Waking up with chipmunk cheeks is less than ideal. Sometimes, you can blame it on that extra glass of wine you drank at dinner the night before, but if the facial swelling seems to have come on for no reason, it could be a sign that something else is going on.
Allergic reactions are a common culprit of sudden facial puffiness. 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.
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Sometimes facial swelling can 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. If the swelling is persistent or worsening and you have other symptoms such as pain, burning, itching, or a fever, you should get checked out by your doc.
Still, for some peace of mind, you may want to find out what you're potentially dealing with. Here are all possible reasons your face is swollen, according to doctors. Thankfully, most of them can be easily treated. (Phew!)
Meet the experts: 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.
1. You've got a nasty 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 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 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 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 can 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 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, 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 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.
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: 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.
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, 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. 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. 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 few weeks, per the Centers for Disease Control and Prevention, 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.
Don't freak: 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), 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.”
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 even 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 bad boys, 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 are beneficial, and sometimes you need an antihistamine, which helps, 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, she recommends considering epinephrine as well.)
- Apply cold. Ice or a cold compress are helpful for certain types of facial swelling.
- Limit your salt intake. "Since high-salt diets can contribute to fluid retention, this can make swelling appear worse," she says.
Caroline Shannon-Karasik is a writer and mental health advocate based in Pittsburgh, PA. In addition to Women's Health, her work has appeared in several print and online publications, including The Cut, Tonic, Narratively, Good Housekeeping, Redbook, and DAME. She is currently writing a collection of essays.
Alexis Jones is an assistant editor at Women's Health where she writes across several verticals on WomensHealthmag.com, including life, health, sex and love, relationships and fitness, while also contributing to the print magazine. She has a master’s degree in journalism from Syracuse University, lives in Brooklyn, and proudly detests avocados.
Addison Aloian (she/her) is an editorial assistant at Women’s Health. When she’s not writing about all things pop culture, health, beauty, and fashion, she loves hitting leg day at the gym, shopping at Trader Joe’s, and watching whichever hockey game is on TV. Her work has also appeared in Allure, StyleCaster, L’Officiel USA, V Magazine, and Modern Luxury Media.