Updated 22 May 2015

Facial swelling

Facial swelling is the accumulation of liquid in the face.


Other Names

Distended face; swollen face; moon face; facial oedema


Facial swelling is the accumulation of liquid in the face. It can involve the whole face, as well as the neck and arms. Unilateral or bilateral swelling can occur.

Possible causes

1. Tooth abscess
A tooth abscess can cause swelling on the side of the affected tooth. You can treat the abscess with a cold compress and with anti-inflammatory medication, such as. Myprodol. You should however consider making an appointment with a dentist, as the abscess has to be drained and oral antibiotics need to be taken.

2. Sinusitis
Facial swelling can occur over the cheek bones, as well as on the forehead. This condition can be very painful and has to be treated with antibiotics. Drainage and irrigation of the sinuses may also be necessary. It is therefore important to consult a doctor in order to have sinus X-rays taken, as well as a CT scan of the sinuses.

3. Angioedema
Angioedema is swelling in the deeper layers of the skin and is triggered by minor trauma, viral illnesses and is worsened with emotional upset and stress. It may appear with superficial swelling of the facial skin. This condition can also involve the periorbital (the skin around the eye) region of the eye, as well as the tongue. You should immediately consult your doctor when you present with these symptoms, in order to rule out angioedema and if you in fact have this condition, you will have to get an injection to reduce the swelling. Your doctor will also prescribe the necessary ointments and medication to resolve the problem.

4. Sty (hordeolum)
This is a tender smooth pimple on the lid margin, less than one week old. The sty can be external or internal and may cause swelling of the face around the eyes. You can treat the sty with warm soaks and an external ointment, i.e. chloromycetin. The sty will erupt by itself. If the sty persists, you will have to consult your doctor for incision and drainage.

5. Obesity

6. Surgery to the head, nose or jaws
Apply cold compresses to the affected areas and take anti-inflammatories for the pain and to reduce the swelling.

7. Facial trauma
Injury to the face can be mild or severe. Mild trauma will be trauma with bruising. This can be treated by applying an ice pack and taking pain tablets. Severe trauma to the face can include fractures of facial bones and deep lacerations to the skin. If you have severe facial trauma, you immediately have to visit your doctor for stitching of deep lacerations and X-rays of facial bones.

8. Malnutrition (when severe)

9. Drug Reactions
Facial swelling may occur when a patient has an allergic reaction to certain medications, such as penicillin or aspirin. When you suspect an allergic reaction, you should consult your doctor as soon as possible for anti-allergy injections or oral anti-histamines.

10. Reactions to a blood transfusion

11. Conjunctivitis
This presents with painful redness of the eye, as well as irritation. Swelling may occur around the affected eye. There is usually a thin pus discharge and the patient is normally sensitive to light and has decreased vision. Home treatment involves the application of a cool compress. It is, however, best to consult a doctor to establish if it is a bacterial or viral conjunctivitis.

12. Cellulitis
This is an infection of the eyelid and erythema (redness) of the skin, which does not involve the eye itself, but swelling around the affected area can occur. You should consult a general physician for treatment as soon as possible.

13. Hay fever, allergic rhinitis or a bee sting
Hay fever and allergic rhinitis (immune-mediated response of nasal mucosa to previously sensitised allergen) can cause allergic shiners (dark, puffy, lower lids). You should consult your doctor to start on the correct treatment or you can try using an over-the-counter drug such as Lorano.

A bee sting can also cause facial swelling and if you experience difficulty breathing, you should contact your doctor immediately, in order for emergency measurements to be taken.

Dr Anrich Burger, MB ChB (Stell), February 2008


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