We all experience a puffy face every now and again, especially after a night of drinking alcohol or filling up on salty foods. But if your face is so swollen that you can’t open one of your eyes, or it happens frequently, and you can't figure out why, your body may be trying to tell you something. In fact, a number of health issues can cause facial swelling, and it's often among early warning signs that something more serious is going on.
Unfortunately, swelling is always extremely noticeable on your face, says Josie Conte, D.O., C-NMM, a board-certified osteopathic manipulative medicine specialist at Maine Dartmouth Collaborative Care Center. “The area of the face has a high level of blood supply, and the skin tends to be thin,” she explains. “The swelling can be caused when the small blood vessels lose their integrity and become leaky, allowing fluid to move more easily into the tissues.”
Things like inflammation, hormones and allergens can all contribute to the deterioration of small blood vessels over time, she adds. The good news is these sources of facial swelling can be examined and potentially isolated before becoming larger issues that often require a long-term treatment plan. Below, healthcare providers share some of the most common causes of facial swelling and ways you may resolve the root issue over time.
Just keep in mind that if facial swelling seems to come out of nowhere, and you also have difficulty breathing or swallowing, are experiencing pain or numbness, have a fever or can't move part of your face — call your doctor immediately or visit the emergency room.
This article generalizes clinical treatment information highlighted by doctors and specialists and is not intended to be a complete list of symptoms and/or treatments. It is meant to be educational in nature, and isn't a substitute for actual medical or treatment advice from a licensed professional. Remember: Always call 911 if you are experiencing a life-threatening emergency.
Causes
Inflammation, infections and allergies are among the most likely reasons that trigger fluid buildup in the tissue of your face, which leads to swelling, according to Mount Sinai. This swelling can range from mild to severe, and may even extend to your neck and upper arms. Learn more below about specific causes and how to work with your doctor to resolve them.
One of the most common causes of facial swelling is known as angioedema, a condition that experts liken to hives. This is often an allergic reaction to foods, medications or bug bites or stings that causes swelling in the tissue under the skin’s inner layer. “When allergy cells are triggered, they release dozens of chemical mediators that cause an inflammatory response. Part of this response makes tissues leaky and results in swelling,” says Kara Wada, M.D., an allergist and immunologist at The Ohio State University Wexner Medical Center.
Your skin can also become irritated and inflamed when you come into contact with a trigger, like certain makeup, skincare products, detergents or even poison ivy — a condition known as contact dermatitis.
An EpiPen, antihistamines or steroids may be needed to treat angioedema, depending on the severity and the root cause, which is confirmed by your doctor. Contact dermatitis is also treated with antihistamines or anti-itch creams. Any time your facial swelling causes difficulty swallowing or breathing, fever or oozing blisters, head to the emergency room.
Facial swelling can also be dental-related. “That can be caused by a broken tooth, periodontal disease or a root canal problem," says Sally Cram, D.D.S., a Washington, D.C.-based dentist and spokesperson for the American Dental Association. "Any of those things could create an abscess and an infection in the jawbone, and that could result in swelling to the face or jaw," she explains.
A tooth abscess is a “pocket of pus” in your gums caused by a bacterial infection, according to the Cleveland Clinic. You’ll often also have pain in your tooth or jaw, fever, sensitivity to coldness and swelling in your face.
Dentists diagnose a tooth abscess with an exam and X-ray, and it’s treated by draining the pus, pulling the tooth or prescribing antibiotics. Regular dental X-rays, checkups and cleanings can go a long way in preventing infections and periodontal disease.
Cellulitis is a bacterial infection in the layers of the skin that bring symptoms like swelling, pain and warm-to-the-touch skin, explains Selena Raines, D.O., an American Osteopathic Association board-certified osteopathic family physician in Kentucky. It’s often caused by a skin injury, like a cut or scrape, where bacteria can seep in; these can be small and seem invisible to your naked eye, but may lead to more serious issues down the road.
“These infections can become serious if they start to occur in and around the eyes, so this is something that should always be evaluated by a doctor,” Dr. Raines advises. It’s usually treated with antibiotics. Seek treatment immediately if you have a fever, swelling and a noticeable rash that keeps growing or changing in shape or size.
The stuffy nose, headaches and nasal pressure of a sinus infection (also known as sinusitis) can make your face feel like it’s going to explode. It can also make it swell up in some cases. Any time you think you have a sinus infection, Dr. Raines suggests getting checked out by your doctor so the infection can be treated properly.
“If it is a bacterial infection, antibiotics are used as treatment,” she says. “If it’s a viral infection, often we just treat the symptoms and let the virus run its course — but there are antiviral medications for certain viral infections.”
Call your doctor if you have a fever over 103°F, confusion, vision problems including swelling around your eyes or a stiff neck, per the Cleveland Clinic.
Pink eye, also known as conjunctivitis, is inflammation and redness of the clear tissue lining your eyelids’ surface and the outer coating of your eyes. You can get pink eye from viruses, bacteria or allergens, and it usually causes redness, swollen eyelids, discharge and itchy, burning eyes. Pink eye can be highly contagious through contact and bacterial contamination, but a healthcare provider can advise the best treatment (such as antibiotic eye drops).
A stye is a painful red bump that pops up on your eyelid when the tiny glands in your eyelash follicles get blocked and infected — and it can cause your entire eyelid to swell up, per the Cleveland Clinic. You can treat it with a warm compress and by cleaning your eye area, but sometimes your doctor may need to drain the stye or prescribe antibiotics.
Dozens of salivary glands exist in your mouth, including in your cheeks and under your tongue. Sometimes these glands get infected or blocked, and that can cause facial swelling, Dr. Cram says.
