What are facial injuries?

Facial injuries include cuts and wounds to the face, nose bleeds, a broken nose, and 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?

A facial injury, which affects the face, can include:

Minor cuts and grazes

Wounds and grazes to the face can often be caused by a host 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 is made 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.

A bruise often appears after you are knocked, bumped or pinched. How easily you bruise depends how tender your blood vessels are.

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 a wound.)

A wound or cut is considered to be 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 here.

Fracture (broken bone)

A facial fracture is a break in the bone or cartilage, usually the result of a trauma (force caused by an accident, contact or a fall). It can be difficult to tell, just by looking at it, 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 and loss of function. If you suspect you, or another person, has a facial fracture you should seek medical help. An x-ray, MRI or CT scan 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 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.

See your doctor 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 and prevents blood from entering the lungs, especially if the person is unconscious

You should call triple zero (000) and ask for an ambulance if you are looking after someone with a head injury and they:

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

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

• Make sure the person has a clear 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 shards of glass or a stick, inside a wound you must leave it where it is. Removing it could cause more damage or serious bleeding.

Go to the nearest emergency department or call triple zero (000) for an ambulance. 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’s positioned securely with the bandaging around it.

How are facial injuries treated at home?

You can easily treat a minor facial wounds or cuts. However, a larger 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, or medical glue or ‘sticky tape’.

If you have a minor injury on your face, this advice may help:

• 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.
• Let the air get to it, if you can. Leave the cut or graze open unless it’s producing pus, discharge or blood.
• 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 a plaster (Band-Aid) 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 not had a full course of tetanus immunisation or if you have not had your booster vaccination for tetanus, contact your doctor.
• Check the wound daily. You should 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, follow this first-aid advice:

• 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 really 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 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 ice pack over the bruise to reduce any swelling. A frozen bag of peas wrapped in a tea towel makes a good ice pack. 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

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. You should avoid any strenuous activity, such as playing sports, for 24 hours after the bleeding has stopped.

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 are unsure who to speak to, call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria) to discuss your concerns.

Where to 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.