Facial swelling is not only a cosmetic defect; if it appears frequently or is accompanied by redness and pain, it is a sign of quite serious health problems that need to be identified and treated.
ALENA PARETSKAYA
Pathophysiologist, immunologist, member of the St. Petersburg Society of Pathophysiologists ANDREY GRACHEV Leading cardiologist of the SM-Clinic holding, MD, academician of the Russian Academy of Medical Sciences
Facial edema is not a separate disease, but only a reflection of an imbalance between retention and excretion of fluid in the body. But what problems in the body can cause the face to swell and how serious is it?
Why does the face swell in adults?
Swelling on the face can occur at different times of the day - mainly in the morning or late afternoon, or they persist throughout the day, decreasing or increasing.
There are two types of reasons:
- physiological (or natural, not associated with diseases), they are usually not pronounced, not very strong, and disappear quickly;
- pathological, can be very strong, with changes in facial features, signs of inflammation, and are often quite persistent.
Each type of edema has the most typical causes; they occur mainly in the morning or evening hours, or do not depend in any way on the time of day. These characteristics are important for the doctor so that he can identify the leading causes and determine the tactics of examination and treatment.
Principles of treatment
Treatment of leg swelling due to heart failure is based on eliminating the main cause - the disease itself. Of course, curing such a disease is quite difficult. But control is quite possible. In order not to aggravate the patient’s condition, it is important not to allow the disease to progress. In the first stages of the disease, rest, foot massage, and the use of cold compresses help well. Subsequently, more radical methods are required.
To relieve swelling in heart failure, cardiologists use medications - diuretics. They cause frequent urination, which leads to a decrease in fluid in the body. Both chemicals and natural remedies can be used as diuretics. Chemical diuretics include:
- Furosemide,
- Bumetanide,
- Piretanide.
Natural urinary products include:
- A decoction of fresh birch buds.
- Decoction of cherry stalks.
- A decoction of cornflower, dandelion and parsley flowers.
In addition to decoctions, it is recommended to eat as many fruits and vegetables as possible, which help remove water from the body. Raw cabbage, baked potatoes, cucumbers and pumpkin - all these products should be in the patient’s regular diet. Once or twice a week it is recommended to carry out fasting days, during which you should consume apples and cottage cheese.
If your legs swell due to heart failure, it is recommended to take glycosides. These are plant-based drugs that affect the entire human body. These medications help remove more water, thin the blood, and normalize blood circulation.
Is there swelling on the face due to heart disease?
Yes, these questions usually worry women, says cardiologist Andrei Grachev.
They run to see a cardiologist when they can’t put a ring on their finger in the morning because it’s swollen or put on makeup because their face is swollen. The patient wants to look great, regardless of age and health status. And this is commendable. Men, as a rule, do not contact a cardiologist with such questions. The peculiarity of this issue is due to the fact that in patients with cardiovascular diseases, as a rule, swelling on the face appears at the final stage of a complication such as heart failure. First, they appear on the legs (the lowest point in relation to the heart), then fluid accumulates in the abdominal cavity, the liver and spleen enlarge (as a blood depot). And only after the fluid reaches the pleural cavities and the heart sac, swelling may occur on the face or hands.
Development of edema
Patients suffering from heart failure need to know that as the disease progresses, all accompanying symptoms worsen. If at the first stages of the disease the accumulation of fluid in the body is insignificant, then over time, this symptom manifests itself more and more. Patients are mistaken in believing that edema due to heart failure is a temporary phenomenon. Often, fluid accumulation in the legs is associated with fatigue. After all, after rest, the condition of the lower extremities improves, and the patient does not experience discomfort. But, over time, the disease progresses, and the accumulation of fluid does not seem so harmless. Legs swell not only at the end of the working day; this condition occurs at any time of the day, regardless of physical activity. Along with this condition, the patient notes a deterioration in health and the appearance of other symptoms of the disease.
When do they occur most often?
