Swollen feet after a sunburn many years ago

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Submitted by Dr T on June 30, 2011 – 11:11am

When I was 26, I got a severe sunburn on my feet.  Later that day, they started swelling and got small red “pinprick” size spots; no blisters.  They swelled so big, I could barely wear flip-flops.  My doctor back then gave me hydrochlorothiazide (I believe 25 mg).  The swelling went down.  When I turned 29, they started swelling again, with no apparent cause/reason.  My current doctor says it is pitting edema and has added 5 mg of lisinopril.  This only temporally fixes the swelling.  I have also tried compression stockings and elevating them, but that doesn’t really help either.  Because of the sunburn, the skin is very sensitive to sunlight (they feel like they are sizzling) and the red “pinpricks” return periodically.  It is also painful to wear shoes all day because my feet get hot and that makes them hurt as well.
They are very stiff feeling and painful when they swell.  I am also getting small groups of spider veins on my feet and near my ankles.  Sometimes there will just be a small puffy area (about the size of an apricot) near my ankles.  On a side note, I recently dropped a can of soda on one of my feet and now it swells more than the other one (my doctor doesn’t seem to be worried about that, but I think it is a problem).
I am now 30 and getting tired of having this happen; it’s painful and looks gross.  They doctors I have seen don’t seem to take my concerns seriously.  They simply say there is nothing they can do.  I am in relatively good health.  I am 5’10” and 160 lbs.  My blood-pressure is naturally low. I also take 112 mg of levothyroxine.  I also only take the hydrochlorothiazide and lisinopril (separately) when the swelling occurs.  Thank you

While the sunburn surely caused a local injury at the time, that injury should have healed a long time ago. Therefore it seems to me the cause of your edema has yet to be found. The most common local conditions that cause edema are varicose veins and thrombophlebitis (inflammation of the veins) of the deep veins of the legs. Problems with your heart, liver or kidneys may also cause peripheral edema. If blood tests have excluded your heart, liver and kidneys as a source for your edema, you need to look for local problems with either the veins or lymphatic system in your legs.

Lymphatic obstruction (Lymphedema) is caused by a blockage of the lymph vessels that drain fluid from tissues throughout the body and allow immune cells to travel where they are needed.

You can read more about pitting edema here:

You can read more about peripheral edema caused by Heart Failure here:

Your veins can be checked with an ultrasound exam, but an evaluation for lymphedema requires CT or MRI scan, even Lymphangiography.

It appears you need at least an ultrasound to look at the veins in your legs. Depending on the outcome, other tests may be necessary to find the appropriate treatment for you.

Hope this helps,
Dr T

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