Facial swelling is the fluid retention in the tissues of the face which may also involve the neck and upper arms. If the facial edema is mild, it may go undetected.

Below are various causes of fluid retention in the face.

Allergic reaction

Puffy face may be a symptom of an allergic reaction caused by hay fever,spider bites, bee stings or allergic rhinitis, an inflammation of the mucous membrane lining the nose caused by an irritant such as dander, dust or pollen.


Angioedema is a reaction in which the body accumulates fluid leading to swelling of the skin, mucosa and submucosal tissues. Swelling of the face and airways are almost always occur in angioedema patients although it can happen in different parts of the body too. The swelling and bumps on face often disfiguring and frightening to the patient. Moreover, since the progression of the disease is very fast, it can lead to potential airway obstruction and suffocation. Thus, angioedema is treated as a medical emergency.

Blood transfusion reaction

Blood transfusion reaction is another cause of facial swelling. An allergic reaction from blood transfusion is caused by the body’s immune system responding to certain substances in the plasma of the donated blood. Symptoms of allergic reaction to blood transfusion include developing hives, which are characterized by itchy skin, swollen patches or bumps on the skin, and swollen body tissues such as sudden facial swelling. The symptoms are usually mild, uncomfortable, but they are not dangerous and can be treated with antihistamines.

Facial cellulitis

Facial cellulitis, which is one type of cellulitis, is a bacterial skin infection on the face characterized by swelling, redness, warmth, and pain and can affect people of all age groups. Besides puffy face, face swelling or other noticeable appearance of the skin in the affected area, symptoms of facial cellulitis may include fever, chills, irritability, and a swollen, tender, warm tongue. Treatment for facial cellulitis involves antibiotics and recurrence prevention. If facial cellulitis is left untreated, it can lead to serious complications.

Conjunctivitis (inflammation of the eye)

Conjunctivitis may also cause facial swelling. Conjunctivitis is redness and swelling of the conjunctiva, the mucous membrane that covering the eyeball and under surface of the eyelid.

Drug reactions

Drugs such as aspirin, penicillin, sulfa, glucocorticoids, and others are common fluid retention in the face causes. Further reading Allergic Reaction Face Swelling and Brain Cancer and Face Swelling - Steroids to Treat Hydrocephalus.

Head, nose, or jaw surgery Edema after facial surgery including head, nose, or jaw surgery is a very common occurrence. Here are several facial surgery that may cause swelling and bumps on face.

  • Face lifts or rhytidectomyy The rhytidectomy or facelift is a cosmetic surgery specifically designed to restore a more youthful appearance by removing major obvious wrinkles and sagging skin from the facial area. Face lifts brings critical side effects also, some being serious such as hematoma, an allergic reaction to the medicine, facial swelling, scarring, facial nerve damage, and anesthetic related risks.
  • Facial liposuction surgery Bruising and edema after facial liposuction surgery in and around the liposuction areas are usually. A normal appearance is achieved within five to seven days. Further reading: Swelling after Liposuction.
  • Facial minisculpture Facial minisculpture is a very refined type of liposuction. There may be some minor bruising and swelling of the face or puffy face, but are often virtually undetectable and the discomfort from both is minimal.
  • Rhinoplasty surgery Nasal surgery (Rhinoplasty surgery) is a procedure that changes the structure of the nose, manipulating the bone and cartilage structure and the skin to improve the appearance of the nose. There is typically some edema after facial surgery that may goes away after about one week.

Chemical peeling

As the name implies chemical peeling peels the skin with chemicals allowing new skin to form, which is new and fresh, and without some wrinkles. With medium or deep chemical peeling, the skin may develop blisters and swelling along with redness and peeling that may last for up to two weeks.

Injury to the face

Injury or trauma to the face (such as a burn) also may cause puffy face.


In extreme cases, malnutrition can lead to swelling of the face, resulting in a head that seems much larger in proportion to the rest of the body.


Being overly overweight is on of many causes of fluid retention in the face.

Salivary gland disorders

Saliva glands are any of three major pairs of glands in the mouth and digestive system that secrete saliva for digestion. When there is a problem with the salivary glands or ducts, you may experience symptoms such as salivary gland swelling leading to facial edema, dry mouth, pain, fever, and foul-tasting drainage into the mouth.


Other cause of facial swelling or puffy face is sinusitis. Sinusitis is an inflammation of one of the paranasal sinuses. The inflammation could be caused by an infection from a virus, bacteria or fungus. It may also be the result of an allergic or autoimmune reaction.

High Pathogenicity Avian Influenza

High Pathogenicity Avian Influenza (HPAI) has more severe symptoms which include sudden death, loss of energy and appetite, decreased egg production, respiratory problems, facial swelling (edema), poorly formed eggs and diarrhoea.

Tooth abscess

A tooth abscess is pus enclosed in the tissues of the jaw bone at the apex of an infected tooth’s root(s). In some cases, a tooth abscess may perforate bone and start draining into the surrounding tissues creating local facial swelling. More on this topic please read Swelling in The Face and Abscess Tooth.


Another cause of facial swelling is hypothyroidism. Hypothyroidism (low thyroid)is a hormone imbalance because the thyroid does not produce enough thyroid hormone. The most common symptoms of hypothyroidism are fatigue and intolerance to cold. Other common symptoms are mental instability or depression, muscle weakness and fatigue, poor memory, lethargy and headaches, deep slow speech, loss of hair, cold hands and feet, constipation, pale thick skin, brittle nails, and swelling of the face and eyelids, excessive and painful menstrual flow, nervousness and palpitations. Read more about hypothyroidism at Swollen Thyroid Gland – Diseases, Causes, Symptoms, Treatment

Pleural mesothelioma

The symptoms that are associated with pleural mesothelioma include persistent coughing, difficulty swallowing, facial edema, weight loss, fever, rasping and coughing up blood.

Swollen face during pregnancy

Slight swelling is expected during pregnancy especially in the third trimester; however, if if there’s sudden face swelling during pregnancy or hand swelling, it could be a sign of preeclampsia. Read also Preeclampsia: Excessive Swelling during Pregnancy. You should consult with your doctor further if you experience any sudden swollen face during pregnancy.

There you have it, various causes of fluid retention in the face! Seek for medical attention as soon as possible if your facial swelling is sudden, painful, or severe and accompanied by difficulty breathing, fever, tenderness, or redness, warmth.