Easing Summer Swelling

Overview

Summer swelling, sometimes called heat edema (edema means fluid buildup), is puffiness in the feet, ankles or lower legs when the weather is hot. Heat makes blood vessels widen, and gravity can let fluid collect in the tissues. It usually affects both legs and is often mild.

Yes. Mild swelling of the ankles and feet is common in hot weather, especially for people who stand or sit for long periods.

Anyone can get summer swelling, but it is more likely in older adults, pregnant people, people who are overweight, people with varicose veins, and people who stand or sit for long stretches.

Symptoms

Common symptoms

• Puffy ankles, feet or lower legs, often worse in the evening or hot weather
• Shoes, socks or rings feeling tight
• Skin looking slightly shiny or stretched
• Mild heaviness or tiredness in the legs
• Swelling that improves after cooling down or raising the legs
• Usually both legs are affected

Symptoms in children

• Children can get mild ankle puffiness after a hot day or long standing.
• Swelling in a child should be checked if it is persistent, one-sided, painful, or around the eyes.
• Get urgent advice if a child has swelling with fever, much less urine, breathing trouble, or seems very unwell.

Symptoms in older adults

• Swelling is more common because veins and circulation change with age.
• It can be a side effect of some prescribed medicines.
• It may be a sign of heart, kidney, liver or vein problems, so new swelling should be checked.
• Watch for breathlessness, rapid weight gain, less urine, or swelling in one leg.

Causes

Main causes

• Hot weather: blood vessels widen to release heat, and fluid can collect in the tissues.
• Gravity: standing or sitting for a long time lets fluid pool in the lower legs.
• Long travel or being still for hours.
• Hormone changes, such as pregnancy or monthly periods.
• Weak veins or varicose veins (swollen, twisted veins).
• Some prescribed medicines, including certain blood pressure, hormone, diabetes and anti-inflammatory medicines.
• Heart, kidney, liver or thyroid conditions.
• A blood clot, infection or lymph problem (less common but serious).

Risk factors

• Older age
• Pregnancy
• Being overweight
• Varicose veins or a past blood clot
• Standing or sitting for long periods
• Hot weather and high salt intake
• Some medicines
• Heart, kidney, liver or thyroid disease

When to see a doctor

See a doctor urgently if:

• New swelling in one leg
• Swelling with fever, red hot skin or severe pain
• Rapid weight gain, much less urine, or breathlessness when lying flat
• Swelling after an injury or fall
• Swelling that is getting worse despite cooling and raising the legs
• A child with persistent swelling, swelling around the eyes, less urine or breathing trouble

Book a routine appointment if:

• Mild swelling that keeps coming back in hot weather
• Swelling that lasts more than a few days
• Swelling with varicose veins or skin changes
• You take a medicine you think may be causing swelling
• You have a long-term heart, kidney, liver or thyroid condition and notice new swelling
• Swelling is affecting your walking, shoes or daily life

Diagnosis

A clinician will ask when the swelling started, whether it is in one or both legs, what makes it better or worse, your medicines and your health history. They will look at your legs, feet, skin, heart and lungs, and check blood pressure and weight. This helps decide whether it is simple heat swelling or something that needs tests.

Tests that may be done

• Blood tests to check kidney, liver, thyroid and general health
• A urine test to check kidney health
• An ultrasound scan if a blood clot or vein problem is suspected
• Heart tests such as an ECG (heart tracing) or scan if heart problems are suspected
• Blood pressure and weight checks
• Sometimes a fitting for compression stockings or a referral to a vein or lymph specialist

What to expect at your appointment

Most people with mild summer swelling do not need many tests. If your clinician finds signs of another condition, they will explain which tests are needed and how to get the results.

Treatment

The first step is to cool down, move, and raise the legs. If a health condition or a medicine is causing the swelling, your clinician will help manage that. Do not stop or change prescribed medicine without advice.

Self-care at home

• Cool down: move to a cooler place, use a fan, or cool your legs with a damp cloth.
• Raise your legs above heart level when resting, several times a day.
• Keep moving: walk around and do gentle ankle circles and foot pumps.
• Avoid standing still for long periods; sit and raise your feet when you can.
• Wear loose shoes and socks, and avoid tight bands around the legs.
• Limit very salty foods and drink enough water in the heat.
• Check your skin daily for redness, cuts or sores.
• Ask a clinician before using compression stockings, especially if you have heart or circulation problems.
• Do not stop or change prescribed medicine without advice.

Medical treatments

If a condition like heart, kidney, liver or vein disease is found, treatment focuses on that condition. Some medicines that help the body pass more urine may be prescribed for certain heart, kidney or liver problems, but they are not a treatment for ordinary heat swelling unless a clinician advises. Compression garments may be fitted by a trained professional. A medicine review can help if a prescribed medicine may be causing swelling.

When is surgery considered?

Surgery is not used for ordinary heat swelling. If repeated swelling is caused by varicose veins or another vein problem, a vein specialist may discuss treatments, including procedures to close or remove damaged veins.

Living with this condition

On hot days, try to rest with your legs raised, wear comfortable shoes, and avoid long stretches of standing or sitting. Check your feet and ankles each evening. If swelling becomes one-sided, painful, or comes with breathlessness, get medical help.

Lifestyle tips

• Stay active with regular walking or gentle exercise.
• Break up long periods of sitting or standing every hour.
• Use shade, fans and cool rooms in hot weather.
• Raise your legs when resting.
• Keep to a healthy weight if you can.
• Limit very salty foods.
• Wear well-fitting, comfortable shoes and avoid tight socks.
• Ask your clinician about compression stockings if swelling keeps returning.

Diet and exercise

Regular walking and ankle movements help blood flow. Swimming or gentle exercise can also be good. Limit very salty foods and drink enough water, especially in hot weather. If you have a long-term condition, ask your clinician about the right level of activity for you.

Mental health and emotional wellbeing

Swelling can be worrying or make you feel self-conscious, and it may affect what you wear or how easily you move. Talk to someone you trust or to your clinician if it is getting you down. If you feel overwhelmed, contact a local mental health service or crisis line. If you are in immediate danger, call your local emergency number.

Prevention

You cannot always prevent summer swelling, but you can reduce it by staying cool, moving regularly, raising your legs and limiting very salty foods. If you have a long-term condition, keeping it well managed helps.

Vaccines

Not applicable. Summer swelling is not prevented by a vaccine.

Screening programmes

There is no routine screening for summer swelling. Regular checks are useful if you have a long-term heart, kidney, liver or vein condition.

Complications

If left untreated

• If swelling is due to an underlying heart, kidney, liver or vein problem, that condition can worsen without care.
• Long-standing swelling can lead to skin changes, dryness, itching or ulcers, especially in the lower legs.
• Swollen skin is more prone to infection and injury.
• A blood clot or infection can cause serious problems if not treated.

Long-term outlook

For most people, summer swelling is mild and settles when the weather cools or after resting with legs raised. If there is an underlying cause, getting it checked early usually makes it easier to manage. Most people can stay comfortable with simple daily steps.

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