If Your Face Is Way More Swollen Than Usual, A Hormonal Issue Could Be To Blame
So you woke up looking like a puffer fish, huh? Having a swollen face can be scary—whether it’s major puffiness around the eyes or red and inflated cheeks. Plus, there are a whole number of reasons that can cause facial swelling, from those cocktails during dinner last night to an actual medical issue.
First: How do you know if your swollen face in NBD or worth calling your doctor about? If you think you may be having a severe allergic reaction (think: you're having difficulty breathing in addition to facial swelling), seek medical attention right away.
Some allergic reactions can be remedied with topical steroid, explains Adam Friedman, MD, professor and interim chair of dermatology at George Washington School of Medicine and Health Sciences—but there are also times when home remedies won't do. 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 medical emergency when it involves both the face and the lining of the respiratory tract (which may cause difficulty breathing).
But if you're breathing fine, there's no need to call 911. You're probably experiencing general face swelling caused by one of the other medical problems below. Luckily, there's something you can do about most of them (whew!).
1. You've got a nasty sinus infection.
If the lining of your sinuses—the air-filled spaces between the eyes and behind your forehead, nose, and cheekbones—becomes inflamed or infected, they can get clogged with mucus. The pressure caused by that 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 antibiotics—just wait it out). Focus on resting, drink lots of fluids, and try an over-the-counter antihistamine, says Rosalyn Stewart, MD, 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.
Your dentist can prescribe antibiotics and will likely have to perform a root canal to remove the infected nerve. 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 affects 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 inflammation, per the NIDDK.
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, pollen, or even a medication 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 blood or heart pressure medications, Dr. Friedman says. The swelling will usually appear 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. But it often requires higher then the recommended doses, so you may still want to see your doc.
Luckily, 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: Over-the-counter allergy meds, like topical steroids, can help dial down inflammation and reduce swelling. If it's more severe, an MD may prescribe oral steroids, Dr. Friedman says.
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 rays. "Ultraviolet light exposure from your everyday activities adds up,” says Joshua Zeichner, MD, 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 applying a light moisturizing lotion to soothe and hydrate your skin. If the burn is uncomfortable or doesn't improve in a few days, visit a dermatologist for professional treatment.
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 Stewart.
If you develop these symptoms—and especially if the swelling spreads—high-tail it to the emergency room, stat. Left untreated, the illness can be deadly. And it's relatively easy to treat—a weeklong course of antibiotics should clear it up.
7. You've got the mumps.
Sounds old school, but this highly contagious illness is actually making a (scary) comeback. If you come down with mumps, you’ll likely have a headache, fever, and muscle aches, in addition to telltale chipmunk cheeks, according to the U.S. National Library of Medicine.
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 few weeks, per the Centers for Disease Control and Prevention.
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. “Everything fills out a little,” says Dr. Stewart, referencing overall swelling.
You’ll probably also feel chilly and weak and may notice that you have dry skin or that your periods have become irregular. Don't freak: Your doctor can run a simple blood test and prescribe medication if necessary.
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), a nasty 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.”
Dr. Collman says treatment for pink eye will depend on the type—it could be a viral or bacterial infection. "Viral conjunctivitis is typically treated with supportive therapy to include cool compresses and artificial tears for comfort," she says. "For a 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 even emotional stress can all lead to facial flushing, burning, and even swelling.
Dr. Zeichner says a gentle cleanser, moisturizer, and a daily application of sunscreen can help keep rosacea symptoms in check. Your dermatologist can also give you a prescription for a cream or pill that can help calm inflammation related to the condition.
11. You're taking a steroid.
If you have been prescribed one of these bad boys, then your puffy face might be the result of that condition mentioned earlier called “moon face,” says Chirag Shah, MD, a board-certified emergency medicine physician and co-founder of Accesa Labs.
While the presence of moon face might be an indicator of an underlying medical condition like Cushing's disease (as mentioned!), it can also be the result of taking prescribed steroids—and higher doses could lead to more significant side effects.
If you are struggling on a dose of steroids, then you should discuss with your doctor the possibility of reducing the dosage. Possible good news? Actress Sarah Hyland—who has been on prednisone as a result of a lifelong kidney condition—swears by using a face roller to reduce the appearance of a puffy face.
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