Brief Answer:
Antihistamines, please provide more details

Detailed Answer:
Hello,

Thank you for asking at HCM.

I went through your history and would like to know more about you as follows:

a. I would like to know history of your allergy symptoms in detail. Since when are you taking Singulair and Zyrtec? Why? What are your nose symptoms? running nose, sneezing, nose congestion, loss of smell? Do you have headache or facial heaviness? any sinus symptoms?

b. Have you ever had hives/urticaria/itchy rash? When? What frequency?

c. Did you experience puffy lips for the first time? Do you have any past history of angioedema? swelling of lips? swelling of other parts such as around eyes, limbs, etc?

d. Do you have any other medical conditions?

e. Do you take any other medications on regular/frequent basis?

f. Have you ever been investigated for allergies? What are the results of previous tests? What are your known allergies?

Above details would help me to know more about you and therefore to make more specific suggestions for you.

At present, from your provided details, I would like to make suggestions for you as follows:

1. As you have known history of allergic rhinitis, I would first think of a form of angioedema involving lips.

2. The treatment is usually antihistamines. I usually suggest my such patient an additional dose of cetirizine (Zyrtec in your case).

However, please note that addition of antihistamine can cause sedation and drowsiness. So please avoid tasks like driving, etc.

3. Also, please note that such swelling usually takes minimum 2-3 days to completely disappear despite taking antihistamines. So it is always important to consider the risk of possibility of sedation against your personal requirements.

4. Usually Volatile organic compounds in paints are known to aggravate respiratory allergies (like rhinitis, asthma, etc) but they are not very much known to cause angioedema. So it is difficult to say that paints have definitely cause swelling of lips.

5. Also, I would like to know whether you have been tested for cat & dog allergies. Whether cat & dog cause you allergic rhinitis.

6. You should worry if you experience symptoms of swelling affecting inner parts of pharynx or larynx like difficulty in breathing, difficulty in swallowing, etc. These symptoms require emergency room visit.

You should also consult your doctor if your swelling of lips continues to increase despite antihistamines or does not subside after 2-3 days.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask at HCM.

Wish you the best of the health ahead.

Thank you & Regards,

Dr Parin N Parmar

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