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Facial Problems, Noninjury

Topic Overview

Facial problems can be caused by a minor problem or a serious condition. Symptoms may include pain, swelling, or facial weakness or numbness. You may feel these symptoms in your teeth, jaw, tongue, ear, sinuses, eyes, salivary glands, blood vessels, or nerves.

Common causes of facial problems include infection, conditions that affect the skin of the face, and other diseases.

Infections

  • Bacterial infections such as impetigo and cellulitis can cause facial pain and oozing blisters or sores.
  • Viral infections such as shingles may affect nerves in the face or head, causing severe facial pain or eye problems (keratitis).
  • An infected or blocked salivary gland or a salivary stone (sialolithiasis) may cause facial swelling or pain, especially in the parotid gland (parotitis), which is located near the ear.
  • Lyme disease is an infection that is spread by the bite of ticks infected with bacteria. It may cause facial pain, headache, stiff neck, or paralysis of the facial nerves.

Skin conditions

  • Rosacea is a chronic skin condition that causes redness on the face, usually on the cheeks, nose, chin, or forehead.
  • Acne commonly occurs on the face, especially in teens and young adults.
  • Seborrheic dermatitis causes red, itchy, flaky skin patches along the eyebrows, nose, and mouth.

Other conditions and diseases

  • Sinusitis causes a feeling of pressure over the facial sinuses. Sinusitis can follow a cold or may be caused by hay fever, asthma, or air pollution. It is more common in adults, but it can occur in children as an ongoing (chronic) stuffy nose.
  • Dental problems, including infections, can cause facial pain and swelling in and around the jaw area. Jaw pain may be caused by a temporomandibular (TM) joint problem. This condition can cause pain in the TM joint (located in front of the ear), in the ear, or above the ear. For more information, see the topic Mouth Problems, Noninjury.
  • Headaches, such as migraines or cluster headaches, can cause severe pain around the eyes, in the temple, or over the forehead. Giant cell arteritis generally affects older adults and may cause headache and pain and may lead to blindness if not treated. For more information, see the topic Headaches.
  • Trigeminal neuralgia is a condition that causes abnormal stimulation of one of the facial nerves. It causes episodes of shooting facial pain.
  • Closed-angle glaucoma causes vision changes and severe, aching pain in or behind the eye.
  • Conditions that cause problems with the muscles or nerves in the face include:
    • Bell's palsy, which is caused by paralysis of the facial nerve. Weak and sagging muscles on one side of the face is the most common symptom. It also may cause an inability to close one eye and mild pain in the facial muscles.
    • Multiple sclerosis, which may affect facial muscle control and strength, affect vision, and cause changes in feeling or sensation.
    • Myasthenia gravis, which causes facial muscle weakness leading to drooping eyelids and difficulty talking, chewing, swallowing, or breathing.
    • Facial paralysis from a stroke.
  • Lupus causes inflammation, fatigue, and a butterfly-shaped rash across the cheeks.

