Sudden Facial Swelling in Teens: Causes and When to Seek Help

Sudden swelling of the cheek?

My 16-year-old son suddenly developed swelling in his cheek after returning from a tomb-sweeping visit on Sunday afternoon.
The swelling is not painful, itchy, or red.
We visited a nearby clinic's ENT department, but the doctor couldn't identify any issues and sent us home without any treatment.
However, the swelling has not subsided after two days, and he has no fever or other discomfort.
I'm hesitant to go to a large hospital for fear of wasting medical resources, and I'm unsure which department to visit.
What could this possibly be? If we go to a large hospital, which department should we see? Thank you!

Liao Mama, 40~49 year old female. Ask Date: 2017/03/28

Dr. Chen Taicheng reply Family Medicine

● To assess the degree and location of the swelling, if one side of the cheek suddenly becomes swollen, it is more likely due to an infection or inflammation.
For example, swelling can occur from mosquito bites while visiting a cemetery, or it may be due to cellulitis of the cheek (some cases may be caused by a dental abscess).
If the swelling is near the area in front of the ear, it is important to consider whether there is parotitis or salivary gland stones.
● If there are no discomforting symptoms, you may observe whether the swelling resolves on its own; if the lesion persists, please consult an otolaryngologist or a family medicine physician for further evaluation.
● Wishing your son good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department is concerned about you~

Reply Date: 2017/03/28

More Info

Sudden facial swelling in teenagers can be concerning, especially when it appears without pain, redness, or other accompanying symptoms. In your son's case, the swelling occurred after a specific event (visiting a cemetery), which could suggest several potential causes.

Possible Causes of Sudden Facial Swelling
1. Allergic Reaction: One of the most common causes of sudden facial swelling is an allergic reaction. This could be due to exposure to pollen, dust, or even certain foods. If your son came into contact with something he is allergic to while at the cemetery, this could explain the swelling.

2. Insect Bite or Sting: Another possibility is that your son may have been bitten or stung by an insect while outdoors. Insect bites can cause localized swelling, which may not always be painful or itchy.

3. Infection: While there are no signs of fever or discomfort, infections can sometimes present with swelling alone. Conditions like sinusitis or dental abscesses can lead to facial swelling without significant pain initially.

4. Lymphatic Issues: Swelling can also occur due to lymphatic drainage issues, where lymph fluid accumulates in the tissues. This can happen for various reasons, including infections or other underlying conditions.

5. Angioedema: This is a deeper swelling that can occur in response to allergens or certain medications. It can be serious if it affects the throat or airways, but in your son's case, it seems localized.

When to Seek Help
Given that the swelling has persisted for two days without improvement, it is advisable to seek further medical evaluation. While it may seem like a minor issue, persistent swelling can indicate an underlying problem that needs to be addressed.

1. Primary Care Physician: If you have a family doctor, this is a good starting point. They can perform a thorough examination and may refer you to a specialist if needed.

2. Ear, Nose, and Throat (ENT) Specialist: Since you already visited an ENT, they are well-equipped to handle issues related to facial swelling, especially if it is related to sinus or throat issues.

3. Allergist: If an allergic reaction is suspected, an allergist can conduct tests to determine if your son has any allergies that could be causing the swelling.

4. Dermatologist: If the swelling is suspected to be related to skin issues or insect bites, a dermatologist may provide insights and treatment options.

Conclusion
While it can be daunting to consider visiting a hospital, especially if you are worried about wasting resources, it is essential to prioritize your son's health. Persistent facial swelling should not be ignored, and seeking medical advice is the best course of action. If you decide to go to a hospital, starting with the emergency department may be appropriate, where they can assess the situation and direct you to the right specialist if necessary.
In summary, while there are several potential causes for your son's facial swelling, the lack of pain or redness does not rule out the need for further evaluation. Monitoring his symptoms and seeking medical attention if the swelling persists or worsens is crucial.

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