Facial Trauma
Injury to the soft tissues or bones of the face
Quick Facts
- Type: Injury / emergency
- Common causes: Falls, vehicle crashes, sports, assault
- Range: Minor cuts to broken facial bones
- Top priority: Protect the airway and breathing
Overview
Facial trauma refers to any injury to the structures of the face, including the skin and soft tissues, the facial bones, the nose, the eyes, the teeth, and the jaw. Injuries can be minor, such as a small cut or bruise, or serious, such as a broken cheekbone, eye socket, or jaw.
Because the face contains the airway, the eyes, and many nerves and blood vessels, some facial injuries are emergencies. The first priorities in any significant facial injury are making sure the person can breathe, controlling bleeding, and protecting the spine in case the neck was also injured.
Symptoms
Signs depend on the type and severity of the injury and may include:
- Pain, swelling, and bruising of the face
- Cuts, scrapes, or bleeding
- A nosebleed or a change in the shape of the nose
- Bruising around the eyes or blurred or double vision
- A change in the way the teeth fit together, loose or knocked-out teeth, or jaw pain
- Numbness or weakness in part of the face
- An uneven, flattened, or deformed appearance of the cheek or jaw
Warning signs that need emergency care include difficulty breathing, heavy bleeding, loss of consciousness, vision loss, clear fluid draining from the nose or ears, or neck pain.
Causes
Facial trauma usually results from a direct blow or impact. Common causes include:
- Falls, particularly in young children and older adults
- Motor vehicle, motorcycle, and bicycle crashes
- Sports injuries
- Assaults and fights
- Workplace and household accidents
- Animal bites
The pattern and severity of injury depend on the force involved and where the face was struck.
Risk Factors
- Contact and high-speed sports, especially without protective gear
- Not wearing a seatbelt or helmet
- Conditions that increase the risk of falls
- Alcohol or substance use, which raises the risk of accidents and assaults
- Occupations with a higher chance of impact injuries
Diagnosis
Evaluation focuses first on life-threatening problems, then on identifying specific injuries. It may include:
- Physical exam: Checking the airway, breathing, bleeding, vision, facial movement, sensation, and how the teeth fit together.
- Imaging: X-rays and especially CT scans show fractures of the facial bones and eye sockets in detail.
- Eye and dental assessment: When the eyes, jaw, or teeth are involved, specialists may be consulted.
Because the neck can be injured along with the face, the spine is often protected and assessed as well.
Treatment
Treatment ranges widely depending on the injury.
- First aid and emergency care: Keeping the airway open, controlling bleeding with gentle pressure, and applying cold packs to reduce swelling.
- Wound care: Cleaning and closing cuts, with attention to a good cosmetic result on the face.
- Fracture treatment: Many small fractures heal on their own, while displaced fractures of the cheek, eye socket, nose, or jaw may need surgery to realign and stabilize the bones.
- Dental and eye care: Prompt treatment of knocked-out teeth or eye injuries can improve outcomes.
- Pain relief and infection prevention: Medication and sometimes antibiotics, especially for bites or open wounds.
Prevention
- Always wear a seatbelt and use appropriate child car seats
- Wear helmets and face protection for cycling, contact sports, and similar activities
- Reduce fall hazards at home, especially for young children and older adults
- Avoid driving or risky activities under the influence of alcohol or drugs
- Use proper safety equipment at work
When to See a Doctor
Call emergency services or go to an emergency department immediately for any facial injury with difficulty breathing, heavy or uncontrolled bleeding, loss of consciousness, vision changes, clear fluid leaking from the nose or ears, neck pain, or a deformed face or jaw.
For lesser injuries, see a doctor if you have a deep or gaping cut, a possible broken nose or cheekbone, a knocked-out or loose tooth, persistent pain or swelling, or any wound that may need stitches or that you cannot keep clean.
Frequently Asked Questions
When is a facial injury an emergency?
Call emergency services for any facial injury with trouble breathing, heavy bleeding, loss of consciousness, vision loss, clear fluid draining from the nose or ears, neck pain, or a deformed face or jaw. These can signal life- or sight-threatening problems and need immediate care.
How do I stop bleeding from a facial wound?
Apply firm, gentle pressure with a clean cloth and keep the head elevated if there is no suspected neck injury. Most minor facial bleeding slows with steady pressure. Seek care for deep, gaping, or heavily bleeding wounds, which may need stitches.
Do broken facial bones always need surgery?
No. Many small or non-displaced fractures, including some broken noses, heal on their own with supportive care. Surgery is generally reserved for fractures that are displaced or that affect function or appearance, such as certain cheekbone, eye socket, or jaw fractures.
What should I do about a knocked-out tooth?
Handle the tooth by the crown, not the root, gently rinse it, and if possible place it back in the socket or keep it in milk, then seek dental care urgently. Prompt treatment, ideally within an hour, gives the best chance of saving the tooth.
Could a facial injury also mean a neck or brain injury?
Yes. The force that injures the face can also harm the neck or brain. Watch for neck pain, severe headache, confusion, repeated vomiting, or loss of consciousness, and seek emergency care if any of these occur, keeping the person still until help arrives.
References
- American Academy of Otolaryngology–Head and Neck Surgery. Facial Trauma.
- MedlinePlus, U.S. National Library of Medicine. Facial trauma.
- Mayo Clinic. Broken nose and facial fractures.
- Centers for Disease Control and Prevention (CDC). Traumatic Brain Injury and Concussion.