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Facial swelling is the build-up of fluid in the tissues of the face. Swelling may also affect the neck and upper arms.

Puffy face; Swelling of the face; Moon face; Facial edema

If the facial swelling is mild, it may be hard to detect. To assist the health care provider in diagnosing the cause, it is important to note the following:

• Pain, and where it hurts
• How long the swelling has lasted
• What makes it better or worse
• If you have other symptoms

• Allergic reaction (such as allergic rhinitis, hay fever, or a bee sting)
• Angioedema
• Blood transfusion reaction
• Cellulitis
• Conjunctivitis with swelling around the eye(s)
• Drug reactions, including those due to aspirin, penicillin, sulfa, glucocorticoids, and others
• Head, nose, or jaw surgery
• Injury or trauma to the face (such as a burn)
• Malnutrition (when severe)
• Obesity
• Sinusitis
• Stye with swelling around the infected eye
• Tooth abscess

Apply cold compresses to reduce swelling from an injury. Raise the head of the bed (or use extra pillows) to help reduce facial swelling.

You should call your health care provider if you have:

• Sudden, painful, or severe facial swelling
• Facial swelling that lasts a while, particularly if it is getting worse over time
• Difficulty breathing
• Fever, tenderness, or redness, which suggests infection

If facial swelling is caused by burns, or respiratory distress is present, emergency measures must be taken first. Then the medical history will be obtained and a physical examination performed.

Medical history questions documenting facial swelling in detail may include the following:

• How long has the facial swelling lasted?
• When did it begin?
• What makes it worse?
• What makes it better?
• What is your height and weight?
• How is your diet?
• Has there been exposure to something to which the person may be allergic (an antigen)?
• What medication are you taking?
• Have you had recent facial injury?
• Have you had a recent test or surgical procedure?
• What other symptoms are also present? Especially, is there:
  • Facial pain
  • Sneezing
  • Difficulty breathing
  • Hives or rash
  • Eye redness
  • Fever

Bolognia J. Infections, hyper- and hypopigmentation, regional dermatology, and distinctive lesions in black skin. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 467.