Due to a number of circumstances, adds cardiologist Andrei Grachev, such as the flow of fluid to the upper half of the body in a lying position, changes in the biorhythms of hormone production (more often their active synthesis occurs at night or in the early morning hours), edema syndrome most often manifests itself in the early morning hours .
Morning
If we talk about physiological reasons, morning swelling is usually associated with constant lack of sleep, fasting or strict diets (limiting protein and fats). Sometimes swelling in the morning is caused by the wrong selection of skincare products (face cream, toner or cleanser). Also, morning swelling of the face can be caused by crying or stress in the evening or at night.
Possible swelling of the face in the morning due to an incorrectly selected pillow (it is too high, it provokes a narrowing of the blood vessels in the neck). Another physiological factor is an excess of fried, salty foods or liquids taken in the evening, before bed. In women, facial swelling in the morning can be caused by hormonal fluctuations, PMS or pregnancy. Some women report morning swelling during menopause.
Pathological causes of morning edema are mainly kidney damage. Such swelling is usually soft, mobile, appears on the face after sleep, and the skin acquires a waxy or yellowish tint. The most common causes of facial swelling are:
- glomerulonephritis - the acute form of the disease leads to edema, which lasts up to 2-3 weeks, if the process enters the chronic phase, edema is typical for periods of exacerbation of inflammation;
- Kidney amyloidosis - edema is typical of the second stage (proteinuria), when protein loss occurs and kidney function gradually deteriorates;
- membranous nephropathies - occur after taking certain medications, tumor therapy, acute infectious pathologies. Edema occurs in waves, with sharp or barely noticeable symptoms;
- chronic kidney disease (previously called renal failure) - swelling occurs gradually as renal damage progresses;
- kidney damage in severe systemic pathologies - edema is typical for nephropathy due to diabetes or systemic lupus erythematosus.
Evening
Sometimes facial swelling becomes noticeable in the evening, especially after an active day. Often this is one of the manifestations of pathologies of the cardiovascular system. Often, swelling of the face is accompanied by severe swelling in the area of the extremities - hands and feet, legs. These swellings are denser, the skin has a lower temperature than on other parts of the body, and such swelling goes away slowly. Often occur against the background of the following pathologies:
- amyloidosis of the heart and blood vessels;
- cardiomyopathy;
- sclerotic heart disease (cardiosclerosis);
- certain types of arrhythmia;
- constrictive pericarditis;
- some heart defects;
- arterial hypertension;
- cardiac lesions due to rheumatism.
Day
Sometimes facial swelling is most pronounced during the day or its appearance is not clearly related to the time of day. Among the main pathologies that lead to such edema are endocrine disorders - especially a lack of thyroid hormones (hypothyroidism). Facial swelling is especially pronounced with congenital hypothyroidism, in pregnant women or with autoimmune thyroiditis, cytokine-induced thyroiditis.
Rapidly increasing swelling of the face during the day can be a sign of allergies - to food, insect bites, cosmetics, medications and even cold. Sometimes facial swelling occurs during an attack of bronchial asthma due to difficulty breathing and fluid retention in the veins.
Facial swelling is possible in people who smoke and drink alcohol. This is due to the increased work of the lymphatic system to remove toxins from tissues.
Severe swelling of the face during the day is possible with respiratory infections and their complications - sinusitis, tonsillitis, frontal sinusitis. Swelling of the face is possible with a deficiency or excess of vitamins (especially fat-soluble ones).
Diagnosis of heart failure
Electrocardiography (ECG) helps doctors identify signs of hypertrophy and insufficient blood supply (ischemia) of the myocardium, as well as various arrhythmias.
An ECG with a load - a special modification of a bicycle (bicycle ergometry) or a “treadmill” (treadmill) - provides information about the reserve capabilities of the pumping function of the heart.
Echocardiography (EchoCG). Using this method, you can not only determine the cause of heart failure, but also evaluate the contractile function of the ventricles of the heart.
