest. I've been lying under a cold flannel for the last hour because my face feels like it is on fire.

I have googled and have a pharmacy a 6 mins walk away that opens at 8am so I will go and grab some antihistamines but does it sound like an allergic reaction?

I'm wondering whether the pillows have duck feathers or something and it's bothered me. I genuinely can't think what else it could be. Is there any other condition that suddenly makes your face look like a tomato 😂

Hi all, last day here today and I fly back tonight. I honestly can't wait to get home! The steroids have totally mucked up my sleep. I'm so tired but only managed 3.5 hours asleep in bed last night, I just wasn't tired. Of course that has made me feel sick today (and that's before I take the meds!).

The swelling is now focused in one area mainly - around my right eye - which I imagine is where the infection started. I emailed the ENT consultant's secretary yesterday and sent pictures plus the medicines I've been given so that he has some notes before my appointment on Friday. I can see the progression as I took a photo every day - I looked horrific on Tuesday (both eyes swollen closed and bright red skin) so the improvement is immense.

Really just want to get home now - I fly tonight and dp is going to pick me up. The doxycycline does appear to be working and so are the steroids but there is something still there so it will be good to see the ENT. Tbh if I didn't have that appointment lined up, I think I might have been a lot more worried. It was so scary how quickly this developed - if it was a type of cellulitis I can see how this becomes an emergency so fast. Luckily it was easy for me to get such quick help here in Ireland and thanks again to everyone for helping.

I'll let you know what the ENT says!

Laundry detergent. I take a pillowcase with me when I travel otherwise I’d have the same reaction. Hopefully an antihistamine will help OP.

I sympathise with the steroid insomnia it’s horrible, I was exactly the same last night. Physically tired but my brain was wired.

I hope your ENT appointment goes well and you get some help.

That sounds really terrifying. I hope you get an answer pretty soon.

@Yourinmyspot poor you it's so horrible. I hope you feel better soon. I'm taking 60mg of prednisone and I feel totally wired but it's definitely working on bringing the inflammation down so that's something!

@healthybychristmas thanks so much, I can't wait to be home

Thats a lot! I’m on 40mg, only for a week though but like you it’s doing its job. I’m on long term Doxycycline and it still makes me feel sick occasionally.

I hope you continue to feel better and get some help from ENT.

The ENT is not convinced it's my sinuses (mainly because he thinks the swelling is bilateral).

He thinks it's either an allergy or a skin infection (potentially). He took blood for allergy testing - my concern is that I've been taking antihistamines and steroids all week so I don't know how accurate they will be. He's also testing for infection markers but I'm on day 3 of the antibiotics so really not sure what my blood will show.

He says it's a medical conundrum for the time being. They want me to have a CT of my sinuses just to check for a 'pocket' of infection but he had a look in my nose and says my sinuses look ok.

Anyway whatever it is, the doxycycline is working and I'm getting better 😂

So no real answers! Hopefully it continues to settle down and isn’t sinus related. It sounds like they are looking at everything.

@GreenAlien Glad to hear you’re at least on the mend OP! Fingers crossed whatever is going on shows in the tests and you can get it sorted 😊

hi all, just to give you the update and see what you think

I didn't have the CT scan because by the time they could book me in, the swelling had gone and my sinuses were no longer sore so I didn't think it was worth it

the blood test came back with no infection markers so it wasn't cellulitis they don't think

what concerns me is that when they did the blood test I had taken 60mg prednisone and 2 different types of antihistamine - they still tested for allergies though (which I didn't think you could do after antihistamines) and on the back of this have concluded it was either an allergy or angioedema but I didn't show up as 'very' allergic in my blood and tbh when they did the test, I was still swollen so I would have expected it to

I have asked them to refer me to the allergy clinic - if this is a 'new' allergy, I would rather get tested for it. He said he couldn't do that and is going back to the GP (which annoyed me because it will take time!). I

I'm now really worried about this happening again. I was swollen like that for 7 days and only a 5 day course of 60mg prednisone actually brought it down. They said they can't diagnose me as it wasn't an ENT emergency (fair enough) but I am left now with 2 options. Either a) it's a new allergy I'm not aware of and I need to figure it out pretty quickly so it doesn't happen again (and given it wasn't responsive at all to the antihistamines, it's a big concern) or b) I've suddenly developed angioedema and it may well happen again

Doesn’t angioedema often happen as part of an allergic reaction too?

Sorry OP, I’m not much help as not a doctor, but allergies run in my family unfortunately do have a bit of experience.

The rash on your chest was puzzling me all along, because that didn’t sound like sinusitis to me (but, as I said, not a doc). Was it urticaria, looks like nettle rash, as that’s typical of an allergic reaction as far as I know?

https://www.allergy-ireland.ie/allergy/urticaria-angioedema

Just adding this link in case it’s in any way useful.

That sounds scary and frustrating @GreenAlien.

Looking at the link above, posted by @BlueAlbatross, I was wondering if you've had any thorough thyroid testing (including T3) done? When I was first developing Hashimoto's, I didn't have anything quite as dramatic, but I did have chronic spontaneous urticaria, several allergic reactions and an ongoing issue with chronic sinus infections that never seemed to respond to antibiotics. All went away when I was diagnosed and treated.

Hope you get to the bottom of things.

If you have had long covid perhaps it's Mast Cell Activation Syndrome MCAS?

Thanks all! I think they looked for MCAS but that might have been ages ago when I was first diagnosed with long covid but thanks, I will ask about it.

Yes apparently angioedema can come as part of an allergic reaction but sometimes it's not related. What was weird is that the antihistamines didn't really work. The rash on my chest wasn't hives - it was sort of red but not raised. The doctor did say I may have had a virus that triggered it because my white blood cells looked a bit odd but nothing massively unusual. I haven't actually seen my results.

They fully tested the thyroid stuff and it was all in normal range apparently

Yes, I would go to your GP and asked to be referred to the allergy clinic as like you said, the steroids, antihistamines and antibiotics could mask your bloods for an allergy.

If you go back to the same place you where at when it happened it could be worth you taking your own pillow if possible and take antihistamines before you go and while your there.

It’s good that your better and I hope you get some answers soon.

Did you get an EpiPen prescribed??

I don’t think they’d give an epipen when they’re not even sure it’s an allergy?

DS had a confirmed peanut allergy as well as other food allergies and the consultant didn’t/wouldn’t prescribe an epipen until the ‘airways became compromised’ during a reaction.

No I haven't actually seen my own doctor yet as this happened when I was away and then I coincidentally had an ENT appointment when I came back. It didn't affect my breathing last time and I guess the epipen is only where it looks like it might progress to anaphylaxis.

I've got slightly swollen lips today fgs - only v slightly but I can feel it argh!