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facial pain

Alternative 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.

What are the signs and symptoms of the condition?
When a person complains of facial pain, the doctor will ask questions about the pain, such as:
  • the exact location of the pain
  • when the pain started
  • the type of pain, such as sharp, dull, or throbbing
  • whether the pain is constant or only occurs sometimes
  • whether there has been any injury to the painful area
  • whether anything makes the pain better or worse
  • whether or not there have been any other symptoms, such as facial swelling, rash, or fever
  • what other medical conditions a person has, if any
  • what medications, drugs, or herbs a person takes, if any
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
  • chronic sinusitis or acute 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.
  • allergic-type conditions, such as 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 tumour or cancer in or under the skin of the face, such as skin cancer
  • a salivary gland tumour
Other causes are also possible. Sometimes, no cause can be found.

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. Skin cancer protection measures such as avoiding prolonged sun exposure and using sunscreen can help prevent skin cancer. Many cases cannot be prevented.

How is the condition diagnosed?
Diagnosis begins with the history and physical examination. 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 tumour of the saliva glands is suspected, a CT scan or MRI may be ordered to look at the gland.

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, which may happen 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.

What are the risks to others?
Facial pain is not contagious and usually poses no risk to others.

What are the treatments for the condition?
For usual pain, such as that from injury, over-the-counter analgesics 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, are often used to treat nerve pain, such as that from trigeminal neuralgia. Antimigraine drugs, such as sumatriptan, 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 tumour or cancer is the cause of pain, the doctor may recommend surgery, chemotherapy, or radiation therapy.

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. Any surgery carries a risk of bleeding, infection, or allergic reactions to anaesthesia.

What happens after treatment for the condition?
Analgesia can be increased, changed, or decreased if needed. Those with an injury often heal and need no further treatment or monitoring. Those with a tumour or cancer may need regular monitoring for years after treatment.

How is the condition monitored?
Any change or response to treatment can be reported to the doctor. Other monitoring depends on the cause. For instance, those with a tooth cavity will need to have regular dental visits to watch for further cavities.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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