Numb face: symptoms, causes and treatment
If you think your face is numb from a stroke, call 911 immediately.
Facial numbness can be alarming. It is a symptom that can occur with neurological problems that affect the brain or trigeminal nerve (the nerve that controls facial sensations). It can also occur with dental or oral problems, after facial trauma, or under the effects of medications or toxins.
If you experience numbness, pain, or an unexpected change in the sensation of your face, seek medical attention immediately. This article will discuss the symptom of having a numb face, possible causes, diagnosis, and treatment.
Symptoms of a numb face
A numb face can be painful, cause unusual sensations, or lack normal sensation. You can have any combination of these symptoms, and they can vary in severity or come and go.
Symptoms that may accompany a numb face include:
- facial pain
- Hypersensitivity when something touches the face
- Pain when chewing
- Uneven or unbalanced face
- facial weakness
- Droopy eyelid or eyelid that does not close completely
- Tongue deviation (the tongue is moved to one side of the mouth)
- Visual changes
- Weakness or changes in sensation on one side of the body
- Headache on one side of the head
Associated symptoms depend on the cause of facial numbness. For example, a migraine can cause headache on one side of the head, and Bell’s palsy would cause an uneven facial appearance.
Causes of Numb Face
Many medical conditions can affect facial sensation, potentially causing numbness. Some of them are reversible and not dangerous, but there are also serious medical issues that can numb your face.
Causes of facial numbness include:
- Drugs or toxins, especially numbing drugs
- migraine episode
- Damage to the trigeminal nerve due to trauma or surgical injury
- Trigeminal neuralgia: A type of irritation of the trigeminal nerve
- Neuropathy: nerve disease that can occur due to diabetes, alcohol use, and inflammation
- Inflammation or infection of the face or mouth
- Shingles: a painful rash due to reactivation of the virus that causes chickenpox infection
- Post-herpetic neuralgia: a complication of shingles
- Ramsey Hunt syndrome: a complication of shingles
- Meningitis: Inflammation or infection of the meninges (the layers of tissue that surround the brain)
- Bell’s palsy: an inflammatory disease that causes facial weakness
- Stroke: A type of brain injury caused by insufficient blood supply to part of the brain
- A brain tumour: primary (beginning in the brain) or metastatic due to spread of cancer to another area of the body
- A malformation of the blood vessels in the brain: such as an aneurysm (outpouring of a blood vessel) or an arteriovenous malformation (AVM)
- Multiple sclerosis (MS): an inflammatory neurological disorder
These conditions can cause other symptoms as well as facial numbness. The timing of facial numbness and other symptoms can be a major aspect of identifying the disorder affecting facial sensation. Many of these conditions require treatment with medical or surgical procedures.
How does facial numbness occur?
Numbness of the face is due to a decrease in the function of the trigeminal nerve or its branches. This nerve has three main branches, often described as V1, V2, and V3. Each of these branches also has smaller branches that sense facial sensations.
A problem with the trigeminal nerve or its branches can occur due to nerve damage or a condition that affects the nerve (such as postherpetic neuralgia).
Facial numbness can also occur due to a medical condition that affects areas of the brain that interpret facial sensation, including the brainstem sensory pathways, the thalamus, and the cerebral cortex sensory strip.
What medications can cause a numb face?
Any medication that affects sensation can potentially cause facial numbness. This may be an intentional effect, such as when numbing medication is injected into the mouth before surgery. Sometimes facial numbness is a side effect that may only affect some people who are taking medication, such as allergy medications.
Medications most likely to cause facial numbness include anesthetics (medicines used to inhibit sensation) injected or sprayed into the face or mouth. Additionally, a nerve block, which is an injection into a nerve, can also be used before a procedure or as a treatment for chronic pain.
Although these treatments are intentionally used to numb the face, sometimes the numbness can last longer than expected. In general, prolonged numbness should disappear within a few days, without any adverse consequences.
Medications that can cause facial numbness as a side effect include:
Toxins can also cause facial numbness, and there are a variety of chemical exposures that can cause this effect.
