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What your face says about your health

“You’re the picture of health!” It’s a common compliment based on the idea our outward appearance reflects our inner health through glowing skin, shiny hair and bright eyes.

But there are some things our faces can reveal that indicate our health is not so good. It’s not the total picture, of course, and not a fool-proof way of diagnosing anything, but here are some signs that all might not be well.


Rash with red, raised patches

What it could be

Rashes can occur for many reasons. But if you have a recurring itchy, burning rash on your scalp, which also has blisters that burst with scratching, and sometimes appears on other parts of the body too, such as the scalp, shoulders, buttocks, knees or elbows, it could be dermatitis herpetiformis – one symptom of coeliac disease.

What to do

Talk to your doctor, who will want to know about any other symptoms you might have. A simple skin biopsy is a starting point and, if positive, the next step is a referral to a gastroenterologist for further testing for coeliac disease.

NOTE: If you suspect coeliac disease, don’t eliminate gluten straight away; this can interfere with getting an accurate diagnosis.

Other facial signs, like easy bruising of the skin, mouth ulcers and swelling, can also be signs of coeliac disease.

Yellow skin

What it could be

Jaundice, or yellowing of the skin and whites of the eyes, is a symptom of a few different problems, all of which require medical attention. Jaundice occurs when there’s too much bilirubin, a yellow-orange substance found in red blood cells, in your blood, and the liver isn’t able to filter it out well enough. Jaundice can be a sign of diseases that affect the liver such as hepatitis or alcohol-related liver disease, or of blocked bile ducts resulting from gallstones or pancreatic cancer. Some medications can also cause damage to the liver.

What to do

Seek medical attention. Your doctor will want to run blood tests to check your levels of bilirubin and other liver functions and combine these with your medical history.

Redness, flushing or rash in the centre of the face and nose

What it could be

Rosacea is a chronic red-coloured rash that usually affects those with fair skin. It can also appear as frequent flushing or blushing, and sufferers often have very sensitive skin that reacts badly to skincare products. It’s not really known what causes it; it could be environmental or genetic factors. Rosacea can be aggravated by anything that makes the face hot: showers, sun exposure, stress or spicy food. It’s not harmful but it can be uncomfortable, especially when it affects the eyes, making the eyelids red and sore, or when it causes thickened and bumpy skin on the nose.

What to do

Your doctor can prescribe antibiotics for a flare-up of rosacea. Other things you can do to prevent future occurrences include always wearing sunblock; limiting alcohol and spicy food; using oil-free skincare and cosmetic products and choosing products designed for sensitive skin. If your rosacea persists, ask to be referred to a dermatologist to explore other treatment options.

Excess facial hair

What it could be

Facial hair patterns in women depend on our ethnic background and genes. But an excess of hair on the face – with excess hair growth elsewhere on the body – is known as hirsutism, and could be due to what’s known as hyperandrogenism, an increase in ‘male’ hormones called androgens. This can be a sign of polycystic ovary syndrome (PCOS), insulin resistance or obesity.

What to do

PCOS needs to be diagnosed properly, so see your doctor. Facial hair growth won’t usually be the only symptom, or the only skin symptom; sufferers often also have acne as well as hormonal symptoms such as irregular menstrual cycles. There are lifestyle changes that can help control PCOS – maintaining a healthy weight and getting regular exercise are important. And there are hormone therapies that can also help.

Face signs not to worry about

As we age, our faces naturally change. We lose fat under the skin in some places, and gain it in others, so our faces might loosen, sag or become more jowly. Movement and facial expression over time creates wrinkles, and sun exposure creates wrinkles, freckles and dark spots. Stress, genes and lifestyle all influence how well our faces age.

Short of surgery, there’s not much we can do about most of these signs, and they’re not harmful to our health. Using sunblock consistently will slow their onset, and using moisturiser to soothe and temporarily plump the skin can make us look fresher. But we shouldn’t worry about signs of ageing in our faces. Think of these as signs of wisdom gained and life lived, not youth lost!

