Waking up with a temporarily puffy face may be something you experience frequently, or it may be an isolated occurrence. Often, puffiness appears below the eyes; other times it appears around the mouth or elsewhere. Typically not a medical concern, seek medical treatment if you have sudden, painful or severe facial swelling, if it won't go away or continually worsens, if you have trouble breathing or if puffiness is accompanied by redness, fever or sensitivity.
Water Retention
A main cause of waking up with facial puffiness, especially below the eyes, is water retention, as the Mayo Clinic explains. Retaining water itself can have an array of causes. It may be as simple as lying flat while you sleep, causing water to pool below the eyes, or increasing atmospheric heat and humidity or a sunburn.
Another common cause is too much sodium in the blood, as from a high-salt diet. Fluid retention is a known side effect of certain prescriptions, including oral contraceptives, blood pressure medications, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs), according to Progressive Health.
Hormonal fluctuations can cause water retention as well, notes Charles Tifft, M.D., of the Boston University School of Medicine. This includes those associated with the menstrual cycle, menopause and pregnancy. Nutritional deficiencies, particularly of certain B vitamins and protein, may lead to edema, or an abnormal storage of fluids, as well, states Progressive Health.
Chronic or excessive water retention may indicate an underlying health problem related to the thyroid, liver, kidney or heart, cautions MotherNature.com.
Allergic Reactions
Facial puffiness may be a symptom of an allergic reaction. Waking up with a swollen face might indicate a reaction to something you ate before going to sleep, to something you inhaled from your surroundings, or even to a bug bite or sting that occurred as you slept.
Medline Plus notes that hay fever and bee stings are possibilities. Some spider bites can cause swelling as well. Allergic rhinitis, a reaction to breathing in an irritant like dander, dust or pollen, is another possibility. Angioedema, welts below the surface of the skin, is another type of allergic reaction that can cause facial puffiness.
Other Possible Causes
Sinusitis or severe conjunctivitis, an inflammation or infection in membranes around the eyes, may be to blame for morning facial puffiness, according to Medline Plus. Your puffy face may also be a side effect of a drug you took before going to bed. Some known to trigger this reaction cited by Medline Plus include aspirin, penicillin, sulfa and glucocorticoids. If you recently suffered an injury or had surgery anywhere on your face, swelling may be an after-effect. Puffiness might also indicate an underlying infection. For example, swelling around the mouth can be a sign of a tooth abscess.
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