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Whether you had a few glasses of wine or scrubbed your face a little too hard when exfoliating, there’s nothing fun about facial swelling. But when the puffiness appears for seemingly no reason, it might be an indicator that something else is going on.
The occasional facial swelling may be no big deal and can be caused by stress, dehydration, sleeping with your makeup on, or having a little too much alcohol, says Laura Purdy, MD, a family medicine physician in Nashville, Tennessee.
However, allergic reactions are also a common culprit of sudden facial swelling and may be more serious. While some cases can be treated with a topical steroid, at-home remedies can’t fix everything, says Adam Friedman, MD, a professor and the interim chair of dermatology at George Washington School of Medicine and Health Sciences.
Severe angioedema, or acute face swelling usually caused by an allergic reaction, is one of them, says Dr. Friedman. This swelling can become a life-threatening emergency if your face and respiratory tract lining are affected because it can make it hard to breathe.
Sometimes facial swelling can also result from an infection, or in association with an underlying medical condition, or as a medication side effect, says Marisa Garshick, MD, a dermatologist in New York City.
Meet the experts: Faranak Kamangar, MD, is a dermatologist, psoriasis specialist, and founder of PSOTelehealth.
Laura Purdy, MD, is a family medicine physician in Nashville, Tennessee.
Adam Friedman, MD, is a professor and the interim chair of dermatology at George Washington School of Medicine and Health Sciences.
Marisa Garshick, MD, is a dermatologist in New York City.
Kristamarie Collman, MD, is an Atlanta-based family medicine physician and health expert.
Rosalyn Stewart, MD, is an associate professor of medicine at Johns Hopkins University School of Medicine.
Joshua Zeichner, MD, is the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital.
Chirag Shah, MD, is an emergency medicine physician and the co-founder of Accesa Labs.
When To See A Doctor For Facial Swelling
If your swelling is painful to touch, severe, or accompanied by a fever, rash, burning sensation, or joint pain, call your doctor because this could be a sign of infection, says Dr. Purdy. And if the swelling worsens or becomes persistent, it’s best to visit your doc ASAP, she adds.
Now, when the swelling is accompanied by severe pain, difficulty breathing or swallowing, throat tightness, itching, hives, or fainting, you need to seek immediate medical attention as these symptoms may indicate a severe allergic reaction that needs prompt, life-saving treatment, says Faranak Kamangar, MD, a dermatologist, psoriasis specialist, and founder of PSOTelehealth.
And as always, remember that YOU know you best. So if you’re debating over whether it’s worth a call or visit to your doctor, it probably is.
11 Possible Reasons Your Face Is Swollen, According To Doctors
1. You've got a sinus infection.
If the lining of your sinuses—the air-filled spaces between your eyes and behind your forehead, nose, and cheekbones—becomes inflamed or infected, they can get clogged with mucus.
The pressure caused by this backup causes a dull ache around your eyes, greenish-yellow discharge from your nose, pounding headaches—and sometimes, a swollen face.
Most of the time, the infection is caused by a virus (translation: You don’t need necessarily antibiotics—just wait it out). A sinus infection can last from days to several weeks and it can go away on its own, Dr. Garshick says. Focus on resting, drink lots of fluids, and try an over-the-counter antihistamine, says Rosalyn Stewart, MD, an associate professor of medicine at Johns Hopkins University School of Medicine.
2. You have an abscessed tooth.
Having a cracked or chipped tooth or an untreated cavity can allow bacteria to sneak into the pulp—the soft innards—of your tooth, where they can multiply, says Dr. Stewart. The abscess (a.k.a. infection) results in a collection of pus and swelling around the tooth or gums. Translation: You’ll have a wicked toothache and some jawline swelling.
In general, you should get a tooth abscess evaluated by your dentist, Dr. Garshick says. Your dentist can prescribe antibiotics and it's possible that a root canal might have to be performed to remove the infected nerve. It's possible that it can take days to weeks for the swelling to go down, but in the meantime, saltwater rinses and over-the-counter painkillers can make you more comfortable.
3. You have Cushing's syndrome.
Cortisol is a stress hormone, but it also helps regulate your blood pressure, blood sugar, and a slew of other things. When too much of it gets pumped out by your adrenal glands, it can lead to Cushing’s syndrome, a condition characterized by a round, moon-shaped face, skin that bruises easily, and thicker or more body hair.
Cushing's syndrome is rare, with fewer than 20,000 cases a year, says Dr. Purdy. However, it does affect women nearly three times more often than men, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and it often crops up in people who have been on glucocorticoids, which help with inflammation.
"In order to improve the facial swelling, it is important to address the underlying condition," Dr. Garshick explains, adding that it can take months for the swelling to go down.
