Numb Face

Facial numbness can be alarming. It’s a symptom that can occur with neurological problems that affect the brain or the trigeminal nerve (the nerve that controls sensations of the face). It can also happen with dental or mouth problems, after facial trauma, or as an effect of medications or toxins.

If you have any unexpected numbness, pain, or change in the sensation of your face, get 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 feel painful, cause unusual sensations, or lack normal sensation. You can have any combination of these symptoms, and they can vary in severity or may come and go. 

Symptoms that can accompany a numb face include:

• Pain of the face 
• Hypersensitivity when something touches the face 
• Pain when chewing 
• Uneven or lopsided face 
• Facial weakness 
• Droopy eyelid or eyelid that won’t fully close 
• Tongue deviation (the tongue is moved toward one side of the mouth)
• Vision changes 
• Weakness or changes in sensation on one side of the body 
• Head pain on one side of the head 

The associated symptoms depend on the cause of the facial numbness. For example, a migraine may cause head pain on one side of the head, and Bell’s palsy would cause an uneven appearance of the face. 

Causes of Numb Face 

Many medical conditions can affect sensation of the face, potentially causing numbness. Some of these are reversible and are not dangerous, but there are also serious medical problems that can make your face feel numb. 

Causes of facial numbness include: 

• Medications or toxins, especially numbing medication
• Migraine episode
• Damage to the trigeminal nerve due to trauma or a 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 in the face or mouth 
• Shingles: A painful rash due to reactivation of the virus that causes chickenpox infection 
• Postherpetic neuralgia: A complication of shingles
• Ramsey Hunt syndrome: A complication of shingles
• Meningitis: An inflammation or infection of the meninges (the tissue layers that surround the brain) 
• Bell's palsy: An inflammatory condition that causes face weakness
• Stroke: A type of brain damage caused by inadequate blood supply to a section of the brain 
• A tumor in the brain: Primary (starting in the brain) or metastatic due to spread from cancer in another area of the body 
• A blood vessel malformation in the brain: Such as an aneurysm (outpouching of a blood vessel) or an arteriovenous malformation (AVM) 
• Multiple sclerosis (MS): An inflammatory neurological disorder 

These conditions can cause other symptoms along with facial numbness. The timing of facial numbness and other symptoms can be a major aspect of identifying which disorder affects facial sensation. Many of these conditions require treatment with medical or surgical interventions.

How Does Face Numbness Happen? 

Facial numbness occurs due to diminished 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 detect sensations from the face.

A problem with the trigeminal nerve or its branches can occur due to a nerve injury or a disease that affects the nerve (such as post-herpetic neuralgia). 

Facial numbness can also occur due to a medical condition that affects the areas of the brain that interpret facial sensation, which includes the sensory pathways in the brainstem, the thalamus, and the sensory strip in the cerebral cortex.

What Medications Can Cause a Numb Face? 

Any medication that affects sensation can potentially cause facial numbness. It can be an intentional effect—such as when numbing medication is injected into the mouth before surgery. Sometimes facial numbness is a side effect that might only affect some people who take a medication, such as allergy medications. 

The medications most likely to cause face numbness include anesthetics (medications that are 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.

While these treatments are intentionally used to numb the face, sometimes numbness might last for longer than intended. In general, prolonged numbness should wear off within a few days, without any harmful consequences. 

Medications that can cause facial numbness as a side effect include:

• Anti-seizure medications, such as Dilantin (phenytoin)
• Antibiotics such as Cipro (ciprofloxacin) and Biaxin (clarithromycin)
• Antihistamines, which are used to treat allergies, such as Zyrtec (cetirizine)
• Blood pressure medications like Zestril (lisinopril)

Toxins can also cause facial numbness, and there are a variety of chemical exposures that may cause this effect.

How to Treat a Numb Face 

Some of the symptoms associated with facial numbness can be treated. Pain can be treated with medication or interventional therapy, such as injected pain medications.

Pain medications that can be prescribed for the treatment of facial numbness include anti-epilepsy medications like Neurontin (gabapentin) and Tegretol (carbamazepine) and antidepressants, such as Elavil (amitriptyline). 

Underlying conditions that cause facial numbness can often be treated. 

Treatments for conditions that cause face numbness include: 

• Triptans like Imitrex (sumatriptan) for an ongoing 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 a bacterial infection 

After treatment of the underlying condition, facial numbness may resolve. However, if the trigeminal nerve is severely damaged, you might not regain normal facial sensation. 

Are There 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 there may not be a need for tests—such as when it occurs with an anesthetic.

If you are being seen by a healthcare provider for face numbness, your medical history and physical examination may point to an underlying cause, such as a stroke, fracture, or multiple sclerosis. A mouth examination and dental evaluation may identify the underlying problem.

You may need to have diagnostic tests as part of your evaluation. Tests that may be used during an evaluation of facial numbness:

• A mouth X-ray may identify a dental abscess or facial bone fracture.
• Brain imaging tests, such as computerized tomography (CT), magnetic resonance imaging (MRI), or ultrasound, can diagnose a stroke, MS, brain tumor, or vascular malformation.
• Electrodiagnostic studies may identify patterns consistent with nerve damage, neuropathy, or trigeminal neuralgia.

When to See a Healthcare Provider 

Facial numbness is never something to ignore. If you experience any new, sudden, or unexpected change in sensation to your face, mouth, or head, it’s important to seek medical help. 

After a dental procedure or another procedure that involves numbing medication, your healthcare provider will let you know what to expect and how long the numbness should last. Call their office if it’s not resolving as expected. 

Get emergency medical attention for any of the following: 

• Changes in vision 
• Facial weakness
• Diminished sensation of your face 
• Pain or unusual sensations of your face 
• A severe injury of your face 
• Possible broken bones of the jaw, nose, or face
• Bruising, swelling, or redness of your face 

If you have been diagnosed with a condition that may cause recurrent facial numbness, like post-herpetic neuralgia or migraine, talk to your healthcare provider about a treatment plan. The plan will include what treatment to have on hand to use if your symptoms recur and instructions about when to call your healthcare provider.

Summary 

Face numbness feels uncomfortable, and it may be associated with pain and other symptoms. There are many causes, and the associated symptoms may help point to the cause.

Unexpected face numbness is a medical emergency that requires urgent evaluation because 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 is resolving.

A Word From Verywell 

Often, the pain is the most stressful aspect of living with face numbness, and pain therapy can be a major part of managing your condition. There are many treatments, and you might need a combination so that you can find relief.

If you are experiencing depression or anxiety as you are working with your healthcare provider to find the right treatment, reach out for a referral to a mental health professional to talk to about the challenges of chronic pain until your pain is adequately treated.