Facial swelling: causes, treatment and home remedies

Facial swelling: causes, treatment and home remedies

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Puffy face

If a facial swelling occurs, it causes a great deal of fright and an unpleasant feeling of shame for many sufferers. In parallel, pain, discomfort such as tingling or an increased sensitivity to pressure occur in many cases, which can make the swelling very uncomfortable and stressful. The causes are varied, often it is an allergy or diseases of the kidneys, liver or heart.

An underactive thyroid, problems in the tooth and jaw area or headache can also lead to a swollen face. There are also comparatively “harmless” reasons such as a sleepless night or a heavily salted meal the night before. As a swelling can be a symptom of many diseases, it should always be checked by a doctor as a precaution, which is especially true if symptoms persist for a long time or suddenly.

Causes of facial swelling

If there is a swelling on the face, this is a sign of a water accumulation in the tissue, which is medically called "edema". There are various possible causes, such as lack of sleep, certain medications (e.g. cortisone or antidepressants), alcohol or drug abuse, an insect bite or an abscess. Inflammation of the sinuses, diseases of the kidneys and liver as well as heart failure (heart failure) can also be the triggers. An underactive thyroid, tooth and jaw diseases such as pulpitis or childhood diseases such as mumps also quickly lead to water accumulation on the face.

Facial swelling in allergy

Another reason for facial swelling can be an allergic reaction, as a result of which the messenger substance histamine is released by the body (histamine-mediated angioedema). This is a natural substance that is found in almost all animal and human cells and, among other things, causes the walls of the vessel to become temporarily permeable and liquid to escape from the blood vessel into the surrounding tissue. As a result, the swelling occurs, and the histamine also causes the blood vessels to expand, causing reddening of the skin.

The cause can be hay fever, for example, which causes angioedema in the form of swelling of the nasal mucous membranes, food allergies can also cause swelling in the neck and mouth area or, in an emergency, even an anaphylactic shock.

Histamine-mediated angioedema can also have other, non-allergic triggers, but this leads to allergy-like reactions. Examples include a flu infection, drug intolerance (e.g. aspirin) and autoimmune reactions. There are also a number of non-specific triggers, such as intense physical exertion, emotional stress, cold or warmth, long periods of sitting or standing, or contact with certain chemicals. Angioedema often occurs together with urticaria (urticaria). In addition, it can happen that the reason for the skin changes cannot be clarified or cannot be fully clarified ("idiopathic angioedema").

In addition to the histamine-mediated form, angioedema can also occur in rare cases due to an inherited deficiency or defect of the so-called "C1-esterase inhibitor" (short: "C1-INH"), which is a protein that has different metabolic processes regulated ("hereditary angioedema"). Likewise, the swelling of the skin as a result of taking cardiovascular medications (ACE inhibitors such as Benazepril or AT inhibitors such as candesartan) or due to certain diseases or processes in the body that lead to a lack of C1-INH (“acquired angioedema”), arise.

All forms of angioedema are characterized by swelling of the skin, whereby the extremities (arms, legs, hands, feet), the face and the genitals are most often affected. The skin changes do not usually show up as an itchy rash, but cause tingling, tension or pain. Histamine-mediated angioedema in particular occurs primarily on the face, especially on the lips and around the eyes, with only one eye swollen in some cases. Since these occur relatively often with hives, wheals and reddening of the skin are also typical.

Swelling of the mouth or throat

Histamine-mediated angioedema occurs in the mouth or throat area (larynx) less often - but all the more dangerous - which can lead to a foreign body sensation in the throat, voice changes, difficulty swallowing, difficulty breathing and hoarseness.

Danger: Since there is an acute risk of suffocation due to the swelling, a doctor should be consulted immediately if the larynx or tongue becomes suspected, or the emergency service should be called on 112.

