Table of ContentsView AllTable of ContentsWhen to Seek CareCauses of NumbnessDiagnosis
Table of ContentsView All
View All
Table of Contents
When to Seek Care
Causes of Numbness
Diagnosis
There are many possible causes of facial numbness, including migraines, Bell’s palsy, an allergic reaction, or even a stroke. Even certain medications can cause a loss of sensation in the face.
This article describes the causes and symptoms of facial numbness, including how the different conditions are treated or prevented. It also explains when it is time to seek medical care if part or all of your face suddenly goes numb.
Adene Sanchez / Getty Images
When to Seek Emergency Care
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 immediately.
Causes of Numb Face
Facial numbness ultimately involves the nerves that supply sensations to the face, most notably thefacial nerve(cranial nerve 7) which starts in a part of the brain called thebrainstem. Many different conditions can directly or indirectly affect thiscranial nerve, disrupting the transmission of nerve impulses that lead to facial numbness.
Some of the more common causes of a numb face include:
Migraine
Hemiplegic migraine may be treated withnonsteroidal anti-inflammatory drugs (NSAIDs)like Advil (ibuprofen) or prescription drugs likeTopamax (topiramate). Unlike other types of migraines, hemiplegic migraines are not treated withtriptanslike Imitrex (sumatriptan) due to an increased risk of stroke.
How Migraines Are Treated
Allergies
Facial numbness can be a sign of a type of allergy calledallergic contact dermatitis. This is a relatively harmless condition in which contact with an allergy-causing substance (allergen) causes symptoms like skin swelling, itching, a bumpy rash, and dry, flaky skin.
Many different allergens are linked to contact dermatitis, including soaps, detergents, fragrances, latex, poison ivy, and metals such as nickel and chrome. Removing the offending agent is the main form of treatment, buttopical steroidscan help ease symptoms faster.
Multiple Sclerosis
The cause of MS is unknown. Treatment may involve a wide range of prescription medications, including steroids,immunosuppressants, muscle relaxants, and antidepressants.
What Is the First-Line Treatment for Multiple Sclerosis?
Stroke
There are two types of stroke:
A stroke is a medical emergency that requires rapid response, includingblood thinnersand possibly surgery, to restore blood flow and prevent further damage to the brain.
How Stroke Is Treated
Transient Ischemic Attack
These include one-sided arm tingling and weakness, transient vision changes, slurring of words, loss of grip strength, and sudden loss of sensation on one side of the face. For some people, it is possible to have TIA and not even notice it.
This doesn’t mean that TIAs are not serious. Studies have shown that having a TIA greatly increases your risk of a full-blown stroke in later life. Blood thinners likePlavix (clopidogrel)are commonly prescribed when TIA is diagnosed. Ongoing treatment may be recommended to reduce your future risk of stroke.
Shingles
Once you get over chickenpox, the virus doesn’t disappear but instead lies dormant on the nerve roots of the spine. When the virus reactivates, often after the age of 40, it quickly multiplies and moves up from the nerve root to the skin where it causes an outbreak of painful blisters and sores. The location of the outbreak varies based on whichspinal rootis affected.
Reactivation of the varicella virus on the facial nerve can manifest with numbness or tingling on one side of the face prior to the outbreak. Even after the infection clears, the damage to nerves, calledpost-herpetic neuralgia, can cause facial pain and numbness for many months or years.
Symptoms of shingles can be greatly reduced with a course of antiviral drugs likeValtrex (valacyclovir). Shingles can also be prevented with a two-dose vaccine calledShingrix.
Bell’s Palsy
Bell’s palsyis an often distressing condition that causes the sudden weakness or paralysis of facial muscles. In addition to one-sided facial drooping, a person may experience uncontrollable tearing, drooling, and one-sided facial numbness.
The cause of Bell’s palsy is unknown but is thought to be the result of the reactivation ofherpes simplex virusor varicella virus (albeit without the appearance of a skin rash). The symptoms usually start to improve after a couple of weeks and will resolve within six months.
There is no specific treatment for Bell’s palsy, but corticosteroid drugs likeprednisoneor antiviral drugs likeZovirax (acyclovir)are often used.
Infections
Depending on the cause, the loss of sensation may be limited to one side of the face or only involve a small portion of the face. With systemic (whole-body) infections, the numbness may affect both sides of the face or the face as a whole.
Infections that can potentially cause facial numbness include:
The treatment of infections can vary, but bacterial infections like tuberculosis generally respond well toantibiotics, while viral infections like herpes or HIV are commonly treated withantiviral drugs. Some viral infections resolve on their own without treatment.
