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Does Hypothyroidism Change Your Face?

Hypothyroidism, or an underactive thyroid, can significantly impact a person’s health and wellbeing. It can also alter their appearance. One of the most common manifestations of this is facial swelling.

“Hypothyroidism can affect facial features in many different ways, including facial puffiness, loss of hair from the outer part of the eyebrows, and in particular, swelling around the eyes,” says Ronald Lechan, MD, PhD, endocrinologist and co-director of the Hypothalamic and Pituitary Disease Center at Tufts Medical Center in Boston.

Changes in appearance, known as myxedema, are typically associated with severe hypothyroidism. The term myxedema can also refer to the changes to a person’s skin that occur because of the condition.

Do Hypothyroid Conditions Cause Your Face to Swell? Why?

In people with hypothyroidism, the thyroid gland does not produce enough thyroid hormone. This chemical directly influences various bodily organs and processes, including the skin.

Thyroid hormone receptors are present in the epidermis and dermis (the top two layers of skin), as well as in hair. When the thyroid works properly, it plays a key role in maintenance and regeneration.

One of its main jobs is to metabolize sugar compounds. Hypothyroidism can cause excess deposits of sugar molecules, known as glycosaminoglycans, to collect in the skin. These compounds, which include hyaluronic acid, attract water. Over time, too much fluid can accumulate, causing the skin to swell.

Is Puffy Face a Sign of Hypothyroidism?

A puffy face can indicate hypothyroidism. But because everyone’s bodies are different, not everyone with hypothyroidism will have this symptom. Facial swelling can also be linked to conditions other than hypothyroidism. These include an allergic reaction, cellulitis (a bacterial skin infection), or sinusitis (a sinus infection).

Hypothyroidism tends to progress slowly, and many people don’t notice symptoms for months or even years. According to the American Thyroid Association, up to 60% of people with the condition don’t know that they have it.

Facial puffiness usually occurs in the advanced stages of the condition. It can also arise in patients who have stopped taking their thyroid medication.

People with hypothyroidism typically have more symptoms than just a puffy face. Some of the most common include:

  • dry skin
  • dry, thinning hair
  • fatigue
  • loss of energy
  • memory problems
  • weight gain
  • increased sensitivity to cold
  • muscle cramps
  • heavy or irregular menstruation
  • depression

How Do You Reduce Face Puffiness Due to Hypothyroidism?

To reduce facial swelling associated with hypothyroidism, you must address the condition itself. Both are easier to treat in the early stages.

Treatment is not one-size-fits-all. It will depend on the condition’s cause and severity, as well as your medical history. Some forms of hypothyroidism, such as postpartum thyroiditis and subacute thyroiditis, dissipate on their own. However, most are lifelong conditions that can be managed, though not cured. That includes Hashimoto’s thyroiditis, an autoimmune condition that is the leading cause of hypothyroidism in the United States.

Generally, managing an underactive thyroid and its symptoms involves hormone replacement therapy. The standard medication is levothyroxine (Synthroid, levoxyl, tyrosin). This is a synthetic hormone identical to the body’s natural thyroid hormone. It’s usually prescribed as a pill but is also available in liquid form.

A health care provider will check your blood hormone levels about six to eight weeks after you’ve begun taking the medication and adjust your dose if necessary. Once you arrive at a dose that works for you, your health care provider will want to regularly check to ensure that your thyroid hormone levels remain stable. They will usually wait six months, then take another blood test, and then repeat this test annually.

Finding the perfect dosage may take time and some trial and error, but it’s important to follow your health care provider’s instructions carefully. Stopping the medication could cause unwanted side effects. Similarly, taking too much can result in complications as well.

“Almost all facial changes due to hypothyroidism are reversible when the condition is properly treated,” Lechan notes.

Depending on the condition’s cause, a health care provider might recommend lifestyle changes in addition to medication.

FAQs About Hypothyroidism and Facial Changes

Does Hypothyroidism Cause Fat Face?

A lack of thyroid hormone can be associated with facial swelling, though not everyone with hypothyroidism experiences this symptom.

Facial puffiness is most common in advanced hypothyroidism. It usually accompanies other changes in a person’s appearance, including a change in skin texture and tone.

Can Hypothyroidism Change Your Appearance?

Hypothyroidism can change a person’s appearance in multiple ways. Often, people with an underactive thyroid have facial puffiness, especially around the eyes. The skin may also become dry and scaly.

Dr. Lechan explains that “the facial skin also can become pale or even develop a yellow hue due to the development of hypercarotenemia, and occasionally, there can be bulging of the eyes (proptosis) when associated with autoimmune thyroid disease.” He adds that specific changes depend on the disease severity and, sometimes, the underlying cause.

In addition, people with severe hypothyroidism may have a broadening of the nose, a thickening of the lips, and an enlargement of the tongue. They may also lose hair, including from the outer portion of the eyebrows.

Hypothyroidism and hyperthyroidism can cause the thyroid gland to enlarge, resulting in goiter in the neck. A lump may also appear in the neck due to thyroid cancer. A health care provider will conduct a physical exam. They may also use a blood test, imaging, or a biopsy to arrive at a diagnosis.

Some people with autoimmune-related hypothyroidism have bulging eyes. While most changes in appearance dissipate with thyroid hormone replacement therapy, proptosis might need special treatment, according to Lechan.

Weight gain associated with an underactive thyroid can also change a person’s facial appearance.

What Does Hypothyroid Skin Look Like?

Besides puffiness, skin affected by hypothyroidism is often dry, cold, pale, waxy, and firm to the touch. It may also be scaly and have a yellowish tint because of excess carotene. Rashes might develop, especially in skin creases. Other effects include flushing and reddish spots that come and go.

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