8 Things That Cause a Puffy Face in the Morning

A puffy face in the morning doesn't exactly tell the world, "I'm awake and refreshed!" So if you're waking up with swelling around your eyes or cheeks, you probably want to solve the problem stat.

Fortunately, most cases of a.m. puffiness come down to lifestyle behaviors that are easy to remedy, says Donna Casey, MD, an internist with Texas Health Presbyterian Hospital Dallas in Dallas, Texas.

But in some cases, a swollen face in the morning could be a sign of a health problem.

So how can you tell what you're dealing with? These clues can help you figure it out. Plus, learn what you can do to de-puff.

Went to town on pizza or fries, or had a big dessert last night? High amounts of sodium or sugar can both cause fluid retention, which can leave you with a puffy face in the morning, Dr. Casey says.

The swelling might be particularly bad around your eyes, along with your stomach, hands and feet, notes the Cleveland Clinic.

Alcohol initially acts as a diuretic, encouraging you to pee out more fluids.

"But there can be a rebound effect of fluid retention if your body, for instance, becomes alarmed after a long weekend of alcohol and dehydration," Dr. Casey says.

As a result, your body will work harder to hang onto as much fluid as possible, leaving you puffy and swollen.

Too many zzzs can leave you looking the opposite of refreshed.

"Too much sleep can cause fluid retention in the face," Dr. Casey says.

Lying prone for hours on end can cause fluid to build up in your face (instead of being pulled towards your feet by gravity). Plus, you're hanging on to extra water from not peeing, she explains.

Snoozing belly-down can cause more fluids to build up in your face compared to sleeping on your back or side, Dr. Casey says. (You might wake up with a neck- or backache too.)

Hormone fluctuations that strike in the days or week before your period can make your face bloated and puffy (along with the rest of your body).

It's also normal to have mood swings, irritability, food cravings, breast tenderness, headaches and fatigue, to name just a few of the most common premenstrual syndrome (PMS) symptoms, notes the American College of Obstetricians and Gynecologists (ACOG).

Tried a new personal care product on your face last night, or recently donned a new piece of jewelry?

If you woke up with a swollen face along with redness, itching or irritation, your skin could be having an allergic reaction.

Dust mites, pet dander and new detergents used for washing sheets or pillows are other common culprits, Dr. Casey says.

Sinus infections, tooth infections and even severe acne can cause inflammation on or around your face that leads to swelling, Dr. Casey notes.

Other symptoms will depend on the type of infection you're having. Sinus infections can cause congestion and pain or pressure around the nose or under the eyes, while tooth infections typically cause mouth pain and sensitivity.

Acne is typically marked by painful red pimples that may be filled with pus.

Undermanaged sleep apnea can cause loud snoring and daytime fatigue or headaches — and leave you with a swollen face in the morning.

"This occurs when people slow down or stop breathing [while sleeping]," Dr. Casey says.

Anyone can be affected by sleep apnea, but it most often occurs in adults who are older or have obesity.

In some cases, waking up with a puffy face could be a sign of a serious underlying health problem. These can include:

• ‌Hypothyroidism:‌ Hypothyroidism occurs when the thyroid produces too little thyroid hormone. Common symptoms include fatigue, weight gain, dry skin and sensitivity to cold, but some people also experience mild facial swelling, according to Merck Manuals.
  
• ‌Cushing's syndrome:‌ A condition where the body makes too much of the hormone cortisol, Cushing's syndrome can cause a person's face to appear round or swollen, notes the Mayo Clinic. It can also cause unexpected weight gain, stretch marks, acne, slow wound healing and a rounded hump between the shoulders.
  
• ‌Severe allergic reaction:‌ In rare instances, sudden facial swelling can be caused by a severe allergic reaction, also called anaphylaxis. "This is extremely dangerous, as it can cause difficulty swallowing," Dr. Casey says. Other symptoms might include a skin rash, nausea, vomiting, dizziness or a swollen tongue or throat. Call 911 or go to the nearest emergency room if you're having these symptoms.
  

Keeping a morning balloon-face at bay depends on what's causing the swelling. But in general, healthy lifestyle habits can help reduce the risk for a.m. puffiness, Dr. Casey says. Some steps to try:

• ‌Watch your salt and sugar intake.‌ Limit your intake of highly processed foods, packaged snacks and sugary foods or drinks. They tend to be high in sodium and sugar, which encourages fluid retention and can cause puffiness. (Eat foods that help with bloating instead, like fruits and veggies.)
  
• ‌If you choose to drink, do so in moderation.‌ Alcohol encourages the body to hold on to more water. Stick with no more than one to two drinks per day.
  
• ‌Stay hydrated.‌ Drink plenty of water throughout the day, especially if you'll be eating something salty or sugary or if you'll be consuming alcohol.
  
• ‌Elevate your head while you sleep.‌ Use a second pillow to keep your head propped. That'll encourage fluids to flow downward rather than pooling in your face when you sleep.
  
• ‌Get enough sleep, but don't overdo it.‌ Aim for seven to nine hours of sleep per night. Oversleeping can up your risk for fluid retention.
  

Let your doctor know if you're waking up with persistent puffiness, especially if it's accompanied by other symptoms. You could have an underlying health problem that needs to be addressed.

Call 911 if you or someone else is experiencing sudden or severe facial swelling. These could be signs of a life-threatening allergic reaction, which requires immediate medical attention.