Cushing's syndrome can be treated in different ways depending on the underlying cause of the high cortisol—if you're on glucocorticoids, your doc may be able to lower the dosage, but if you have a tumor causing it, you might need to be treated by surgery, radiation, or chemotherapy (the latter if it's cancerous), according to the Cleveland Clinic. The prescription medication ketoconazole can also help slow down cortisol production.
Left untreated, Cushing's syndrome can lead to heart attack, stroke, and type 2 diabetes, among other medical issues, says the NIDDK.
4. You're allergic to something.
Beyond causing red eyes and a rapidly emptying tissue box, an allergic reaction to food or pollen can cause facial inflammation, especially around your eyes and nose, says Dr. Stewart. Angioedema can actually be caused by an allergic reaction to certain medicines too, like Aspirin, ibuprofen, and certain heart or blood pressure medications, Dr. Friedman says.
The swelling typically appears in the form of hives, usually on the lips and eyelids (think: Will Smith in the movie Hitch!).
If someone with angioedema develops difficulty breathing, that is a medical emergency, as mentioned earlier. But for non-emergency cases, antihistamines can be useful, Dr. Friedman says. Note, though, that you may need higher than the recommended dose, and depending on the severity, epinephrine may be necessary, Dr. Garshick says, so you may still want to see your doc.
Many allergic reactions are a form of contact dermatitis (a reaction from coming in contact with a substance you're allergic to, like a new soap or lotion). Swelling and other symptoms typically develop 24 to 36 hours after exposure (think: a poison ivy reaction), Dr. Friedman says.
Luckily there's a quick fix in this case: Eliminate the trigger and get your hands on some over-the-counter allergy meds, like topical steroids, which can help dial down inflammation and reduce swelling. The problem should go away in days to weeks, Dr. Garshick says. If it's more severe, your doctor may prescribe oral steroids, Dr. Friedman adds.
5. You have a secret sunburn.
Yep, it's possible to get a sunburn even if you don't feel like you've been soaking up the rays. "Ultraviolet light exposure from your everyday activities adds up,” says Joshua Zeichner, MD, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital. “Not only can this cause redness, but in some cases, swelling as well.”
Nix your chances of getting a sunburn by applying sunscreen daily. And if you've already gotten a sunburn, Dr. Zeichner suggests putting on a light moisturizing lotion to soothe and hydrate your skin. You can also use anti-inflammatory drugs like ibuprofen to reduce swelling, but chances are it'll go away on its own, Dr. Garshick adds. If the burn is uncomfortable or doesn't improve in a few days, visit a dermatologist.
6. You have cellulitis.
Nope, we're not talking dimpled skin here (that's cellulite). Cellulitis is a bacterial skin infection that can cause your face (or anywhere else on your body, TBH) to rapidly inflate and become hot and red, says Dr. Stewart.
The most common cause of cellulitis is a bacterial infection, usually by Staphylococcus or Streptococcus, because these bacteria can enter the skin through cuts, wounds, insect bites, or other breaks in the skin barrier, says Dr. Kamangar. However, people with chronic skin conditions like eczema, psoriasis, or fungal infections like athlete’s foot may also have compromised skin barriers, making them more susceptible to cellulitis, she explains. Diabetics are also more prone to cellulitis due to reduced blood circulation, impaired immune function, and peripheral neuropathy (when the nerves located outside the brain and spinal cord become damaged) which can lead to unnoticed injuries and breaks in the skin, she adds.
If you develop these symptoms—and especially if the swelling spreads—high-tail it to the emergency room, stat. And it's relatively easy to treat—a weeklong course of antibiotics should clear it up, and it should be gone in days to weeks.
7. You've got the mumps.
Sounds old school, but this highly contagious illness is actually making a (scary) comeback. “In recent years, there have been outbreaks of mumps in some communities, particularly among populations with low vaccination rates,” says Dr. Kamangar. “Mumps can spread easily in close-contact settings such as schools, colleges, and other crowded environments, so individuals who are unvaccinated or have not received the recommended two doses of the MMR (measles, mumps, and rubella) vaccine are at higher risk of contracting mumps.”
The virus is spread from person to person through coughing, sneezing, and saliva, says Dr. Purdy. If you come down with mumps, you’ll likely have a headache, fever, and muscle aches, in addition to telltale swelling along the jawline, according to the U.S. National Library of Medicine. The swelling happens around the salivary glands and decreases as the condition gets better, Dr. Garshick notes.
If your doc confirms the condition through a saliva swab or blood test, your only choice is to wait it out. Most cases resolve in a couple weeks, per the CDC, but in the meantime, pain relievers and anti-inflammatories, as well as using a compress over the swollen glands can help, Dr. Garshick says.
