Facial Swelling Symptom Evaluation

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Facial swelling may appear as a small swelling affecting a part of the face, or a generalized swelling of the face.

Facial swelling is one of the symptoms that rarely go unnoticed. It may be localized to one part of the face, or may affect the whole face. Swelling of the whole face may be due to some condition affecting the entire body like kidney disease, low thyroid hormone level, or an allergic reaction. A small localized swelling affecting a part of the face is usually due to a problem in that part alone.

Causes of localized facial swelling include:

• Lymph node swelling: Lymph nodes, small nodes that drain lymphatic fluid, swell up when the area that they drain is infected or sometimes cancerous. Lymph nodes in the face and neck region are commonly enlarged in the presence of an infection of the respiratory tract. In such cases, the nodes may be painful and the skin overlying the nodes may be red. In case the nodes are draining an area that is cancerous, the nodes are usually very hard to feel.
• Sinusitis: Sinusitis sometimes results in swelling in the upper cheek and brow region. Swelling around the eye orbits could be due to inflammation of the frontal or ethmoidal sinuses, the sinuses located in that area. The infection could affect the bone overlying the frontal sinus and result in an abscess, a condition referred to as Pott puffy tumor. This condition is rare nowadays with the available antibiotics.
• Tooth infection: A tooth or gum infection with or without an abscess can result in swelling of the face over the jaw. The swelling is also accompanied by severe pain and difficulty with opening the mouth.

• Eye infection: An eye infection may result in swelling around the eye. The eye may be red and sometimes painful. A swelling may occur at the edge of the eyelid due to infection of a hair follicle; this condition is referred to as stye. A swelling on the upper and outer part of the eye may indicate a problem with the tear gland.
• Salivary gland disorders: Swelling of the salivary glands may be observed in the presence of an infection. The swellings are present just below the cheeks or under the lower jaw. Mumps is a common viral infection that results in painful and swollen salivary glands. In some cases, a small stone may block the salivary ducts and prevent the free flow of saliva, resulting in swelling.
• Cysts and other swellings present from birth: Some swellings like cysts may be present since birth and may continue to remain their original size. Some of these swelling like hemangioma (swelling of blood vessels) may increase in size slowly.
• Cancers: Cancers result in swellings that grow very rapidly. Two skin cancers - basal cell cancer and squamous cell cancer commonly affect the face. Besides, cancers can also affect the salivary glands. Mouth cancers are quite common in people who chew tobacco. The cancers could affect a nerve and cause paralysis of the facial muscles supplied by the nerve. Painless lymph node swellings may also be present.

Conditions that can result in swelling of the entire face include:

• Allergic reactions: An allergic reaction can cause swelling and puffiness of the face. The reaction could be due to a medication, food, blood transfusion, bee sting or due to any other reason. The swelling may be accompanied by a rash and itching. Food allergy commonly results in swelling of the lips. Extreme allergy can cause swelling of the neck region that may be accompanied by difficulty in breathing.
• Facial injury: Injury to the face following an accident or surgery is often accompanied by facial swelling. Abrasions indicating the injury may be present on the face. The swelling usually subsides in a few days.
• Malnutrition and kidney disease: Severe malnutrition and kidney disease result in low protein levels in the body. This is followed by excessive accumulation of fluid in the tissues under the skin, a condition called edema. Edema in the facial region results in swelling of the face. People especially children with kidney disease who use corticosteroids over prolonged durations may suffer from a condition called "moon face," where the face appears round and puffy.
• Low thyroid hormone levels: Low thyroid hormone levels are associated with puffiness of the face and weight gain. The condition is diagnosed by estimating the thyroid hormone levels. The swelling reduces once the thyroid hormonal levels returns back to normal.

Frequently Asked Questions (FAQs)

1. Which doctor should I visit in case I suffer from facial swelling?

You should see a specialist depending on the type of facial swelling. For example, for a swelling over the eyes, you need to visit an ophthalmologist. In case you are not sure which doctor to visit, you could ask your family doctor to guide you.

2. How is facial swelling treated?

Facial swelling usually subsides when the underlying cause is treated. Cold compresses may be applied in cases where the swelling is due to an injury. Warm compresses are useful in the treatment of styes. The head end of the bed may be elevated to reduce the swelling in some cases.

References:

1. Khanna G, Sato Y, Smith RJH, Bauman NM, Nerad J. Causes of Facial Swelling in Pediatric Patients: Correlation of Clinical and Radiologic Findings RadioGraphics 2006; 26:157�171
2. Facial swelling - (http://www.nlm.nih.gov/medlineplus/ency/article/003105.htm)

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