Tumors
A tumor is an abnormal growth of cells that consolidates into a mass. It is an uncommon cause of facial numbness but one that can cause persistent or worsening symptoms. The tumor may bebenign(non-cancerous) ormalignant(cancerous) and affect either the facial nerve or brainstem.
One of the more common benign causes is afacial nerve neuroma. These tumors often develop after facial surgery a traumatic injury to the face. In many people, a neuroma can cause intense pain, but, in others, it may only cause persistent tingling or numbness.
A rare cancer affecting the facial nerve is called malignant peripheral nerve sheath tumor (MTNST). The tumor arises from the myelin coating on nerve cells, causing symptoms that are easily mistaken for Bell’s palsy.
Surgery is sometimes used to treat facial paralysis. One of the more common approaches isnerve graftingwhere a piece of nerve tissue is surgically inserted to bridge areas of nerve damage.
Drug Interactions
Many medications are known to causeparesthesia(abnormal nerve sensations), including tingling, numbness, or pins-and-needles sensations. The hands and feet are most commonly affected, but certain medications can also cause paresthesia of the face.
In most cases, the sensation will be bilateral (affecting both sides of the face) and can persist until the treatment is stopped.
Among the medications known to cause facial numbness are:
With some drugs, including alcohol and certain HIV medications, exposure to the offending agent will need to be stopped to avoid permanent nerve injury.
The Anatomy of the Brain
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.
You may need to have diagnostic tests as part of your evaluation. Tests that may be used during an evaluation of facial numbness include:
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 resolves.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Coutts SB.Diagnosis and management of transient ischemic attack.Continuum (Minneap Minn). 2017 Feb 3;23(1):82092. doi:10.1212/CON.0000000000000424Genetic and Rare Diseases Information Center.Hemiplegic migraine.Novak-Bilić G, Vučić M, Japundžić I, Meštrović-Štefekov J, Stanić-Duktaj S, Lugović-Mihić L.Irritant and allergic contact dermatitis - skin lesion characteristics.Acta Clin Croat. 2018 Dec;57(4):713-720. doi:10.20471/acc.2018.57.04.13Ghasemi N, Razavi S, Nikzad E.Multiple sclerosis: pathogenesis, symptoms, diagnoses and cell-based therapy.Cell J. 2017;19(1):1–10. doi:10.22074/cellj.2016.4867Kale N.Optic neuritis as an early sign of multiple sclerosis.Eye Brain.2016;8:195–202. doi:10.2147/EB.S54131Richards LG, Cramer SC.Advances in stroke: therapies targeting stroke recovery.Stroke. 2021;52(1):348-350. doi:10.1161/STROKEAHA.120.033231Centers for Disease Control and Prevention.Clinical overview of shingles (herpes zoster).Holland NJ, Bernstein JM.Bell’s palsy.BMJ Clin Evid. 2014;2014:1204.Greenlee JE.Nervous system complications of systemic viral infections.Aminoff Neurol General Med.2014 :857–883. doi:10.1016/B978-0-12-407710-2.00043-6Islamoglu Y, Celik B, Kiris M.Facial paralysis as the only symptom of COVID-19: a prospective study.Am J Otolaryngol.2021 July-August;42(4):102956. doi:10.1016/j.amjoto.2021.102956Censi R, Vavassori V, Borgonovo AE, Re D.Infection related inferior alveolar nerve paresthesia in the lower premolar teeth.Case Rep Dent.2016;2016:2623507. doi:10.1155/2016/2623507Thompson AE.Infectious mononucleosis.JAMA. 2015;313(11):1180. doi:10.1001/jama.2015.159Pathapati D, Barla K, Dayal M, Gati R, Lakota PK.Facial nerve schwannoma: the rare/great mimicker of vestibular schwannoma/neuroma.Indian J Radiol Imaging.2021 Apr;31(2):510–513. doi:10.1055/s-0041-1734356Cancer Research UK.Malignant peripheral nerve sheath tumours (MPNST).Grinsell D, Keating CP.Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies.Biomed Res Int. 2014;2014:698256. doi:10.1155/2014/698256Jones MR, Urits I, Wolf J, et al.Drug-induced peripheral neuropathy: a narrative review.Curr Clin Pharmacol.2020 Apr;15(1):38–48. doi:10.2174/1574884714666190121154813Pauli N, Grinups M, Folkestad L, Gudnadottir G.Patient-reported symptoms after midfacial trauma.Surg J(NY). 2022;8(1):e22-e27. doi:10.1055/s-0041-1742174