Talk to a health care provider
Many different medications can cause facial numbness as a side effect. If you experience this symptom after starting a new medication, call your healthcare provider and check to see if your medication could be the cause.
How to treat a numb face
Some of the symptoms associated with facial numbness can be treated. The pain can be treated with medication or interventional therapy, such as injected painkillers.
Pain relievers that may be prescribed for the treatment of facial numbness include antiepileptic drugs like Neurontin (gabapentin) and Tegretol (carbamazepine) and antidepressants, like Elavil (amitriptyline).
Underlying conditions that cause facial numbness can often be treated.
Treatments for conditions that cause facial numbness include:
- Triptans like Imitrex (sumatriptan) for persistent migraine
- disease-modifying therapy like Aubagio (teriflunomide) for multiple sclerosis
- Antiviral therapy for shingles
- Surgical removal of a tumor or blood vessel affecting the trigeminal nerve
- Antibiotics for bacterial infection
After the underlying condition is treated, the facial numbness may go away. However, if the trigeminal nerve is severely damaged, you may not regain normal facial sensation.
Are there any tests to diagnose the cause of a numb face?
Many tests can help identify the underlying cause of facial numbness. Sometimes the cause is known and testing may not be necessary, such as when it occurs with an anesthetic.
If you are seen by a healthcare professional for facial numbness, your medical history and physical exam may point to an underlying cause, such as a stroke, fracture, or multiple sclerosis. A mouth exam and dental evaluation can identify the underlying problem.
You may need to take diagnostic tests as part of your assessment. Tests that may be used during a facial numbness assessment:
- An oral X-ray can identify a dental abscess or a facial bone fracture.
- Brain imaging tests, such as computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound, can diagnose stroke, multiple sclerosis, brain tumor, or vascular malformation.
- Electrodiagnostic studies can identify patterns consistent with nerve damage, neuropathy, or trigeminal neuralgia.
When to See a Health Care Provider
Facial numbness is never something to ignore. If you experience a new, sudden, or unexpected change in the sensation of your face, mouth, or head, it is important to seek medical attention.
After a dental procedure or other procedure involving numbing medications, your healthcare provider will tell you what to expect and how long the numbness should last. Call their office if it doesn’t resolve as expected.
Get emergency medical care for any of the following:
- Vision changes
- facial weakness
- Diminished feeling of your face
- Pain or unusual sensations in your face
- A serious injury to your face
- Possible broken bones of the jaw, nose, or face
- Bruising, swelling or redness of the face
If you’ve been diagnosed with a condition that can cause recurring facial numbness, such as postherpetic neuralgia or migraine, talk to your healthcare provider about a treatment plan. The plan will include treatment to have on hand if your symptoms return and instructions on when to call your health care provider.
Facial numbness is uncomfortable and may be associated with pain and other symptoms. There are many causes and associated symptoms can help identify the cause.
Unexpected facial numbness is a medical emergency that requires urgent evaluation as some of the causes can be life threatening if not treated promptly. There are different treatments for the causes of facial numbness, and the associated pain can also be treated as the underlying condition resolves.
A word from Verywell
Often, pain is the most stressful aspect of living with facial numbness, and pain therapy can be a major part of managing your condition. There are many treatments and you may need a combination to find relief.
If you suffer from depression or anxiety while working with your healthcare provider to find the right treatment, ask to be referred to a mental health professional to talk about the challenges of chronic pain until your pain is adequately treated.
Frequently Asked Questions
What does facial numbness look like?
It can feel like tingling, tingling, like your face has “fallen asleep” and sometimes it’s painful. Depending on the cause, it can come and go, and it can be associated with other symptoms, such as facial weakness, headaches, vision changes, etc.
How does facial numbness start?
It depends on the cause. Facial numbness can come on suddenly with stroke, it can persist with certain fluctuations in severity with MS, and it can occur before or during migraine episodes. Facial numbness caused by surgical anesthetic drugs should go away as the drug wears off in a few minutes, but sometimes it takes longer.