Main Line Pediatrics
Are You Sick?
Face Injury
Is this your symptom?
- Injury to the face (cheek, chin, forehead, or jaw).
Some Basics...
- There are many types of face injuries. The face is made up of skin, muscles, ligaments and bones. These can all be injured.
- Treatment depends on the type of injury.
Types of Injuries
- Abrasion: This is the medical term for scraped skin. This happens when an injury scrapes off the top layer of the skin. Pain is usually mild. This can usually be treated at home. Making certain the wound is clean is the most important thing.
- Contusion: This is the medical term for bruise. It is caused by a direct blow to the skin and muscles. The skin is not broken, and there is no cut. The bruised skin may first look red, then purple, and finally orange-yellow. These skin color changes are from blood that leaked from tiny torn blood vessels in the bruised area. The skin may also be swollen. Pain is usually mild to moderate. Bruises are tender to touch. Most often this can be treated at home. A cold pack can help reduce the pain and swelling.
- Cut - Superficial: Superficial cuts (scratches) only go part of the way through the skin and rarely become infected. A scratch is an injury to the skin made by a sharp edge. For example, scratches can be caused by fingernails, a sharp nail, a piece of metal, or a branch of a tree or bush. A paper cut is a scratch from the edge of a piece of paper. This can usually be treated at home. Making certain the wound is clean is the most important thing.
- Cut - Deep: Deep cuts (lacerations) go through the skin. A laceration is caused by cutting the skin with the sharp edge of an object. Cuts on the face longer than ¼ inch (6 mm) usually need sutures (stitches).
- Fracture: This is the medical term for a broken bone. It means the same thing as a break or crack in the bone. The pain can be severe. Minor fractures can be treated with cold packs and pain medicines. More severe fractures may need surgery.
- Jaw Dislocation: This is when the jaw (mandible) bone comes out of the joint. The person will feel like the mouth is locked open and will not be able to fully close the mouth. The pain is severe. A doctor will treat this by putting the bone back into the joint socket.
What Cuts Need to be Sutured?
- Any cut that is split open or gaping probably needs sutures (or skin glue).
- Cuts on the face longer than ¼ inch (6 mm) usually need sutures (stitches).
- Any open wound that may need sutures should be evaluated by a physician regardless of the time that has passed since the cut occurred.
Pain Scale
- None: No pain. Pain score is 0 on a scale of 0 to 10.
- Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
- Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
- Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.
Warning!
- Always consider the chance of a neck injury in people with face or head injuries.
- Watch for neck pain and arm or leg numbness or weakness. These may be signs of a neck injury.
When to Call for Face Injury
Call 911 Now
Call Doctor or Seek Care Now
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Contact Doctor Within 24 Hours
Contact Doctor During Office Hours
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Self Care at Home
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Call 911 Now
- Major bleeding (nonstop bleeding or spurting)
- Deep penetrating wound (such as from a knife, gunshot wound, or sharp object)
- Seizure occurred
- Knocked out (unconscious) for more than 1 minute
- Trouble waking up or acting confused
- Neck pain after face or head injury
- You think you have a life-threatening emergency
Call Doctor or Seek Care Now
- Severe face pain
- Skin is cut and No past tetanus shots
- Looks like a broken bone (cheekbone is flat on one side)
- Can't fully open or close the mouth
- Double vision or unable to look upward
- Taking a blood thinner like Coumadin (warfarin) or have a bleeding disorder
- You think you have a serious injury
- You think you need to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Large swelling or bruise
- Closing the mouth and biting down does not feel normal
- Numbness of the face
- Dirty cut or hard to clean and no tetanus shot for more than 5 years
- Clean cut and no tetanus shot for more than 10 years
- You think you need to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Pain from injury keeps you from working or going to school
- Pain from injury is not better after 3 days
- Injury is still painful or swollen after 2 weeks
- You have other questions or concerns
Self Care at Home
- Minor face injury
Care Advice for Minor Face Injury
Minor Bruise
- What You Should Know - Direct Blow (Contusion, Bruise):
- A direct blow to your face can cause a contusion. Contusion is the medical term for bruise.
- Symptoms are mild pain, swelling, and bruising.
- Here is some care advice that should help.
- Apply a Cold Pack:
- Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes. Repeat this in 1 hour and then every 4 hours while awake.
- Do this for the first 48 hours after an injury.
- This will help decrease pain and swelling.
- Apply Heat to the Area:
- Beginning 48 hours after an injury, apply a warm washcloth or heating pad for 10 minutes three times a day.
- This will help increase blood flow and improve healing.
- Caution: avoid burns. Make sure it is warm, not hot. Never sleep on, or with, a heating pad.
- What to Expect:
- Swelling and pain from bruises start to get better 2 to 3 days after an injury.
- Swelling is usually gone by 7 days. It may take 2 weeks for a bruise to fade away.
- Call Your Doctor If:
- Pain becomes severe
- Pain is not better after 3 days
- Pain or swelling lasts more than 2 weeks
- You think you need to be seen
- You get worse
Minor Cut, Scratch or Scrape
- What You Should Know:
- You can treat small shallow cuts and scrapes at home.
- Here is some care advice that should help.
- Bleeding: Apply direct pressure for 10 minutes with a sterile gauze to stop any bleeding.
- Cleaning the Wound:
- Wash the wound with soap and water for a few minutes.
- For any dirt, scrub gently with a washcloth.
- For any bleeding, apply direct pressure with a sterile gauze or clean cloth for 10 minutes.
- Antibiotic Ointment:
- Apply an Antibiotic Ointment(such as OTC Bacitracin), covered by a Band-Aid or small gauze dressing. Change daily or if it becomes wet.
- Option : A TEFLA dressing won't stick to the wound when it is removed.
- Call Your Doctor If:
- Looks infected (pus, redness, increasing tenderness)
- Doesn't heal within 10 days
- You think you need to be seen
- You get worse
Over-the-Counter Pain Medicines
- Pain Medicine:
- You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
- They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
- Use the lowest amount of a drug that makes your pain feel better.
- Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
- Read the instructions and warnings on the package insert for all medicines you take.
- Call Your Doctor If:
- You have more questions
- You think you need to be seen
- You get worse
And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
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