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Facial Pain

Alternate Names

  • face pain
  • pain in the facial area

Definition

Facial pain refers to pain or discomfort in the front of the head. The face includes the eyes, nose, mouth, forehead, cheeks, and chin.

What is going on in the body?

Pain in the face can occur for many reasons. It can be mild or severe, and involve any area of the face. Most causes of facial pain are not life threatening, but a few are serious.

Risks

What are the causes and risks of the condition?

There are many possible causes of facial pain. Common causes include:
  • trauma or injury to the face, such as being hit
  • irritation of the skin of the face, such as from an insect bite or sunburn
  • skin infections, such as cellulitis
  • acute or chronic sinusitis
  • temporal arteritis, which can cause forehead or jaw pain and is thought to be an autoimmune disorder. An autoimmune disorder is one in which the person's body attacks its own tissues for no known reason.
  • seasonal allergies, which can cause a burning sensation or even pain in the eyes from inflammation. Cheekbone pain from sinus congestion may also occur.
  • headaches, especially migraines
  • trigeminal neuralgia, a type of nerve pain that occurs for unknown reasons
  • dental cavities
  • diseases of the temporomandibular joint, where the back of the jaw attaches to the skull
  • a tumor or cancer in or under the skin of the face, such as skin cancer
  • a salivary gland tumor
Other causes are also possible. Sometimes, no cause can be found.

Prevention

What can be done to prevent the condition?

Prevention is related to the cause. Regular brushing and flossing of the teeth can help prevent cavities. Avoiding prolonged sun exposure and using sunscreen can help prevent skin cancer. Many cases of facial pain cannot be prevented.

Diagnosed

How is the condition diagnosed?

Often the diagnosis is obvious from the history and physical exam. If not, further tests may be ordered. For instance, a blood test called an erythrocyte sedimentation rate is usually ordered if temporal arteritis is suspected. If a tumor of the saliva glands is suspected, a CT scan or MRI may be ordered to look at the gland.

Long Term Effects

What are the long-term effects of the condition?

Long-term effects are related to the pain and the cause of the pain. If severe pain occurs, such as with trigeminal neuralgia, a person may be unable to perform normal activities. Pain due to trauma or injury usually goes away as the injury begins to heal. The injury may cause no long-term effects, or may cause permanent deformity of the face. Temporal arteritis can cause blindness in some cases.

Other Risks

What are the risks to others?

Facial pain is not contagious and usually poses no risk to others.

Treatments

What are the treatments for the condition?

For usual pain, such as that from injury, over-the-counter pain medications are often used. If the pain is unusual, such as that from migraine headaches or nerve pain, treatment of the cause is needed to relieve the pain. Anti-seizure medications, such as carbamazepine (i.e., Carbatrol, Equetro, Tegretol), phenytoin (i.e., Dilantin) or gabapentin (i.e., Neurontin) are often used to treat nerve pain, such as that from trigeminal neuralgia.
Anti-migraine drugs, especially the triptan medications, are often used to treat migraine headaches. If an infection is present, antibiotics may be needed. If a serious injury occurs, surgery may be needed. If a tumor or cancer is the cause of pain, the provider may recommend surgery, chemotherapy, or radiation therapy.

Side Effects

What are the side effects of the treatments?

All medications have possible side effects. For instance, aspirin can cause stomach upset, allergic reactions, and ulcers. Antibiotics can also cause allergic reactions and stomach upset. Surgery can be complicated by bleeding, infection, or an allergic reactions to the anesthetic.

After Treatment

What happens after treatment for the condition?

Pain medication can be increased, changed, or decreased if needed. Those with an injury often heal and need no further treatment or monitoring. Those with a tumor or cancer may need regular monitoring for years after treatment.

Monitor

How is the condition monitored?

Any change or response to treatment can be reported to the healthcare professional. Other monitoring depends on the cause. For instance, an individual who has had one or more tooth cavities filled needs to make regular visits to a dental professional to watch for further cavities and receive instruction on how to prevent them.

Sources

Conn's Current Therapy, 1999, Rakel et al.

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