Salivary stones are mineral deposits that can form in the glands — and create a blockage. They might be caused by not drinking enough fluids, trauma to the inside of the mouth, smoking and gum disease, according to Johns Hopkins Medicine. Dr. Cram says you’ll likely notice a lump in your mouth, but these blocked glands don’t always hurt. The stones often go away on their own, but they may need to be removed by a physician, or you might need a round of antibiotics.
Blushing, a flushed appearance and visible blood vessels in your face are common symptoms of rosacea. You might also notice swollen bumps on your face or an enlarged nose, caused by skin thickening. These symptoms could flare up for a couple of weeks and then go away. What causes rosacea is ultimately unknown, but it may be related to an overactive immune system, genetic factors, the environmental or a combination of things.
Even though rosacea and acne aren’t the same, rosacea is often treated with acne medications. Laser treatment and topical treatments can also minimize the appearance of rosacea.
If you’re pregnant or just delivered a baby and notice swelling in your face, it could be preeclampsia, a serious blood pressure condition, Dr. Raines stresses. Shortness of breath, blurry vision and headaches are other symptoms to watch for and tell your doctor about immediately.
“This really is a blood flow problem that can cause swelling in the face and the extremities,” she says. “It can become a serious complication of pregnancy, so any significant change in swelling or a significant amount of swelling in the extremities or face should prompt someone to seek evaluation from a doctor.”
Ultimately, you may require blood thinners and special supervision during pregnancy, or targeted medication to prevent seizures.
Any injury to the jaw or a tooth, even on the exterior of your face — such as from falling off your bike or experiencing a car crash — can cause facial swelling, Dr. Cram says. If the swelling lingers or you have lots of pain, call your doctor to rule out something serious.
A severe sunburn can injure the skin and sometimes cause swelling, as well as bright red skin, pain and headaches. Seek treatment if you have a fever, too, or develop severe swelling, blisters or start to feel confused.
Your thyroid is a butterfly-shaped gland located at the base of your neck that helps regulate bodily processes, like your metabolism. When your thyroid is underactive, a condition known as hypothyroidism, you can see swelling around your eyes and lips, says Dr. Conte. “Other symptoms might include thinning of the eyebrows, shortness of breath, fatigue, depression, dry skin, low energy, constipation and in women in their childbearing years, irregularities with their menstrual cycles."
Your doctor can order blood tests to find out if your thyroid is off kilter. If it is, they will likely prescribe medication and recommend monitoring.
Some autoimmune disorders, including systemic lupus, polymyositis and Sjogren’s syndrome, can cause swelling of the face, around the eyes and the hands, Dr. Conte explains. If you notice other symptoms, like joint pain, fever or fatigue, talk to your doctor. They may refer you to a rheumatologist.
Cushing syndrome is a rare condition that occurs when your body produces too much of the hormone cortisol, which is known as the "stress hormone,” according to the Cleveland Clinic. The condition is exceedingly more common in women and brings rapid weight gain in the face, which is sometimes referred to as “moon face" in clinics and treatment centers. The condition must be diagnosed by a healthcare provider, and treatment involves medication, radiation, chemotherapy or surgery.
Treatment
First, don’t panic. “Most of the time, facial swelling can be treated at home,” Dr. Conte stresses. Assuming the swelling doesn't seem to be an emergency, you can take these steps at home to reduce it:
Apply a cold compress.
Stay hydrated.
Sleep upright.
Take an over-the-counter antihistamine.
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When to see a medical professional
Monitor your facial swelling symptoms closely, Dr. Wada advises. While some over-the-counter products — such as antihistamines, pain relievers or hydrocortisone creams — might provide relief in certain situations, call your doctor if you cannot figure out the cause of your facial swelling, especially if it persists longer than 48 hours or worsens at any point, says Dr. Conte.
If you have any of these symptoms — in any combination or severity — head to the emergency room immediately:
Swelling in your throat, tongue or lips — as in, your throat feels tight and itchy.
Difficulty breathing.
Racing heart.
Dizziness.
Fever of 103°F or higher.
According to University of Florida Health, doctors will work with you to pinpoint the exact cause of your facial swelling. They'll determine if diagnostic tests are needed so be prepared to answer questions like:
How long has your swelling lasted, and when did it begin?
Have you taken anything to treat it, and has it worked?
Have you come into contact with something that you may be allergic to?
What medication are you taking?
Did you recently injure yourself, or undergo surgery?
What are the other symptoms you are currently experiencing?
The bottom line
When your face swells up, it can be alarming. Many things can cause it, from an allergic reaction or infection, to a dermatology issue or even a dental issue. Usually, it’s not super serious, but if you're uncertain, it's always smart to see a doctor. And if your swelling is accompanied by difficulty breathing, a high fever or your throat feels like it’s closing up, contact your doctor immediately or head to a nearby emergency room.
Eric M. Ascher, D.O. is a board-certified family medicine physician. He completed medical school at the New York College of Osteopathic Medicine, his family medicine residency and fellowship at Northwell Health, and has been working for Northwell Health since. Dr. Ascher practices in New York City and focuses on preventative medicine and healthy lifestyles. He has been recognized annually on The Super Doctor’s List posted in the New York Times and has been recognized by Northwell Health as a Rising Star and Physician of the Year. He hosts a series on YouTube in collaboration with Northwell Health called “Hack Your Health,” where viewers are taught why household items may relieve their ailments. Dr. Ascher is an assistant professor of the Zucker Hillside School of Medicine at Hoftsra Northwell, has been a pioneer for telehealth throughout his career, has been a media expert, and is heavily involved in practice and technology optimization. He appreciates building relationships with his patients and their families to encourage long, happy, and healthy lives.
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