What are facial injuries?

Facial injuries include:

• cuts and wounds to the face
• nosebleeds
• a broken nose
• injuries to the eyes and airways

Some minor injuries can be managed at home, while others will need urgent medical attention.

What causes facial injuries?

Facial injuries can affect any part of the face, with a wide range of causes that can include:

Minor cuts and grazes

Wounds and grazes to the face can often be caused by a range of things, such as falling over, shaving or knocking into something. Accidental bumps and knocks are a part of everyday life but wounds can also be the result of deliberate harm.

Bruises

A bruise forms when blood leaks out from the small blood vessels under the skin. As the blood has nowhere to go, it forms a purple-red mark on the skin. The bruise will change colour and eventually fade away.

When a bruise forms around the eye, it’s often called a black eye.

A bruise often appears after you are knocked, bumped or pinched. How easily you bruise depends how tender your blood vessels are. People who have certain medical conditions, such as some blood disorders, and those who take blood-thinning medicines, may also bruise more easily.

Open wounds

Wounds caused by sharp objects, such as knives, can cause internal damage, even if the outside wound only appears to be small.

See below for first aid treatment for an object stuck inside (embedded in) a wound.

A wound or cut is considered 'deep' if tendons, muscle or bone can be seen. A gaping wound is one where the edges of the cut can't be pulled back together.

Nosebleeds

While there are many causes of nosebleeds, they often occur as a result of a bump or knock to the head or face.

Find out how to treat a nosebleed.

Fracture (broken bone)

A facial fracture is a break in the bone of the face. It is usually the result of a trauma (force caused by an accident, contact or a fall).

It can be difficult to tell, just by looking, whether an injury is a fracture, dislocation, sprain or strain. If in doubt, always treat the injury as a fracture.

Signs of a fracture can include:

• pain or tenderness at the site
• swelling
• deformity
• redness
• bruising
• loss of function

If you suspect that you, or another person, has a facial fracture, you should seek medical help. An x-ray, CT scan or MRI may be needed.

Bleeding or cut tongue

Your tongue is a sensitive muscle that can be injured by anything sharp or rough, such as your teeth, cutlery or sharp pieces of food. It is also possible to injure your tongue if, for example, you fall or play sport. You may also bite your tongue, causing it to bleed or swell.

When should I call an ambulance or go to the emergency department?

Some facial injuries need urgent medical treatment.

Call triple zero (000) and ask for an ambulance, or go to your nearest hospital emergency department if the injury:

• is a deep wound and the bleeding can't be stopped
• is a severe eye injury
• affects the airways, especially if the person is unconscious

• are pale
• have cold or clammy skin
• have fast or shallow breathing
• have a fast or weak pulse

While you are waiting for the ambulance, apply first aid:

• Make sure the person has a clear airway:
  • Check their mouth and throat are clear.
  • If there is foreign material, roll the patient on their side and clear their airway with your fingers.
  • If there is no foreign material, leave them in the position you found them in.
  • Gently tilt their head back and lift their chin to clear their airway.
• Have them rest somewhere quiet and cool, preferably on their side with their head slightly raised.
• Apply pressure to any bleeding point with a clean cloth or dressing.
• The person should not have anything to eat or drink until they have been assessed by ambulance officers.

Embedded objects

If there is an embedded object, such as a knife, long pieces of glass or a stick, inside a wound, leave it where it is. Removing it could cause more damage or serious bleeding.

In the meantime, do the following:

• Apply firm pressure around the sides of the embedded object to help control bleeding.
• Position padding around the object to prevent the object from twisting or moving. Place bandages over and around the padding to secure the foreign object, if it's safe to do so. Do not put any pressure on the object itself.
• If the object is quite long, ensure it is positioned securely with the bandaging around it.

How are facial injuries treated at home?

You can easily treat minor facial wounds or cuts yourself. However, a large or deep wound or cut will need medical attention.

A large wound that is gaping open will need to be professionally closed. It may require stitches, closure with medical glue or to be taped with a 'butterfly bandage'.

Minor injuries

If you have a minor injury on your face:

• Wash the injured area thoroughly but gently. If there is anything in the cut or graze, such as gravel, gently try to remove as much as you can. It is important to get as much debris out as possible to avoid getting an infection. Pat the area dry with a clean cloth.
• If the injury is likely to get dirty or you are going somewhere that may have lots of dirt or dust in the air, cover the injury with an adhesive plaster, bandage or sterile dressing.
• If the plaster or dressing gets wet or your injury leaks through it, change the dressing regularly until the wound has healed.
• If you have never had a full course of tetanusimmunisation or if you have not had a booster vaccination for tetanus in the last 10 years, contact your doctor.
• Check the wound daily. Look out for increasing redness, swelling, pain, or yellow discharge, since these are signs of a possible infection.

Wounds and cuts

If you have a wound or cut:

• Use a clean cloth or gauze and apply direct pressure to the wound. If these aren't available, use your fingers until a sterile dressing is available. Be very careful if you think a bone may be broken.
• If the bleeding is very heavy, it may seep through the dressing. You should use a second dressing to cover the first one.
• If the bleeding continues through both dressings and pads, remove the second bandage only and apply a new one.
• If the wound is not bleeding, bathe it with clean water.
• Pat dry with a clean cloth, then cover the wound with a dry, sterile, non-sticky dressing to help prevent infection.

Bleeding or cut tongue

A cut on your tongue may bleed a lot. This may make you think your injury is worse than it is. Usually, a cut on your tongue will heal quickly and not cause you any problems.

To treat a small cut on your tongue, rinse your mouth with saltwater to help keep it clean. If it won't stop bleeding, firmly press the injury with gauze or a piece of clean cloth, and then see your doctor or go to the nearest hospital emergency department.

If you smoke, you should avoid smoking for as long as possible. Try not to smoke while the cut is fresh as it can impair healing and increase the risk of infection.

Bruising

Hold an icepack over the bruise to reduce any swelling. A frozen bag of peas wrapped in a tea towel makes a good icepack. Do not put ice directly on the skin (the bag of peas can be repeatedly re-frozen, but don't eat the re-frozen peas).

The swelling should go down quickly, leaving just the bruising. If the swelling continues, speak to your doctor.

Nosebleed

Learn how to stop a nosebleed.

If you have a facial injury which means you can't put pressure on your nose to stop the bleeding, go to your nearest hospital emergency department.

Deliberate injury

If you were assaulted or hit by another person — or suspect that the facial injuries of another person were caused deliberately and were not the result of an accident — you should seek help from a healthcare professional as soon as possible. Talk to your doctor, community nurse, emergency department or school nurse.

If you're not sure who to speak to, call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria) to discuss what to do next.

Where can I seek help?

If you're not sure what to do about a facial injury, call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria) to speak with a registered nurse (24 hours a day, 7 days a week).

You can also see your GP or local pharmacist for advice.

Resources and support

• For first-aid information and fact sheets in English and other languages, visit St John Ambulance Australia.
• Call Lifeline on 13 11 14 to help put you in contact with a crisis service in your state.
• 1800RESPECT is the National Sexual Assault, Family & Domestic Violence Counselling Line for any Australian who has experienced, or is at risk of family and domestic violence and/or sexual assault. Call 1800 737 732 (24 hours, 7 days a week).