Hereditary angioedema (HAE), in particular, also causes swelling attacks in the gastrointestinal area, which can manifest themselves in the form of nausea and vomiting, cramps and diarrhea. Here it can happen that the swelling occurs only "internally" and there are no externally recognizable skin changes, so that the complaints are not seldom other diseases such as e.g. an irritation or inflammation of the appendix.

Facial swelling after cortisone

It is also possible that a swollen face is caused by treatment with cortisone (cortisone), which is also an endogenous hormone and one of the best known drugs. The colloquial term "cortisone" includes several hormones (glucocorticoids) that are produced in the adrenal cortex and affect the cardiovascular system and metabolism, among other things, and have an anti-inflammatory effect.

Accordingly, these are mainly used for rheumatism, bronchial asthma and inflammatory bowel diseases such as Crohn's disease as well as for skin diseases such as neurodermatitis, psoriasis or eczema in order to contain the inflammatory reactions. Since glucocorticoids also suppress immunological processes (immunosuppression) and thereby prevent excessive auto-aggressive immune reactions, cortisone is often used in the treatment of allergies and autoimmune diseases.

The drug used here is synthetically produced glucocorticoids, which can be used almost universally and can therefore help very effectively, particularly in the case of chronic inflammation. Nevertheless, there is often a certain skepticism about the drug, because patients are anxious and uncertain about the term “cortisone” and fear serious side effects such as thin skin and puffy faces.

This fear is not unfounded, because in addition to the desired effects, the drug can have a variety of possible side effects, especially when used in high doses and / or for long periods. E.g. If gels, creams or ointments containing cortisone are used for longer than approx. two weeks at a time, thinning of the skin, red veins or a form of acne (steroid acne) may occur.Nose drops containing cortisone can thin the nasal mucous membrane and dry out what often results in nosebleeds.

Other possible side effects of cortisone after short-term, high-dose use can be dizziness, headache, insomnia or depression.

If the dose is too high over a longer period of time, the risk of symptoms of a so-called “Cushing syndrome” increases, which are caused by the increased hormonal effects of the glucocorticoids on the tissues. These include muscle weakness or muscle loss, osteoporosis, high blood pressure, weight gain, facial swelling ("full moon face"), facial flushing, cloudy eyes (cataracts), bruising or water retention in the tissue.

Reduce side effects of cortisone

Now that side effects have been well researched, cortisone is used differently and more carefully now than in the past. Accordingly, acute cases are treated as shortly as necessary, and only very low doses are used for chronic diseases that require long-term treatment. In addition, the active ingredient has been further developed in recent years and the side effects reduced, especially because this is due to the new dosage forms such as Creams, ointments, eye drops or inhalers can be used in a targeted and limited manner and no longer have an automatic effect on the whole body, as was previously the case with tablets or injections.

In addition to this, patients who have to take cortisone regularly can do a few things themselves to alleviate or avoid side effects. According to the professional association of German internists (BDI), it is particularly important to regularly monitor body weight to prevent weight gain, which can result from an increase in appetite as a result of taking the medication. Since this increases the blood sugar level, care should be taken to ensure that the diet is as low in sugar as possible. It is also important to have sufficient protein intake with a low fat content in the diet, since the cholesterol level also rises.

Since higher doses suppress the body's salt excretion and a reduction in bone density can occur, a low-salt diet is recommended to avoid high blood pressure and osteoporosis, as well as a high calcium and vitamin D intake Be integrated into everyday life to keep the body resilient and fit.

The adrenal cortex most often forms the body's own cortisone in the morning, so it is generally advisable to take cortisone tablets between 6 and 8 a.m. in order not to disturb the natural rhythm of the body as much as necessary. If the drug has been used for a long period of time, treatment should never be stopped abruptly, otherwise the symptoms may become worse, or circulatory failure or shock may occur. Instead, the medication is slowly discontinued (“tapering off”) by gradually reducing the dosage until the body can start producing the cortisone in the adrenal cortex again.

