Cold compresses aren’t a first-line therapy for hereditary angioedema (HAE), but they may provide relief from swelling-related discomfort for some people.
HAE is a rare genetic disorder that causes episodes of soft tissue swelling in places like the skin, airways, throat, and intestines. It’s caused by inherited mutations in the C1NH gene, which carries instructions for producing a protein called C1 esterase inhibitor (C1-INH).
Without enough C1-INH, your body produces too much bradykinin, a molecule involved in inflammatory responses, blood vessel dilation, and cellular permeability. Too much bradykinin in HAE causes blood vessels to widen and leak fluids, which can lead to episodes of painful swelling that typically last
Doctors treat HAE using medications that target C1-INH and bradykinin. Cold compresses aren’t a standard HAE therapy because they don’t address the underlying causes of swelling, but they may provide symptomatic comfort for some people.
Knowing how to use a cold compress in HAE safely is important for preventing unintentional side effects.
Doctors often recommend cold therapy for swelling conditions because it can help with vasoconstriction (blood vessel constriction) and slow cell metabolism. In situations like soft tissue injuries, cold compresses can help reduce inflammation, pain, and swelling.
In HAE, fluid accumulation in soft tissues results from a genetic mutation that causes too much bradykinin. While cold compresses will still promote vasoconstriction in people with HAE, cold therapy won’t alter the bradykinin levels or genetics that cause fluid buildup in tissues.
To manage HAE attacks, your doctor will provide you with HAE-specific medications to manage symptoms as quickly and effectively as possible. Cold compresses may not work for your HAE swelling, and they may not be appropriate based on your individual circumstances and other underlying conditions.
For example, doctors generally do not recommend cold therapy for people with:
- low cold tolerance
- Raynaud’s disease
- peripheral vascular disease
- open wounds
- burns
- cryoglobulinemia
- paroxysmal cold hemoglobinuria
- neuropathy
- dementia
- an impaired ability to communicate
If you want to try a cold compress for HAE, you don’t need to reach for an ice pack. Sometimes a cool item is enough to get the soothing benefit of cold therapy. A cold washcloth, for example, will be less intense on your skin than an icepack from the freezer — even an icepack you’ve wrapped in a towel.
And, since the temperature isn’t as extreme, you could safely leave a cool compress on your skin for longer.
As a general rule, you should only leave an icepack on your skin for 15 to 20 minutes, with a barrier like a thin towel between your skin and the ice itself. Using an ice pack longer than that, or using one without some layer of protection on the skin, could cause damage to soft tissue or
People apply cold compresses to specific sites of swelling, but those areas of your body aren’t always broad or flat. A stiff ice pack might not contact enough of the swollen area to make a difference.
For more complete coverage, consider using flexible, gel cold packs — or even a packet of frozen veggies from the freezer that can take shape around the body part in need.
You can make your own flexible ice pack at home by mixing 3 cups of water with 1 cup of rubbing alcohol in a sealable freezer bag. Remove as much air as possible from the bag and freeze it to create a slush-like cold compress.
People’s sensitivity to cold can vary. Even if you’re applying a cold compress in HAE for the standard 15 to 20 minutes, your skin tolerance for cold may be lower. Check your skin often throughout cold compress application for signs of irritation like numbness, redness, or blanching (excessive skin whitening).
Cold compresses aren’t a substitute for standard HAE therapies. You should used them to supplement your doctor-recommended management plan if there are no contraindications.
Cold compresses may not help reduce HAE swelling and they may increase your discomfort, particularly if you apply them to areas like your throat or chest where cold can affect your airways. If you’re using a cold compress and any of your symptoms worsen, it’s best to stop and stick to your first-line management strategies.
Hereditary angioedema (HAE) is a rare genetic condition that causes episodes of painful swelling. Because it is caused by a genetic mutation and bradykinin imbalance, HAE might not respond to cold therapy in the same way other swelling conditions do.
If you find cold therapy soothing in HAE, practicing general safety strategies can help prevent complications like frostbite. Protecting your skin, keeping cold therapy under 20 minutes in duration, and using less extreme temperatures are a few tips to consider.