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Coutts SB.Diagnosis and management of transient ischemic attack.Continuum (Minneap Minn). 2017 Feb 3;23(1):82092. doi:10.1212/CON.0000000000000424Genetic and Rare Diseases Information Center.Hemiplegic migraine.Novak-Bilić G, Vučić M, Japundžić I, Meštrović-Štefekov J, Stanić-Duktaj S, Lugović-Mihić L.Irritant and allergic contact dermatitis - skin lesion characteristics.Acta Clin Croat. 2018 Dec;57(4):713-720. doi:10.20471/acc.2018.57.04.13Ghasemi N, Razavi S, Nikzad E.Multiple sclerosis: pathogenesis, symptoms, diagnoses and cell-based therapy.Cell J. 2017;19(1):1–10. doi:10.22074/cellj.2016.4867Kale N.Optic neuritis as an early sign of multiple sclerosis.Eye Brain.2016;8:195–202. doi:10.2147/EB.S54131Richards LG, Cramer SC.Advances in stroke: therapies targeting stroke recovery.Stroke. 2021;52(1):348-350. doi:10.1161/STROKEAHA.120.033231Centers for Disease Control and Prevention.Clinical overview of shingles (herpes zoster).Holland NJ, Bernstein JM.Bell’s palsy.BMJ Clin Evid. 2014;2014:1204.Greenlee JE.Nervous system complications of systemic viral infections.Aminoff Neurol General Med.2014 :857–883. doi:10.1016/B978-0-12-407710-2.00043-6Islamoglu Y, Celik B, Kiris M.Facial paralysis as the only symptom of COVID-19: a prospective study.Am J Otolaryngol.2021 July-August;42(4):102956. doi:10.1016/j.amjoto.2021.102956Censi R, Vavassori V, Borgonovo AE, Re D.Infection related inferior alveolar nerve paresthesia in the lower premolar teeth.Case Rep Dent.2016;2016:2623507. doi:10.1155/2016/2623507Thompson AE.Infectious mononucleosis.JAMA. 2015;313(11):1180. doi:10.1001/jama.2015.159Pathapati D, Barla K, Dayal M, Gati R, Lakota PK.Facial nerve schwannoma: the rare/great mimicker of vestibular schwannoma/neuroma.Indian J Radiol Imaging.2021 Apr;31(2):510–513. doi:10.1055/s-0041-1734356Cancer Research UK.Malignant peripheral nerve sheath tumours (MPNST).Grinsell D, Keating CP.Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies.Biomed Res Int. 2014;2014:698256. doi:10.1155/2014/698256Jones MR, Urits I, Wolf J, et al.Drug-induced peripheral neuropathy: a narrative review.Curr Clin Pharmacol.2020 Apr;15(1):38–48. doi:10.2174/1574884714666190121154813Pauli N, Grinups M, Folkestad L, Gudnadottir G.Patient-reported symptoms after midfacial trauma.Surg J(NY). 2022;8(1):e22-e27. doi:10.1055/s-0041-1742174
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Coutts SB.Diagnosis and management of transient ischemic attack.Continuum (Minneap Minn). 2017 Feb 3;23(1):82092. doi:10.1212/CON.0000000000000424Genetic and Rare Diseases Information Center.Hemiplegic migraine.Novak-Bilić G, Vučić M, Japundžić I, Meštrović-Štefekov J, Stanić-Duktaj S, Lugović-Mihić L.Irritant and allergic contact dermatitis - skin lesion characteristics.Acta Clin Croat. 2018 Dec;57(4):713-720. doi:10.20471/acc.2018.57.04.13Ghasemi N, Razavi S, Nikzad E.Multiple sclerosis: pathogenesis, symptoms, diagnoses and cell-based therapy.Cell J. 2017;19(1):1–10. doi:10.22074/cellj.2016.4867Kale N.Optic neuritis as an early sign of multiple sclerosis.Eye Brain.2016;8:195–202. doi:10.2147/EB.S54131Richards LG, Cramer SC.Advances in stroke: therapies targeting stroke recovery.Stroke. 