In general, close cooperation between patient and doctor is very important, especially when taking the product for a long time, in order to avoid side effects as much as possible, because internal use may e.g. take no more than 3 to 4 weeks in high doses without medical supervision. For this reason, those affected should inform themselves as extensively as possible about cortisone and its treatment in order to be able to actively shape its course and to minimize risks.

Facial swelling on one side

If the symptoms occur unilaterally, the so-called trigemino-autonomous headache (TAKs) can be the trigger, which refers to a group of attack-like, strongest headaches that occur in the area of ​​the trigeminal nerve. In addition to the pain, there are usually other symptoms such as Eye tears, a runny nose, restlessness, a reddened eye or swelling of the affected half of the face, whereby there is at least one other typical characteristic regardless of the type of headache.

Depending on the duration and frequency of the attacks, different types of trigemino-autonomous headache are distinguished, with all forms being equally episodic, i.e. with longer symptom-free phases, as well as chronic or with almost daily complaints.

The best known example is the cluster headache, which is extremely pronounced, one-sided pain, which sometimes occurs several times a day for about 30 minutes to three hours in the area of ​​the forehead or behind the eyeball. Another well-known form of trigeminal autonomic headache is the "paroxysmal hemicrania", in which the symptoms also occur in seizures, but more often than cluster headache, but for a shorter duration.

Unilateral swelling due to salivary gland inflammation

Inflammation of the salivary gland can lead to sudden, mostly unilateral (with mumps bilateral) and very severe pain and swelling of the face in the area of ​​the affected gland. This feels hardened and is very sensitive to pressure, sometimes the skin is hot and red all around and there is a fever. Symptoms usually increase when eating, as saliva builds up, which puts additional pressure on the affected tissue.

In some cases, pus may drain into your mouth. If the parotid gland is affected, jaw pain and problems with opening the mouth often occur due to the close proximity to the temporomandibular joint and the chewing muscles.

The three large salivary glands (sublingual, mandibular and parotid glands) are most often affected, in addition to which the smaller glands in the throat, lips or cheek mucosa may also be inflamed. In most cases, the inflammation is caused by bacteria (staph or streptococci) or viruses. The most common cause of acute childhood salivary gland inflammation is mumps, but Coxsackie viruses can also be responsible.

A so-called “saliva stone” (sialolite) has a beneficial effect, clogging the passage of the salivary gland and thereby ensuring a secretion of secretion, which provides the pathogens with an ideal breeding ground. Such a stone can in turn be caused by various underlying diseases such as an excess of calcium (hypercalcemia), diabetes mellitus or gout. In addition to this, scars or a tumor can also cause the saliva drain to be disrupted and pathogens can therefore have an “easier game”.

Further risk factors for the development of salivary gland inflammation are insufficient oral hygiene, a disturbed electrolyte or water balance, malnutrition or certain medications that reduce saliva production, e.g. draining agents (diuretics), antidepressants or preparations for allergies (antihistamines). In rare cases, autoimmune diseases such as Sjögren's syndrome (also called “Sicca syndrome”) come into consideration, in which a dry mouth and dry eyes are the typical symptoms.

Swollen face after dental treatment

Often there is a severe swelling of the face after a dental surgery, which is quite normal in this case and almost unavoidable due to the high stress on the tissue. The same applies to the wound pain that appears after a dental operation, but usually physical protection and cooling of the affected area helps to alleviate the symptoms. However, it should be ensured here that the Coolpack or similar. wrapped with a cloth and not placed directly on the wound to avoid skin damage or hypothermia.

In addition to this, it is advisable to avoid physical exertion, exercise and household chores, as this increases blood pressure and delays healing. The same applies to coffee, black tea, cola, alcohol and nicotine, as well as hot spices, hot and very cold drinks and food, juices and milk should be avoided for a day or two to avoid bleeding and poor wound healing.