8. Your thyroid might be out of whack.
The butterfly-shaped gland in your throat pumps out a hormone that regulates your metabolism and body temperature. If it’s producing too little, metabolic changes can cause your subcutaneous tissues (a.k.a. the stuff underneath your skin) to get bigger. "Some individuals with hypothyroidism may experience myxedema, which can include facial swelling," Dr. Garshick explains.
You’ll probably also feel chilly and weak and may notice that you have dry skin or get irregular periods.
Your doctor can run a simple blood test and prescribe medication if necessary. The swelling will ease once you address the underlying issue, Dr. Garshick says.
9. You have pink eye.
If the swelling is focused around your eye area, then you might be dealing with conjunctivitis (a.k.a., good ol' pink eye), an infection or inflammation of the membrane lining the eyelids.
“Most causes of conjunctivitis are due to viruses, but it can also be triggered by allergies, bacteria, or even your contact lenses,” says Kristamarie Collman, MD, an Atlanta-based family medicine physician and health expert. “In addition to swelling, you may also have redness, tearing, or itchy eyes.”
Treatment for pink eye will depend on the type—it could be a viral or bacterial infection, Dr. Collman says. "Viral conjunctivitis is typically treated with supportive therapy to include cool compresses and artificial tears for comfort," she says. "For bacterial conjunctivitis, it will require antibiotic eye drops."
10. You have rosacea.
If you have rosacea (whether you know it or not), certain triggers can lead to a flare-up, Dr. Zeichner says. Hot weather, spicy foods, alcohol, and emotional stress can all lead to facial flushing, burning, and even swelling.
"Facial swelling from rosacea will not necessarily improve on its own, but it is possible someone notices a worsening during flare-ups of rosacea as a result of certain triggers like temperature changes," Dr. Garshick explains.
A gentle cleanser, moisturizer, and a daily application of sunscreen can help keep rosacea symptoms in check, Dr. Zeichner says. Your dermatologist can also give you a prescription for a cream or pill that can help calm inflammation related to the condition. The swelling may last from weeks to months, Dr. Garshick adds.
11. You're taking a steroid.
If you've been prescribed one of these, then your puffy face might be the result of that condition mentioned earlier called “moon face,” says Chirag Shah, MD, an emergency medicine physician and the co-founder of Accesa Labs.
While the presence of moon face might be an indicator of an underlying medical condition like Cushing's disease, it can also be the result of taking prescribed steroids—and higher doses could lead to more significant side effects.
Generally, the swelling will go away after stopping the steroid, or in a matter of weeks to months, but if you have to be on one and the side effects are negatively impacting you, you should discuss with your doctor the possibility of lowering the dosage. It's also helpful to "avoid high salt intake to minimize the potential for fluid retention," Dr. Garshick notes.
How to Get Rid of Facial Swelling
"While not all forms of facial swelling will be responsive, several conditions associated with facial swelling may improve with these at-home treatments," Dr. Garshick says.
- Be gentle. "Use skincare that is gentle to avoid further irritation or further aggravation of the skin," Dr. Garshick says.
- Take OTC medications. Anti-inflammatories like ibuprofen can be beneficial, and sometimes you need an antihistamine, especially if the swelling is the result of an allergy. If so, it can reduce swelling and/or itching if the allergy isn't too severe, she explains. (If you're having difficulty breathing, however, this is a medical emergency.)
- Apply cold. If you wake up in the morning with a puffy face, Dr. Purdy suggests ice rolling or applying a cool compress to decrease swelling. When you’re in a pinch, splashing cold water on your face also does the trick, she adds.
- Limit your salt intake. "Since high-salt diets can contribute to fluid retention, this can make swelling appear worse," Dr. Garshick says.
How To Prevent Facial Swelling
You'll notice some of these sound familiar as many ways to avoid facial swelling all together overlap with those that can help treat it.
- Avoid triggers. Identify and avoid any triggers that may cause facial swelling, such as certain foods, allergens, or environmental factors like extreme temperatures or harsh chemicals, says Dr. Kamangar.
- Manage allergies. If you have known allergies, take steps to manage them effectively by avoiding said allergens, using over-the-counter antihistamines, or seeking medical treatment for severe cases, Dr. Kamangar says.
- Protect your skin. Use gentle cleansers, moisturizers, and sunscreen with at least SPF 30, notes Dr. Kamangar.
- Stay hydrated. Dehydration can contribute to facial swelling, so drink at least 11.5 cups (2.7 liters) of water throughout the day, says Dr. Purdy.
Laura Purdy, MD, is a family medicine physician and founder of SWELL Medical (SMed).
