idiopathic anaphylaxis information center

a resource for people with ia and other mast cell disorders

Anaphylaxis: What do the visible symptoms look like?

What obvious physical signs can we look for?

Having a list of the symptoms of anaphylaxis may not be helpful to those of us who have never seen them. On this page we will show you photographs of actual people exhibiting some of the visible symptoms of anaphylaxis.

Some of the possible symptoms of anaphylaxis

  • Photograph of little boy displaying a bright red flush on his cheeks and lower ears, from a TMS member.
    This little boy, who has mastocytosis, is flushing on his cheeks and lower ears.
  • Photograph of a woman's flushed upper chest, throat, and chin, from a TMS member.
    This woman's upper chest, throat, and lower face are flushed.
  • Photograph of a woman's flushed upper chest, throat, and chin, from an IA Support member.
    This woman's chest, throat, and chin are intensely flushed.
  • Photograph of a person's skin (probably arm) showing goosebumps, from Wikimedia Commons, somewhat modified.
    Sometimes, goosebumps or the sensation of "hair standing on end" can also be a symptom of anaphylaxis.
  • Photograph of a woman whose chest is covered with hives, from an IA Support member.
    Compare the chest flush in picture #2 with these hives on a different woman. While the flush is red, the hives are raised and some even look like welts. Hives are also extremely itchy.
  • Photograph of man's back, covered in hives, from Wikimedia Commons, with some modifications.
    Hives cover this man's back. On his left shoulder blade you can get a sense of how raised they are.
  • Photograph of boy with angioedema around eyes causing them to be swollen shut, from Wikimedia Commons.
    The angioedema around this little boy's eyes has swollen them shut.
  • Photograph of effects of repeated or chronic angioedema of eyes, picture by Candace Van Auken.
    Even though this woman's angioedema is not as severe as that of the boy in photo #7, repeated swelling around the eyes can cause long-term effects.
  • Photograph of man with very swollen upper lip after honeybee sting, from Wikimedia Commons, somewhat modified.
    This man's very swollen upper lip is the result of a honey bee sting.
  • Photgraph illustrating the normal anatomy of the mouth — tongue, tonsil, teeth, and uvula, from Wikimedia Commons, somewhat modified.
    The normal anatomy of the mouth: (1.) tongue, (2.) tonsil, (3.) uvula, and (4.) teeth/roof of mouth.
  • Photograph of man with enlarged and elongated uvula, from Wikimedia Commons.
    This man's uvula is swollen and distended to the point where it rests on his tongue.
  • Photograph of man with enlarged and elongated uvula, from Wikimedia Commons.
    This man's uvula is swollen and distended to the point where it rests on his tongue.

The skin redness that may be the first symptom of anaphylaxis can look like a blush or a menopausal flush. It is, however, usually a dry flush, which means that it is not usually accompanied by sweating. Sometimes an alert friend or family member may first notice the telltale color of someone beginning to flush. (For more information on “wet” versus “dry” flushes see the article, Flushing? Don't sweat it!)

Photographs 1, 2 and 3 show flushing on the face, chest, and neck. It's important to remember that anaphylaxis is not the only reason that a person may flush, and unless the person has either a history of anaphylaxis or another of the symptoms of anaphylaxis that occur in a different bodily system, anaphylaxis should not be suspected on the basis of a flush all by itself. The same is true of a number of the symptoms illustrated on this page.

Some people report that they get goosebumps, as in photograph 4, or can feel the hair on their skin stand erect. Often itching comes next, and the sensation of itchiness can be both intense and can occur in inconvenient places (groin, armpits, ears, back of throat). Some people then report a metallic taste in their mouthes — that kind of tinny, off-flavor that you might get after a bad cold.

The itching can turn into hives (see photographs 5 and 6), which can look more like a red rash or like discrete, raised wheals.

The same process that produces hives produces a different problem — swelling — in the deeper layers of the skin. This is called angioedema, and it can cause a person's face, eyes, throat, uvula, hands, feet, abdomen or other body parts to swell grotesquely. Unlike hives, angioedema doesn't itch, but it can be very painful, depending on the location and extent of the swelling. In photographs 7 and 8, the short-term and long-term effects of angioedema around the eyes is illustrated. (While angioedema may not itch, when the mast cells in our eyes degranulate, the effects can include intense itching.) In photograph 9, we see a man whose upper lip is extremely swollen after a misadventure with a honey bee.

The final two photographs illustrate an uncommon but potentially deadly form of edema or angioedema, namely, swelling of the uvula. Photograph 10 illustrates the normal anatomy of our mouths to help explain what the uvula is. It is a small bit of tissue that hangs down over the back of the tongue. Normally, it cannot interfere with breathing or swallowing, but if it swells (as in photograph 11), it can present a problem that is at least uncomfortable, if not life-threatening. This is not a common symptom of anaphylaxis (and it can also be caused by other conditions), but it is mentioned here to remind us of the broad range of symptoms that anaphylaxis can encompass.

It is important to remember that not every person having anaphylaxis has the same symptoms or has them to the same degree.

Page last updated: May 16, 2011

All information contained in this site is one layperson's interpretation of medical journal articles, textbooks, seminars, presentations, and other materials. Nothing that is stated here should carry more weight than the informed and considered opinions of your own highly trained and qualified medical caregivers. The author of this site is not a doctor and has absolutely no authority to prescribe or diagnose.

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