2021;52(1):348-350. doi:10.1161/STROKEAHA.120.033231Centers for Disease Control and Prevention.Clinical overview of shingles (herpes zoster).Holland NJ, Bernstein JM.Bell’s palsy.BMJ Clin Evid. 2014;2014:1204.Greenlee JE.Nervous system complications of systemic viral infections.Aminoff Neurol General Med.2014 :857–883. doi:10.1016/B978-0-12-407710-2.00043-6Islamoglu Y, Celik B, Kiris M.Facial paralysis as the only symptom of COVID-19: a prospective study.Am J Otolaryngol.2021 July-August;42(4):102956. doi:10.1016/j.amjoto.2021.102956Censi R, Vavassori V, Borgonovo AE, Re D.Infection related inferior alveolar nerve paresthesia in the lower premolar teeth.Case Rep Dent.2016;2016:2623507. doi:10.1155/2016/2623507Thompson AE.Infectious mononucleosis.JAMA. 2015;313(11):1180. doi:10.1001/jama.2015.159Pathapati D, Barla K, Dayal M, Gati R, Lakota PK.Facial nerve schwannoma: the rare/great mimicker of vestibular schwannoma/neuroma.Indian J Radiol Imaging.2021 Apr;31(2):510–513. doi:10.1055/s-0041-1734356Cancer Research UK.Malignant peripheral nerve sheath tumours (MPNST).Grinsell D, Keating CP.Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies.Biomed Res Int. 2014;2014:698256. doi:10.1155/2014/698256Jones MR, Urits I, Wolf J, et al.Drug-induced peripheral neuropathy: a narrative review.Curr Clin Pharmacol.2020 Apr;15(1):38–48. doi:10.2174/1574884714666190121154813Pauli N, Grinups M, Folkestad L, Gudnadottir G.Patient-reported symptoms after midfacial trauma.Surg J(NY). 2022;8(1):e22-e27. doi:10.1055/s-0041-1742174
Coutts SB.Diagnosis and management of transient ischemic attack.Continuum (Minneap Minn). 2017 Feb 3;23(1):82092. doi:10.1212/CON.0000000000000424
Genetic and Rare Diseases Information Center.Hemiplegic migraine.
Novak-Bilić G, Vučić M, Japundžić I, Meštrović-Štefekov J, Stanić-Duktaj S, Lugović-Mihić L.Irritant and allergic contact dermatitis - skin lesion characteristics.Acta Clin Croat. 2018 Dec;57(4):713-720. doi:10.20471/acc.2018.57.04.13
Ghasemi N, Razavi S, Nikzad E.Multiple sclerosis: pathogenesis, symptoms, diagnoses and cell-based therapy.Cell J. 2017;19(1):1–10. doi:10.22074/cellj.2016.4867
Kale N.Optic neuritis as an early sign of multiple sclerosis.Eye Brain.2016;8:195–202. doi:10.2147/EB.S54131
Richards LG, Cramer SC.Advances in stroke: therapies targeting stroke recovery.Stroke. 2021;52(1):348-350. doi:10.1161/STROKEAHA.120.033231
Centers for Disease Control and Prevention.Clinical overview of shingles (herpes zoster).
Holland NJ, Bernstein JM.Bell’s palsy.BMJ Clin Evid. 2014;2014:1204.
Greenlee JE.Nervous system complications of systemic viral infections.Aminoff Neurol General Med.2014 :857–883. doi:10.1016/B978-0-12-407710-2.00043-6
Islamoglu Y, Celik B, Kiris M.Facial paralysis as the only symptom of COVID-19: a prospective study.Am J Otolaryngol.2021 July-August;42(4):102956. doi:10.1016/j.amjoto.2021.102956
Censi R, Vavassori V, Borgonovo AE, Re D.Infection related inferior alveolar nerve paresthesia in the lower premolar teeth.Case Rep Dent.2016;2016:2623507. doi:10.1155/2016/2623507
Thompson AE.Infectious mononucleosis.JAMA. 2015;313(11):1180. doi:10.1001/jama.2015.159
Pathapati D, Barla K, Dayal M, Gati R, Lakota PK.Facial nerve schwannoma: the rare/great mimicker of vestibular schwannoma/neuroma.Indian J Radiol Imaging.2021 Apr;31(2):510–513. doi:10.1055/s-0041-1734356
Cancer Research UK.Malignant peripheral nerve sheath tumours (MPNST).
Grinsell D, Keating CP.Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies.Biomed Res Int. 2014;2014:698256. doi:10.1155/2014/698256
Jones MR, Urits I, Wolf J, et al.Drug-induced peripheral neuropathy: a narrative review.Curr Clin Pharmacol.2020 Apr;15(1):38–48. doi:10.2174/1574884714666190121154813
Pauli N, Grinups M, Folkestad L, Gudnadottir G.Patient-reported symptoms after midfacial trauma.Surg J(NY). 2022;8(1):e22-e27. doi:10.1055/s-0041-1742174
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