It is important that you let the wound rest and do not press on it or the like. otherwise there is a risk that it will burst again and start bleeding. Oral hygiene should generally not be dispensed with even after surgery, but bypassing the wound area. It is advisable to exercise caution when using electric toothbrushes and irrigators to avoid inflammation.

Normally, the facial swelling subsides significantly after a few days, but it lasts longer and is still accompanied by pain and / or persistent bleeding, fever or other disorders of general well-being, e.g. indicate inflammation or a wound healing disorder. Accordingly, a dentist should be consulted immediately in this case in order to clarify the cause and to avoid complications.

Facial swelling in the morning

If the face is swollen and puffy, especially in the morning, there are various reasons for this, e.g. A night that is too short or alcohol or drug use on the evening before may be considered, which can lead to a disturbed lymph flow and thus to water accumulation in the tissue. In many cases, a diet with a lot of salt, protein and sugar is the reason for water retention, which is visible through swelling of the eyes or rings under the eyes, but also through swollen legs or thick feet.

Dental problems are often responsible for those affected waking up in the morning with a "thick cheek" and toothache. The reason for this is often a so-called "pulpitis", which is an inflammation of the dental pulp (medically "pulp"), which fills the inside of the tooth and is enclosed by tooth enamel, dentin and root cement. This is also known as "tooth root infection" or "tooth nerve inflammation" and in most cases is caused by caries that is not treated in time, as a result of which the caries bacteria penetrate step by step into the interior of the tooth and cause inflammation there.

In addition to this, mechanical triggers such as an injury from a blow to the tooth or grinding of the teeth can be considered, as a result of which the protective hard tooth substance of the pulp breaks off and the tooth nerve is exposed. Such an irritation can also result from dental treatment (e.g. preparation of the tooth for a crown), and it is also possible that periodontitis that is not or only insufficiently treated spreads to the tooth root and causes inflammation.

Typical for pulpitis is a strong throbbing or throbbing toothache, which is often exacerbated by the warmth of the bed at night. The affected tooth is extremely sensitive to cold, heat and pressure. The inflammation can quickly spread to the jawbone and the surrounding tissue, causing the swelling of the face known as the "thick cheek".

A “dead” tooth can be responsible for swelling of the gums and cheeks. Other dental problems may also be considered, such as gingivitis, periodontitis or an abscess in the root or jaw area, which can lead to complications such as narrowing of the airways or the spread of germs in the body. Accordingly, in the event of toothache and / or facial swelling due to dental problems, a dentist should always be consulted immediately, who can clarify the cause of the complaints and initiate the necessary treatment steps.

Treatment for a swollen face

For example, while swelling due to dental surgery usually disappears after a few days, water retention in other cases, such as in the case of a thyroid dysfunction, kidney weakness or food allergy, occur again and again or permanently and be of very different degrees. Accordingly, the treatment is carried out depending on the cause, for example in the case of acute allergy, cortisone and antihistamines are frequently administered, or in the case of an underactive thyroid, synthetically produced thyroid hormones. If there is a bacterial infection, antibiotics are used in many cases, as is the treatment of abscesses after dental treatment.

If there is a cluster headache disorder, the treatment usually consists on the one hand of relieving the pain during the seizures (acute therapy) and on the other hand of preventing further attacks in the pain-free phases (prophylaxis). In this way, the complaints can be largely managed in most cases, whereas a complete cure has not yet been possible. In acute therapy, the inhalation of 100 percent oxygen via a face mask is usually the means of choice, but it is also possible to use sumatriptan, which is injected under the skin (subcutaneously) by the person concerned using a so-called "auto-injector" can.

As part of the prophylaxis, the drug "Verapamil" is used above all, other active ingredients are, for example, topiramate, melatonin or valproic acid, although in the case of chronic cluster headaches it is sometimes necessary to combine several drugs for treatment. If these measures do not help, there is the possibility of so-called neuromodulation therapy, in which the transmission of nerve impulses is suppressed by weak electrical stimuli and the frequency and severity of the pain attacks are consequently reduced.