Treatment depends on what is causing your facial problem. In many cases, home treatment may be all that is needed to relieve your symptoms.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have a facial problem?
Yes
Facial problem
No
Facial problem
How old are you?
Less than 4 years
Less than 4 years
4 years or older
4 years or older
Are you male or female?
Male
Male
Female
Female
Have you had a head injury in the past 24 hours?
Yes
Head injury in past 24 hours
No
Head injury in past 24 hours
Have you had an injury to your face in the past 2 weeks?
Yes
Facial injury in the past 2 weeks
No
Facial injury in the past 2 weeks
Do you have symptoms of shock?
Yes
Symptoms of shock
No
Symptoms of shock
Are you having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
Would you describe the breathing problem as severe, moderate, or mild?
Severe
Severe difficulty breathing
Moderate
Moderate difficulty breathing
Mild
Mild difficulty breathing
Could you be having a severe allergic reaction?
This is more likely if you have had a bad reaction to something in the past.
Yes
Possible severe allergic reaction (anaphylaxis)
No
Possible severe allergic reaction (anaphylaxis)
Could you be having symptoms of a heart attack?
In some cases, a heart attack may cause a strange feeling in part of the face, such as the jaw.
Yes
Symptoms of heart attack
No
Symptoms of heart attack
Could you be having symptoms of a stroke?
Yes
Symptoms of stroke
No
Symptoms of stroke
Have you had any new vision changes?
These could include vision loss, double vision, or new trouble seeing clearly.
Yes
New vision changes
No
New vision changes
Did you have a sudden loss of vision?
A loss of vision means that you cannot see out of the eye or out of some part of the eye. The vision in that area is gone.
Yes
Sudden vision loss
No
Sudden vision loss
Do you still have vision loss?
Yes
Vision loss still present
No
Vision loss still present
Did the vision loss occur within the past day?
Yes
Vision loss occurred in the past day
No
Vision loss occurred in the past day
Have you had any changes in feeling or movement in your face?
Changes could include weakness or loss of movement in part of the face, numbness or tingling, facial drooping, or trouble closing an eye.
Yes
Changes in feeling or movement in face
No
Changes in feeling or movement in face
Is there any swelling in your face?
Yes
Facial swelling
No
Facial swelling
Was the swelling sudden?
Yes
Facial swelling was sudden
No
Facial swelling was sudden
Do you think the eyelid or the skin around the eye may be infected?
Symptoms could include redness, pus, increasing pain, or a lot of swelling. (A small bump or pimple on the eyelid, called a stye, usually is not a problem.) You might also have a fever.
Yes
Symptoms of infection around eye
No
Symptoms of infection around eye
Do you have any pain in your face?
Yes
Facial pain
No
Facial pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Do you have any eye pain?
Yes
Eye pain
No
Eye pain
Have you had facial pain for:
Less than 1 full day (24 hours)?
Pain for less than 24 hours
1 day to 1 week?
Pain for 1 day to 1 week
More than 1 week?
Pain for more than 1 week
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have diabetes, a weakened immune system, or any surgical hardware in the area?
"Hardware" in the facial area includes things like cochlear implants or any plates under the skin, such as those used if the bones in the face are broken.
Yes
Diabetes, immune problems, or surgical hardware in affected area
No
Diabetes, immune problems, or surgical hardware in affected area
Do you have a rash or any blisters on your face?
Yes
Rash or blisters on face
No
Rash or blisters on face
Do you think that a medicine may be causing the facial problem?
Think about whether the symptoms started soon after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing facial symptoms
No
Medicine may be causing facial symptoms
Have your symptoms lasted longer than 1 week?
Yes
Symptoms have lasted longer than 1 week
No
Symptoms have lasted longer than 1 week

Severe trouble breathing means:

  • You cannot talk at all.
  • You have to work very hard to breathe.
  • You feel like you can't get enough air.
  • You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

  • It's hard to talk in full sentences.
  • It's hard to breathe with activity.

Mild trouble breathing means:

  • You feel a little out of breath but can still talk.
  • It's becoming hard to breathe with activity.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

  • The child cannot eat or talk because he or she is breathing so hard.
  • The child's nostrils are flaring and the belly is moving in and out with every breath.
  • The child seems to be tiring out.
  • The child seems very sleepy or confused.

Moderate trouble breathing means:

  • The child is breathing a lot faster than usual.
  • The child has to take breaks from eating or talking to breathe.
  • The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

  • The child is breathing a little faster than usual.
  • The child seems a little out of breath but can still eat or talk.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Symptoms of shock (most of which will be present) include:

  • Passing out.
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Symptoms of a severe allergic reaction (anaphylaxis) may include:

  • The sudden appearance of raised, red areas (hives) all over the body.
  • Rapid swelling of the throat, mouth, or tongue.
  • Trouble breathing.

