Sometimes the first hint that something is happening inside your body can appear right on your face.
Yellowing
Yellowing of the whites of the eyes, with or without yellowing of the skin, is known as jaundice. Jaundice occurs when there is an excess of bilirubin in the blood. It may happen in conjunction with liver disease, obstruction of the bile ducts, gallstones, certain blood diseases, or other disorders.
Early stages may be subtle and hard to detect, especially under artificial lighting conditions. Jaundice that is newly noticed in an adult should be evaluated by a physician and should not be dismissed as a change in complexion.
Butterfly rash
Systemic lupus erythematosus may cause a rash over both cheeks and the bridge of the nose. It is red or purplish and may be called a malar rash or a butterfly rash. The rash typically does not affect the creases adjacent to the nose and may become more pronounced with sun exposure. Facial redness can also occur with rosacea and several other skin disorders that can mimic lupus.
Pale skin
Pale skin on the face, lips, or inner eyelids can be associated with anemia, especially if you have pale skin with fatigue, weakness, dizziness, shortness of breath, or a rapid heartbeat.
Iron deficiency is just one reason for anemia. Blood loss, vitamin deficiency, chronic disease and inherited disorders are just some of the other causes. Paleness varies naturally from person to person and can be affected by lighting, so it is not a reliable indicator of anemia. A blood test is required to see if you are anemic or not.
Puffy eyes
Puffiness around the eyes is typically nothing to worry about. It can occur after a poor night’s sleep, allergies, crying, or eating salty foods. However, long-term swelling may occur with kidney disease, especially if fluid retention is causing swelling in other areas of your body.
Thyroid disease and other illnesses can impact the tissues around your eyes as well. Any new swelling that doesn’t go away should be evaluated.
A drooping face
One-sided facial weakness or drooping can be a sign of stroke, particularly if there is also weakness in your arm(s), slurred speech or difficulty talking, confusion, vision problems, loss of balance or severe headache with no known cause. Facial drooping can also be a symptom of Bell’s palsy.
Differentiating Bell’s palsy from stroke symptoms can sometimes be difficult and should be done by a medical professional.
Bulging eyes
Protruding or bulging eyes can happen with thyroid eye disease. The most common cause of thyroid eye disease is Graves’ disease. Other signs and symptoms may be present like dry or gritty eyes, redness, eyelid abnormalities, double vision, or inability to move your eyes normally.
If you naturally have protruding eyes, it may not be caused by an illness. Your baseline appearance is important to consider. Seek evaluation if this is a new change with pain or vision changes.
Cracks at the corners
Cracks at the corners of the mouth that are painful are called angular cheilitis. Causes can include saliva pooling there, irritation, dentures and yeast or bacterial infections. Sometimes angular cheilitis that comes back over and over can be caused by a nutritional deficiency, such as iron deficiency or deficiency of one of the B vitamins.
Swollen eyelids
Chronic swollen eyelids can also be caused by an overactive thyroid, kidney issues, allergies, infection or inflammation. As always, when it comes to your health, timing and other symptoms matter: a red, swollen eyelid that comes on suddenly and hurts will mean something different than mildly puffy eyelids that you wake up with every day.
If you experience shortness of breath, swelling around the eyes or face, fever, intense pain, or changes in vision, seek medical care immediately.
Facial hair changes
Facial hair in women isn’t always a sign of elevated androgen activity. What little hair that women normally have is genetically determined and increases with age. Still, if women notice a new growth of dark, coarse hair on their chin or upper lip, chest, or abdomen, they should be evaluated by a physician.
Polycystic ovary syndrome is a frequent cause, especially if the excess hair growth is accompanied by irregular menstrual periods, acne or thinning hair on the scalp.
A facial twitch
Brief, occasional eyelid twitching is very common. Eyelid twitching may result from fatigue, stress, consuming caffeine, or eye strain. Chronic twitching of one side of the face can be due to other causes, including a neurological disorder known as hemifacial spasm. Facial movement can occur with other neurological conditions and may be a side effect of medication.
A darkened neck
Dark, thickened, velvety skin around the neck may be acanthosis nigricans. It is considered technically below the face despite its name but can sometimes be a helpful clue, as it can signal insulin resistance and related conditions like type 2 diabetes or polycystic ovary syndrome. Other causes can include medications as well as, rarely, an underlying disease.
Persistent facial redness
Flushed cheeks don’t necessarily mean there’s something wrong. Physical activity, heat exposure, blushing, drinking alcohol and moving from cold to warm temperatures can cause temporary redness of the face.
Facial redness that doesn’t go away, especially on the central face, and sometimes along with visible blood vessels or acne-like bumps, may be rosacea. Some autoimmune disorders and hormonal conditions may also cause facial flushing or rashes.
Sources: Please see here for a complete listing of all sources that were consulted in the preparation of this article.
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