Naturopathy for facial swelling

Once the cause of the facial swelling has been clarified by a doctor, depending on the cause and appearance of the water retention in the tissue, in addition to conventional medical treatment methods, various naturopathic methods and home remedies can help to alleviate the symptoms. Cooling is usually a beneficial first aid measure to reduce swelling and reduce severe pain. However, it is important to ensure that cold packs, cool packs or the like. never placed directly on the skin, but wrapped with a cloth to avoid hypothermia or frostbite.

It makes sense to use certain medicinal plants, such as birch or nettle, which have a diuretic and anti-inflammatory effect, thereby preventing the build-up of water in the tissues and promoting their breakdown. Here e.g. Tea is made from nettle leaves by brewing about 8 teaspoons of fresh or dried leaves with boiling water for one liter. After a brewing time of 10 minutes, the tea should then be drunk throughout the day, but is not suitable in the case of facial swelling due to heart or kidney problems.

Certain healing stones can offer effective support, for example by massaging the affected area on the face or taking a liquid preparation (e.g. gemstone water). In the case of swelling in the face, stone medicine offers the minerals "chalcedony" and "beryl", which promote lymph flow, reduce lymph node swelling and edema and alleviate allergic reactions.

In addition to that, natural remedies are well suited for swollen areas as a result of an insect bite, although in the case of an insect bite allergy they can never replace the emergency kit with antihistamine, cortisone and adrenaline and / or the (emergency) doctor. Every allergy sufferer should carry the set with him at all times and take it as quickly as possible after a sting, it is also absolutely important to keep calm and call the emergency doctor immediately, especially if the symptoms also appear on other parts of the body or there is difficulty in breathing and rapid heartbeat.

If, on the other hand, "normal" reactions such as redness, swelling and itching occur at the puncture site, a cut onion, which is placed on the sting for a few minutes, can help. Likewise, a few drops of tea tree or lemon oil, which are dabbed on the sting with a piece of cotton wool, can alleviate the swelling, while lavender oil is also recommended to reduce itching.

Facial swelling usually occurs even after a dental surgery, due to the high stress on the tissue. Arnica is an important remedy in homeopathy, since it supports wound healing and has a decongestant effect. Taking Arnica D12 (or higher) has proven itself, and Symphytum (D8 or D10) and Hypericum (D10 or D12) can also be helpful to relieve symptoms after the operation. In general, it is advisable to take 5 globules or five to ten drops of the medication three to four times a day, but the exact dosage and the duration of use should be discussed with a doctor, homeopath or pharmacist.

Effective home remedies for a swollen face

If the eyes in the morning due to "harmless" causes such as Having a salted or protein-rich late meal, lack of sleep or crying is often the best way to help proven home remedies. The most important thing here is to drink plenty of water to stimulate lymphatic transport and reduce swelling.

Freshly sliced ​​cucumber slices that are placed on the eyes are very popular because they cool and moisturize at the same time. This "small cold shock", which causes swelling, can also be achieved with a spoon that was stored in the ice compartment at night or with cooling glasses. Briefly brewed and cooled tea bags of black or green tea can also be helpful.

With thick eyes, an eyebright compress is recommended, for which one or two teaspoons of eyebright tea (from the pharmacy) are first brewed with boiling water. After the tea has brewed for eight to ten minutes and has cooled slightly, a cotton pad is dipped into the tea, gently squeezed out and placed on the closed eye.

A mask with curd cheese can be very helpful because it has a decongestant, anti-inflammatory and analgesic effect and also cools the face in a pleasant way. To do this, simply place natural quark about half a centimeter thick on a tea towel or kitchen paper, wrap it in it and then place it on the swollen area until the quark has dried. It should be ensured that it is not too cold, but has a temperature of around 18 degrees Celsius when starting to use it. (No)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese


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Video: Reduce Facial Swelling (August 2022).