Get serious with your skin: Changes that need checking

In New Zealand, we have the highest rate of melanoma in the world. If you have a mole or freckle on your face (or anywhere) that suddenly develops, or one that seems to change shape, colour or appearance, get it checked straight away. Melanoma and other less serious skin cancers can be easily treated when they are caught at an early stage.


Red or irritated eyes

What it could be

Our eyes can be red for many reasons, ranging from too much screen time to allergic reactions. Common issues that might need addressing include conjunctivitis (pink eye) and styes – minor eye problems that usually clear up on their own, but may need treatment from a doctor if they don’t come right.

What to do

Conjunctivitis, if viral or bacterial, is infectious, so be careful with hand washing and don’t share towels or face cloths. Allergic conjunctivitis isn’t contagious. Both viral conjunctivitis and stye symptoms can be eased with a compress to the eye, cool for the former, warm for the latter. If you develop severe pain, sensitivity to light or eyesight changes, it’s time to see the doctor. In rare cases, persistent or recurrent eye infections could be signs of more serious diseases including inflammatory bowel disease, so it’s worth getting this checked out.

Eye twitching

What it could be

It can be alarming when our eyes or eyelids twitch of their own accord. Slight eyelid twitching is common, and it’s usually caused by fatigue, stress, smoking, excess alcohol or caffeine intake, or irritation of the eye. There are some eye conditions that include twitching as a symptom and, in rare cases, twitching can be a sign of nervous system or brain disorders. It can also be a side effect of some drugs.

What to do

Eye twitching usually goes away on its own, especially if you address stress, get some sleep and cut back on the alcohol and coffee. If you’re worried and have other symptoms (such as twitches elsewhere in the body) or the twitching doesn’t go away after a few weeks, see your doctor to investigate further.

Dark circles under the eyes

What it could be

Dark circles (and related puffiness or under-eye bags) are not usually signs of anything more serious than lack of sleep or simply age catching up with us. They can also be caused by pigmentation changes, allergies, hay fever or dermatitis. Sometimes what looks like a dark circle is nothing to do with pigmentation, but shadows cast by bags or hollows under the eyes, or thinning of the skin under the eyes due to normal ageing. When this happens the dark blood vessels in this area become more visible.

What to do

Although targeted by many beauty products and promises, dark circles are probably better addressed by making sure you get enough sleep and using a good concealer! See your doctor if you have discoloration or swelling under one eye only and it’s not going away.

Bulging eyes

What it could be

Bulging of the eyes is known as exophthalmos. When this is accompanied by a gritty sensation, pressure or pain in the eyes, redness and puffiness, it could be a sign of the hormone condition, Graves’ disease. This is an immune system disorder that causes an overproduction of thyroid hormones (hyperthyroidism). It’s not known why it happens, and it’s more common in women. If untreated, it can lead to serious heart problems.

What to do

See your doctor if you’re worried. They’ll run checks on thyroid hormones combined with a physical examination. Graves’ disease can be treated with medication and other therapies.


Dry lips

What it could be

Lips can get dry, irritated and flaky in hot dry weather from dehydration and sun exposure, and in winter from dry and cold weather conditions. They’re not usually a sign of serious problems, but could also be a sign, along with dry skin generally, that you’re a bit dehydrated.

What to do

Use a soothing balm to moisturise lips, and if you’re outside make sure it has sunblock in it. Avoid balms with eucalyptus or menthol, which can cause more irritation. Keep up your fluid intake to avoid dehydration. Try not to lick your lips.

Bleeding or painful gums

What it could be

If your gums are sore or bleed easily, it could be a sign of gum disease gingivitis or the more advanced form, periodontitis. These are important to address, not only because periodontitis can cause teeth to fall out, but also because emerging research points to links between poor oral health and serious diseases such as heart disease and diabetes.

What to do

See your dentist and get your gums checked regularly. Gingivitis is reversible with proper attention to looking after the teeth and gums, such as diligent brushing and flossing. Periodontitis is more serious and may need further treatment.

One face sign that needs urgent attention!

If you or someone you know suddenly looks as if their face is drooping on one side, this could be a sign of a stroke. Check for the other stroke signs: arm weakness on one side and jumbled, slurred or lost speech. If any of these are present, be on the safe side and call 111.