X-ray examination of the chest organs in heart failure reveals stagnation of blood in the pulmonary circulation and an increase in the size of the heart cavities (cardiomegaly).
Radioisotope methods for studying the heart, in particular radioisotope ventriculography, make it possible to assess with high accuracy the contractile function of the ventricles of the heart and the volume of blood they contain in patients with heart failure. These methods are based on the administration and subsequent distribution of radioisotope drugs in the body.
Positron emission tomography – PET – allows using a special radioactive “tag” to identify areas of viable myocardium in patients with heart failure.
How to quickly relieve facial swelling in adults
If this is physiological swelling of the face, not associated with serious pathologies that require medical supervision and the use of selected medications, excess fluid can be eliminated through certain simple measures and actions.
Taking a contrast shower or washing with cold/hot water. This method refreshes, increases tissue tone, enhances the outflow of fluid from the skin and reduces swelling.
Using ice – a couple of pieces of ice will help deal with swelling on the face quickly and effectively. In addition, you can prepare herbal decoctions with a tonic effect in advance and freeze them, using them for washing.
Facial massage is an effective remedy that helps improve microcirculation and swelling. Manual massage, the use of rollers, ice cubes, and cold spoons help. Sometimes you can first wipe your face with green tea and apply compresses with it to your face and eye area.
Characteristics of edema of renal origin
Diseases of the urinary system are accompanied by edema with the following features:
- rapid swelling - in less than a day;
- the greatest intensity is on the face, under the eyes, on the arms and legs, and on the abdominal wall;
- when changing posture and active movement, the fluid shifts;
- the surface of the edematous skin is soft and pale.
Swelling of renal origin first appears on the face in the morning, but in acute pathologies and advanced chronic stages the patient may suffer from swelling around the clock.
Edema as symptoms of diseases
In addition to vein problems, swelling can be caused by many other problems. In this case, clinical manifestations are usually observed on both legs.
Heart pathologies
When the heart begins to fail as a pump, fluid pools in areas such as the legs and lungs and causes swelling. In addition, less blood flows to the kidneys, causing fluid retention.
Lung diseases
The cause is acute pulmonary failure, which is associated with the release of transudate from the capillaries. This is fraught with infiltration of the alveoli and a sharp disruption of gas exchange in the lungs.
It manifests itself as shortness of breath at rest, suffocation, a feeling of tightness in the chest, cough with the release of foamy bloody sputum. Accompanied by the development of acidosis and hypoxia.
Kidney diseases
Excess fluid and sodium in the circulation can cause fluid to accumulate. Swelling associated with kidney disease usually occurs in the legs and around the eyes.
Damage to the tiny filtering blood vessels in the kidneys can lead to nephrotic syndrome. In nephrotic syndrome, decreased levels of protein (albumin) in the blood can lead to fluid accumulation.
Severe liver pathologies
With cirrhosis, as a rule, fluid accumulates in the abdominal cavity. Accompanied by liver failure, dilation of hemorrhoidal veins and bleeding from the esophagus.
Quincke's edema
An acute disease that is characterized by the appearance of limited angioedema of the skin and subcutaneous tissue, body systems and various organs. The reasons are autoimmune and infectious diseases, false and true allergies. It occurs acutely and goes away within 2-3 days.
Arthritis
During the inflammatory process in the joint area, a large amount of synovial fluid is released. It accumulates in the cavity of the articular structure. When inflammation spreads to adjacent soft tissues, extensive (spread) edema develops.
Which doctor should I contact for swelling of the legs?
If you have swelling of the legs, you should first consult a general practitioner (general practitioner or family doctor). In order to determine the cause of the swelling, a simple examination may not be enough. You must be prepared that you will need to undergo a series of tests or undergo instrumental examination (ultrasound, MRI). In some cases, after receiving the results of the examination, the therapist may refer you to specialized specialists (cardiologist, urologist, etc.).
