Swelling Of The Face : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 01/09/2022

Swelling of the face occurs due to fluid retention in the soft tissues, accompanied by a change in the contours of the face, giving the impression of puffiness. In a severe case, the face resembles a pillow, the features are deformed. The symptom is caused by physiological causes, allergic reactions, some endocrine and somatic diseases, exogenous intoxications. A connection with external factors, time of day, and the general condition of the patient can be detected. To determine the cause, an external examination, laboratory tests, and imaging studies are carried out. Treatment until the cause of facial edema is more often not indicated, with allergies, antiallergic drugs are taken.

Why does the face swell

Physiological causes

In the absence of allergies, intoxication and chronic diseases of the internal organs, the symptom may be associated with constant lack of sleep, adherence to strict diets, and starvation. In some cases, swelling of soft tissues is due to the wrong selection of decorative cosmetics and skin care products. Puffiness can occur after crying, be noted against the background of chronic stressful situations.

Sometimes morning swelling of the face is explained by sleeping on too high a pillow, since the non-physiological position of the head provokes a narrowing of the cervical vessels. Other possible causes of puffiness in the morning include eating salty, fried foods, or drinking large amounts of liquid in the evening.

Hormonal changes in women

Cyclical fluctuations in hormone levels in women are not a disease, but a normal condition. However, such fluctuations sometimes cause puffiness of the face. In some women, this symptom is part of the premenstrual syndrome. The symptom often appears during pregnancy, due to impaired renal function or physiological changes in the body. Many patients complain of pastosity of the face during menopause.

Endocrine diseases

Puffiness of the face is observed with a persistent deficiency of thyroid hormones. The following forms of hypothyroidism become the cause of the development of the symptom:

  • congenital hypothyroidism;
  • hypothyroidism during pregnancy;
  • peripheral hypothyroidism;
  • hypothyroid phase of autoimmune thyroiditis;
  • the final stage of cytokine-induced thyroiditis.

The symptom is observed constantly, combined with a yellowish or peach skin tone, dryness and brittle hair, and a slowdown in mental processes. It is most severely manifested in myxedema - due to the pronounced mucous swelling of the skin and subcutaneous tissue, facial features coarsen, the chin increases, the palpebral fissures narrow, facial expressions become scarce, and the face acquires a mask-like appearance.

swelling of the face


allergic reactions

Allergic swelling of the face develops acutely against the background of contact with certain substances: drugs, food, pollen, animal hair. It is observed with insect bites, cold allergies. There are several allergic reactions accompanied by the appearance of this symptom:

  • Hives. Edema is combined with rashes, hyperemia, skin itching.
  • contact dermatitis. Puffiness and hyperemia appear in the area of ​​contact with the allergen, are replaced by the formation of papules, which open up, forming erosion.
  • Atopic dermatitis. It develops in early childhood, manifested by edema and erythema, against which vesicles appear.
  • Bronchial asthma. Puffiness of the face is detected during an attack, combined with respiratory disorders, a forced position of the body.

The most severe forms of allergies, accompanied by swelling of the face, are acute allergic reactions - Quincke's edema and anaphylactic shock. With Quincke's edema, the contours of the face change over several minutes, less often - several hours. The symptom is pronounced, especially in the middle and lower parts of the face, persists for 2-3 days. Quincke's edema can develop independently or occur at stage 2 of anaphylactic shock, accompanied by swelling of the airways.

kidney disease

Watery, soft, mobile swelling of the face after a night's sleep, combined with a yellowish skin tone, is characteristic of kidney disease. The following pathologies are the cause:

  • Glomerulonephritis. In the acute form of the disease, edema persists for 2-3 weeks, with a chronic process, it appears during periods of exacerbations.
  • Amyloidosis of the kidneys. The symptom occurs in stage 2 (proteinuric) and progresses as kidney function worsens.
  • membranous nephropathy. It develops after drug therapy, treatment of oncological pathologies, acute infections. It proceeds in waves with episodes of complete or almost complete disappearance of edema.
  • Lesions in systemic pathologies . Edema of the face is detected in diabetic nephropathy, SLE. Appear against the background of symptoms of the underlying disease.
  • Chronic renal failure. Puffiness increases gradually over several years.

