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Suggest Treatment For Swelling On The Side Of Face

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Posted on Wed, 30 Sep 2015
Question: I have a swelling on the left side of my face from a possible insect bite - very puffy, not much pain at all, but looks awful. Could be a piece of debris got in the eye... Puffy under & over eye. The swelling goes into the cheek & to the ear.
doctor
Answered by Dr. Dr. Kakkar (33 minutes later)
Brief Answer:
Kindly upload an Image

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have noted down your concern.

Swelling localised to just one side of face could be either a soft tissue infection Or it could be either a sign of herpes zoster.

It is unlikely to be due to debris in your eye.

I would like to know more from you regarding your query.... Is there any redness of left eye Or discharge from your left eye? Do you have any itchy or burning sensation in that region? Does the swelling or pain also involve the forehead?

I also request you to kindly upload an Image so that I am able to guide you better.

You may upload an Image either at "Reports Section" Or You may mail me an Image at YYYY@YYYY with the subject line as Attn: Dr.Kakkar.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (13 minutes later)
Thank you...
I do not have the ability to send an image at this time.
This does not affect my forehead.
There is a discharge from the tear duct, but just tears, not pus.
This started with what I thought was a large pimple next to the eye & that's why I suspected an insect bite later on.
There is no redness in the eye, just a general, widespread puffiness over & under the eye & into the whole cheek. There is a slight itchiness, but it is quite minimal.
If I touch my cheek near the ear there is a slight yet noticeable pain & the skin is warmer than usual to the touch.
doctor
Answered by Dr. Dr. Kakkar (24 minutes later)
Brief Answer:
Would treat symptomatically with Oral cetrizine and Oral antibiotics

Detailed Answer:
Hi.

Thank you. Significant points in your history are slight pain over affected area and the skin feels warm.

I will keep a possibility of Bacterial soft tissue infection with cellulitis (probably the pimple which you had near eye was a boil or a furuncle) and a second possibility of Insect bite hypersensitivity.
This area near eye swells up very fast since skin here is loose and therefore even a small furuncle Or insect bite reaction can present with a large area of swelling.
I would also like you to keep a watch on how it responds to treatment over the next 24 hours and report back if you notice any vesicles developing on skin Or increased pain Or redness and pain in eye.

Right now I would like to treat empirically with an Oral antihistamine e.g cetrizine tablets, once or twice daily.
I would also suggest that you be started on a course of an Oral antibiotics for a week e.g either Flucloxacillin Or Cephalexin for 5 -7 days. The area is warm and has slight pain which makes me suspect that it could be a bacterial soft tissue infection i.e a furuncle with cellulitis.

An Oral antiinflammatory like ibuprofen, once or twice daily for symptomatic relief from pain and swelling.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (1 hour later)
Dear Dr. Kakkar S.
Thank you for your advice.
I am very impressed with the obvious care & detail you have provided me.
I myself had considered antibiotics & you have confirmed this for me.
I've not use this service before now & I will certainly consider doing so again & will inform others about it.
Your very detailed answer provided me with significant comfort & some clear solutions as to what I can now do.
I still have almost 3 days on this "discussion" & thus have an opportunity to enquire further if I need to.
Again, thanks so much.
Best regards...
doctor
Answered by Dr. Dr. Kakkar (2 minutes later)
Brief Answer:
You are welcome

Detailed Answer:
Thank you. Sure. Do keep me updated how it goes and preferably with a picture if needed.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (24 hours later)
Hello Doctor
Things have improved somewhat in that the swelling has decreased significantly.
I continued to use the prednisone eye drops, a betamethasone cream & also a oregano oil tincture on the original problem - the large disturbed pimple. This oil has antibiotic properties. I was also considering taking large doses of Vitamin C as a substitute to prescription antibiotics because it can act like an antibiotic when it used in mega doses. At any rate this was not necessary.
There is still some slight swelling/puffiness over & above the eye, & a redness in the cheek area. But I feel the worst is over. So far so good.
Thanks again.
Regards...
doctor
Answered by Dr. Dr. Kakkar (10 hours later)
Brief Answer:
May use a topical antibacterial cream over pimple

Detailed Answer:
Hi.

Ok. That is good.

Instead of using betamethasone cream and oregano oil over pimple, you may instead use a topical antibacterial e.g 2% mupirocin ointment Or fusidic acid 2% cream over the pimple.
Can also take a tablet of ibuprofen, twice daily to help reduce inflammation and swelling. A tablet of cetrizine once daily may also be helpful in relieving itching.
I don't think you need to put steroid drops in eye.

Keep me updated
Regards
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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Suggest Treatment For Swelling On The Side Of Face

Brief Answer: Kindly upload an Image Detailed Answer: Hello. Thank you for writing to us I have gone through your query and I have noted down your concern. Swelling localised to just one side of face could be either a soft tissue infection Or it could be either a sign of herpes zoster. It is unlikely to be due to debris in your eye. I would like to know more from you regarding your query.... Is there any redness of left eye Or discharge from your left eye? Do you have any itchy or burning sensation in that region? Does the swelling or pain also involve the forehead? I also request you to kindly upload an Image so that I am able to guide you better. You may upload an Image either at "Reports Section" Or You may mail me an Image at YYYY@YYYY with the subject line as Attn: Dr.Kakkar. Regards