Causes, Symptoms, Risks and Treatment

Facial plethora involves swelling and redness of the face. It is a symptom of another condition, rather than a condition itself.

It happens when blood flow to your face increases. It can also happen when the amount of blood in your body increases.

The underlying causes of facial plethora vary widely, and treatment depends on the specific cause.

Several possible conditions can cause facial plethora. They include:

Cushing’s syndrome

Facial plethora is a primary symptom of Cushing’s syndrome, a rare condition caused by high levels of cortisol, known as the stress hormone.

The hormone cortisol is produced by your adrenal gland. It is involved in bodily functions such as stress response, metabolism, and inflammation.

Too much cortisol can occur if you have a tumor in your pituitary or adrenal gland. The tumor causes your body to overproduce cortisol, resulting in high levels. It can also happen after taking corticosteroids, such as prednisone.

High levels of cortisol can raise blood pressure. This increases the blood flow to your facial skin resulting in a plethora of faces.

Superior vena cava syndrome

The superior vena cava (SVC) is a major vein in your body. It brings blood to your heart from your chest, head, neck, and arms.

Some types of cancer, such as lung cancer, can partially or completely block SCV. A blood clot can also block the SCV. If this happens, a cluster of symptoms called superior vena cava syndrome (SCVS) may develop.

In SCVS, the blockage of blood flow causes swelling in the upper body. This can lead to symptoms like facial plethora.

Carcinoid syndrome

Neuroendocrine cells are involved in basic bodily functions. They work by sending information via hormones.

If neuroendocrine cells turn into a tumor, then it is called a carcinoid tumor. Carcinoid syndrome occurs when the tumor spreads to your liver and produces too much serotonin.

The tumor releases chemicals into the bloodstream, causing a range of symptoms. Certain chemicals widen blood vessels and increase blood flow, causing facial swelling.

polycythemia vera

Polycythemia vera is a rare blood disease that causes excessive production of red blood cells. This increases the mass of red blood cells, causing the blood to thicken and swell.

The swelling can lead to fullness of the face and palms.


Rosacea is a chronic inflammatory skin condition. Inflammation can cause facial redness and swelling.

In people with lighter skin, the rash appears red. In darker skin tones, it may look like brown discoloration.

Other symptoms of rosacea include:

  • acne-like breakouts
  • skin thickening
  • burning
  • hot skin


A sunburn occurs when the sun’s ultraviolet rays damage skin cells. This causes your body to release inflammatory substances, which leads to dilation of blood vessels and increased blood flow.

The increased blood flow leads to swelling and redness, or facial plethora.

In some cases, facial plethora may indicate a syndrome.

According to a 2015 study, facial plethora is one of the earliest identified symptoms of Cushing’s syndrome. It is also one of the first symptoms to improve when Cushing’s syndrome is treated.

Facial plethora can also be caused by SVCS or carcinoid syndrome.

Facial plethora involves a group of features rather than a single feature. These are usually facial symptoms such as:

  • swelling and increased roundness
  • increased puffiness in the cheeks
  • redness (on fair skin)
  • brown discoloration (on darker skin tones)

Symptoms of facial plethora can be uncomfortable. But no research indicates that facial plethora itself is linked to complications.

However, if the underlying condition is left untreated, it can lead to complications. The condition may worsen or cause other side effects.

That’s why it’s important to contact a medical professional if you think you have facial plethora.

Treatment for a bloated face depends on the condition causing it. Treatment may include:


A healthcare professional may suggest using medication for the following conditions:

  • Cushing’s Syndrome. A doctor can prescribe medications that lower your cortisol levels.
  • SVCS. If this condition is caused by a blood clot, a therapy called thrombolysis may be used to break down the clot. This procedure allows medication to reach the site of a blood clot and dissolve the blockage.
  • Carcinoid syndrome. Certain medications can block the chemicals produced by a carcinoid tumor.
  • True polycythaemia. If you have polycythemia vera, you may need medicine to reduce red blood cell production.
  • Rosacea. A dermatologist can prescribe topical medications to manage rosacea symptoms.

Chemotherapy or radiotherapy

Chemotherapy or radiation therapy may be used for tumors that cause:

  • Cushing’s syndrome
  • SVC
  • carcinoid syndrome


In some cases, you might need surgery. This option can be used for tumors that cause:

  • Cushing’s syndrome
  • SVC
  • carcinoid syndrome

If SCVS is caused by a blood clot, surgery may be used to insert a stent or remove the blood clot.

Facial plethora is characterized by facial swelling and puffiness. It can cause redness on lighter skin tones and brown discoloration on darker skin tones.

It is a main symptom of Cushing’s syndrome, but it can also be a symptom of SVCS and carcinoid syndrome. Other causes include polycythemia vera, rosacea, and sunburn.

Treatment depends on the specific cause. If you experience facial swelling and discoloration, contact a medical professional for a diagnosis.

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