Diseases of the cardiovascular system

In diseases of the vessels and heart, edema is more pronounced in the region of the lower extremities, but can also be found on the face, especially in the evening. They differ from renal edema in a higher density, a decrease in local temperature and a bluish tint of the skin, slower formation and resorption. Caused by the development of chronic heart failure, are detected in the following diseases:

  • cardiomyopathy;
  • cardiosclerosis;
  • amyloidosis;
  • constrictive pericarditis;
  • some arrhythmias;
  • heart defects;
  • heart failure in rheumatism;
  • arterial hypertension.

Poisoning and intoxication

In smokers, morning puffiness of the face is more pronounced than in non-smokers due to the negative impact of toxins on the state of the lymphatic system. Episodic swelling of the face can occur the next morning after drinking a large amount of alcohol, especially noticeable when taking beer, impaired renal function.

In patients with alcoholism, swelling becomes permanent, the face acquires a characteristic appearance, the skin is often yellowish or with a purple tint. Edema is aggravated with the development of alcoholic nephropathy. In addition, swelling of the face and body can be observed with the absorption of substances that have a nephrotoxic effect, for example, with vinegar poisoning.

Other reasons

Slight puffiness is quite typical for the manifestation of acute respiratory diseases, is more pronounced in children, but can be found in people of any age. The appearance of swelling of soft tissues is possible with ENT pathologies: sinusitis, frontal sinusitis, tonsillitis. Edema of the face is accompanied by some hypo- and hypervitaminosis.


At the initial stage, patients with swelling on the face often go to therapists who, depending on the clinical picture, carry out diagnostics on their own or redirect patients to other specialists: allergists, endocrinologists, nephrologists, etc. The following methods are used to establish a diagnosis:

  • Interrogation, external examination . The doctor finds out the circumstances, the frequency and time of the appearance of edema, the dynamics of changes during the day, throughout the menstrual cycle. Assesses the severity and prevalence of edema, skin temperature, tissue density.
  • Laboratory tests . In the course of laboratory studies, signs of inflammation are detected, kidney function is studied, and hormone levels are determined. Tests are done to detect allergies.
  • Ultrasonic Methods . Taking into account the peculiarities of clinical symptoms, ultrasound of the kidneys, thyroid gland, echocardiography, and other types of sonography are prescribed.
  • Other Imaging Techniques . To clarify the diagnosis and detail pathological changes, CT and MRI, including contrast-enhanced imaging, can be used.

Skin care procedures help get rid of morning puffiness of the face



Help at the prehospital stage

To eliminate the physiological causes of swelling of the face, it is necessary to adjust the diet, normalize the daily routine, avoid stress, and choose the right cosmetic preparations. Slightly pronounced allergic edema in the absence of signs of difficulty in breathing and the presence of a previously established diagnosis can be eliminated with the help of antiallergic drugs.

In other cases, self-medication is not recommended. It should be borne in mind that self-administration of diuretics can lead to the development of serious side effects and disorders of the body.

Specialized Treatment

Many patients require correction of the diet and food regimen. The tactics of conservative treatment is determined by the etiology of the disease or condition that provoked facial swelling:

  • Hormonal fluctuations in women . Hormonal medications, sedatives are used.
  • Hypothyroidism . Replacement therapy with levothyroxine is carried out. With a lack of iodine, iodine-containing agents are prescribed.
  • Allergic reactions . Effective antihistamines and glucocorticosteroids. In severe cases, resuscitation is necessary.
  • Diseases of the kidneys . With glomerulonephritis, antibacterial agents and drugs for the correction of immunity are indicated. With systemic diseases, treatment of the underlying pathology is required. In all cases, medications with a symptomatic effect are used.
  • Diseases of the heart and blood vessels . Cardiac glycosides, nitrates, vasodilators, B-blockers, anticoagulants, drugs to improve the metabolism of the heart muscle may be recommended.
  • Intoxication . When edema is associated with smoking and alcohol consumption, the patient is recommended to give up bad habits, and medical and non-drug treatment is carried out to eliminate addiction.
  • Poisoning . In some cases, gastric lavage is possible. Produce detoxification activities.

For hypovitaminosis, vitamin preparations are prescribed, for acute infections, symptomatic therapy is carried out, for ENT diseases, antibiotics, symptomatic agents are used, and sinus punctures are performed. Surgical treatment is rarely required. With heart defects, they are surgically corrected. Tonsillitis and sinusitis can be considered as indications for tonsillectomy, maxillary sinusectomy, frontotomy.