Waking up with a puffy face happens from time to time, especially if you drank one too many glasses of wine the night before or overdid it snacking on salty potato chips. But if your face is so swollen that you can’t open one of your eyes, you look like a blowfish — or one of those sad, but adorable dogs with swollen cheeks after a bee sting) — your body may be trying to tell you something. In fact, chronic facial swelling is often among early warning signs that something more serious is going on.
A number of health issues can cause facial swelling, among other instances of inflammation in your body. Swelling is always extremely noticeable on your face, and whether it’s isolated or chronic, can be hard to ignore, 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.”
Inflammation, hormones or allergens can all contribute to the deterioration of small blood vessels over time, she adds. These sources of facial swelling can be examined and potentially isolated before becoming larger issues that often require a long-term treatment plan.
While infrequent swollen cheeks or under eyes aren’t much to fret about, if it 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 — it’s time to call your doctor immediately or visit the emergency room.
Experiencing chronic facial swelling that doesn’t cause you any of these worrying symptoms? You may be wondering where they come from, then. Below, healthcare providers are sharing some of the most common causes of facial swelling and ways you may resolve the root issue over time.
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.
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Facial swelling 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 materials published by the Mount Sinai Health System. 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 something that acts as a trigger, like certain makeup, skincare products, detergents or even poison ivy. This condition is known as contact dermatitis. Chris Adigun, M.D., FAAD, board-certified dermatologist and spokesperson for the American Academy of Dermatology, says contact dermatitis can be caused by an allergic reaction or, more often, irritation to the outer layer of the skin.
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.
First, don’t panic. “Most of the time, facial swelling can be treated at home,” Conte stresses. Here’s how you should attempt to calm swollen facial features at first:
- Apply a cold compress.
- Stay hydrated.
- Sleep upright.
- Take an over-the-counter antihistamine.
When to see a medical professional
Monitor your facial swelling symptoms closely and at least once daily, if not more frequently, Dr. Wada advises. “How quickly are they developing or progressing? Is there a component of itching or a burning sensation? Answers to these questions will help your doctor make their assessment,” she adds.
Before relying solely on over-the-counter products that may promise relief — including antihistamines, pain relievers or hydrocortisone creams — you should work to eliminate guesswork on potential allergic reactions with your doctor. Call your doctor if you notice swelling and cannot pinpoint why it is occurring, especially if it persists longer than 48 hours or worsens at any point, says 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.
- Fever of 103°F or higher.
When facial swelling is a medical emergency
According to clinical care advice published by University of Florida Health, doctors will work with you to pinpoint the exact cause of your facial swelling. They’ll determine if additional diagnostic tests are needed in clinic, 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?
Bottom line: When your face swells up, it can certainly be alarming. Many things can cause it, from an allergic reaction or infection, to a dental problem or even a dermatology issue. Usually, it’s not anything to worry too much about. But, when your swelling comes with difficulty breathing, a high fever or your throat feels like it’s closing up, it’s crucial that you contact your healthcare provider immediately or head to your local emergency room.
Erica Sweeney is a writer who mostly covers health, wellness and careers. She has written for The New York Times, HuffPost, Teen Vogue, Parade, Money, Business Insider and many more.