A severe reaction can be life-threatening. If you have had a bad allergic reaction to a substance before and are exposed to it again, treat any symptoms as an emergency. Even if the symptoms are mild at first, they may quickly become very severe.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness, tingling, or a strange feeling in your chest or other areas.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Symptoms of shock in a child may include:

  • Passing out.
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Symptoms of a stroke may include:

  • Sudden numbness, tingling, weakness, or paralysis in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.
Head Injury, Age 4 and Older

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Facial Injuries
Head Injury, Age 3 and Younger

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Home Treatment

Facial or sinus pressure, mild headache, or nasal stuffiness are common with a cold or flu. Home treatment can help relieve your symptoms.

  • Drink plenty of fluids. Extra fluids help keep mucus thin and draining, which may help prevent blockage of the sinuses.
  • Use a humidifier to keep the air in your home moist.
  • Inhale steam from a vaporizer, or take long, steamy showers. You may also try breathing the moist air from a bowl of hot water. Put a towel over your head and the bowl to trap the moist air. Make sure the water isn't too hot. Be careful not to get burned by the hot water or steam.
  • Use saltwater nasal washes to help keep the nasal passages open and wash out mucus and bacteria. It also may help to gargle with warm salt water. [Add 1 tsp (5 g) to 16 fl oz (500 mL) of water.]
  • Put warm, wet compresses on your eyes and cheekbones if you have pain around that area. Washcloths dipped in hot water work well. Make sure the water is not too hot so you do not get burned.
  • Avoid alcohol. It makes the tissues lining your nose and sinuses swell up.
  • Do not swim in chlorinated swimming pools. Chlorine can irritate nasal and sinus linings.
  • Elevate your head at night. Some people find it helpful to sleep on 2 or 3 pillows.
  • Use decongestants to relieve nasal stuffiness.
    • Decongestants can be taken by mouth or used as nose drops or sprays. Oral decongestants, such as pseudoephedrine (Sudafed), are probably more effective and provide longer relief, but they cause more side effects. Sprays and drops provide rapid but temporary relief.
    • Check with your doctor before using nonprescription medicines if you have high blood pressure or kidney disease. Some state laws require that medicines containing pseudoephedrine (such as Sudafed) be kept behind the pharmacist's counter or be prescribed. You may need to ask the pharmacist for it or have a prescription from your doctor to buy the medicine.
    • Use decongestant nasal sprays sparingly and for only 3 days or less. Continued use may lead to a rebound effect, which causes the mucous membranes to become more swollen than they were before you started using the spray.
Note: Decongestants may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and, in some cases, weight.

Do not smoke or use other tobacco products. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Smoking.

Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

For home treatment measures on other types of facial symptoms, such as eye, nose, mouth, or ear, see the specific topic in Related Information.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Facial pain or swelling increases.
  • Vision changes develop.
  • Painful facial rash develops.
  • Facial feeling or sensation changes develop.
  • Symptoms become more severe or more frequent.

Prevention

The following home treatment measures may help prevent sinusitis:

  • Use a humidifier to keep the air in your home moist.
  • Treat colds promptly. Blow your nose gently. Do not close one nostril when blowing your nose.
  • Drink extra fluids when you have a cold. This helps keep mucus thin and draining.
  • Do not drink alcohol. It makes the tissues lining your nose and sinuses swell up.
  • Do not smoke or use other tobacco products. Smokers are more prone to sinusitis. Also, avoid secondhand smoke. For more information, see the topic Quitting Smoking.
  • Use a decongestant nasal spray before or during airplane flights, especially during landing.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What are your main symptoms? How long have you had your symptoms?
  • Have you had this problem before? If so, how was it treated?
  • What makes your symptoms better or worse?
  • Have you recently had a cough, cold symptoms, allergies, or headaches? Be prepared to describe any nasal drainage or sputum coughed up, or the location and severity of headaches.
  • Have you had an injury to this area? Do you have any continuing problems because of a previous injury?
  • What home treatment measures have you tried? Did they help?
  • What prescription or nonprescription medicines do you take?
  • Do you have any health risks?

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer David Messenger, MD
Last Revised April 3, 2013

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