Facial swelling or facial oedema, occurs when fluid builds up in the tissues of the face, according to the National Institutes of Health. Possible causes include allergic reaction, infection, drug reactions and injury. Another possible cause is the overconsumption of alcohol, Alcohol Advisory Council of New Zealand (ALAC).
When dehydrated, the body will compensate by retaining water, which results in enlarged blood vessels and bloating. Alcohol halts the production of an antidiuretic hormone, causing the body to lose water and essential vitamins through excessive urination, according to the ALAC. Because alcohol dehydrates the body, it can cause water retention and puffiness of the face and body.
Long-Term Excessive Consumption
Excessive alcohol consumption is defined as more than two drinks per day for men, and more than one drink a day for women, according to the Centers for Disease Control (CDC).
A 2007 study from the Department of Internal Medicine, Armed Forces Hospital, Brazil, states that, "by not entirely clear mechanisms, alcohol users present hypersensitivity reactions...alcohol intake has been associated with distinctive skin changes and exacerbation of dermatological disorders,” including a puffy face. The study cites a case of a man with massively swollen eyes and upper lip, most likely due to a decade of excessive alcohol consumption.
Binge drinking is defined by the CDC as heavy consumption of alcohol within a short period of time—five or more drinks in a row by men and four or more by women on at least one occasion in two weeks. A puffy face may occur from binge drinking as a result of a variety of causes: chronic dehydration, vitamin deficiency or hypersensitivity.
An article in the UK Daily Mail describes a BBC filmmaker who, as an experiment, went binge drinking five nights a week for a month. As a result, she lost her jaw line, developed “chipmunk cheeks” and belly fat. She was able to feel “normal” and healthy again a couple of months after she stopped binge drinking.
Alcohol Flush Reaction
Even those who consume alcohol in moderation may experience a puffy face. Alcohol flush reaction is an allergic reaction to alcohol characterised by nausea, rapid heartbeat and a red, swollen face, according to CNN Health.
The allergy is caused by an inherited enzyme deficiency common among East Asians. The enzyme, known as ALDH2, metabolises alcohol into acetate. Without the presence of ALDH2, alcohol enters the bloodstream as acetaldehyde, a toxin known to cause respiratory and skin irritation, including swelling, puffiness and cancer.
Drink in moderation to avoid a puffy face and other effects of alcohol overconsumption. Avoid binge drinking by staggering drinks over the course of several hours. Drink on a full stomach and ingest plenty of water to compensate for dehydration. If you have an alcohol flush reaction it's probably best to stop drinking alcohol.