Diagnosis of burning in the face

If the burning sensation in the face persists, the patient should first consult the family doctor. By looking at the skin and asking about the exact symptoms, first conclusions can be drawn about a trigger. Thus, shingles or trigeminal neuralgia always occurs on one side.

In special cases (e.g. when trigeminal neuralgia is suspected), neurological examination or an imaging procedure (e.g. MRI) can be used. If, on the other hand, an allergy or skin disease is suspected, a referral to a dermatologist can be made.

Associated symptoms

The accompanying symptoms depend on the cause of the burning in the face. If a skin disease such as neurodermatitis is the cause of the burning sensation, it is accompanied by itching and skin changes such as redness and scaling. Dry skin as a cause of burning on the face is also usually accompanied by dandruff and itching.

In the case of shingles, fluid-filled blisters on a reddened background on the affected half of the face usually appear a few days after the onset of the unilateral, burning pain. If the eye or ear is also affected, in extreme cases hearing and vision may be impaired. In the case of an allergy (e.g. to cosmetics), a blurred redness occurs, possibly with scaling and small blisters or pustules.

If the burning is caused by a trigeminal neuralgia, suddenly occurring, seizure-like and lasting a few seconds, the strongest pain occurs on one half of the face. How a classic allergic reaction proceeds is also explained in our article Allergic reaction. In the case of an allergy (e.g. to cosmetics), a blurred redness occurs, possibly with scaling and small blisters or pustules.

If the burning is caused by a trigeminal neuralgia, the strongest pain on one side of the face is suddenly triggered and lasts for a few seconds. How a classic allergic reaction proceeds is also explained in our article Allergic reaction. A burning sensation in the face is often accompanied by itching.

This can be the case with various diseases and is therefore a rather unspecific symptom. Both dry skin and various skin diseases such as neurodermatitis can cause itching in the face. In addition, allergies (allergic contact eczema) are often accompanied by itchy rashes.

For trigeminal neuralgia and shingles (zoster), however, itching is rather untypical. In these cases, the affection of nerves running there leads to clearly burning pain in one half of the face. You can find out what else might be hidden behind itchy skin in our article Skin itches – what to do?

A tingling sensation has to be distinguished from itching and is often described by those affected as walking with an army knife. A tingling in the face indicates an involvement (damage or irritation) of the nerves of the respective area. A tingling sensation can occur in early stages of shingles before the blisters appear.

The tingling is always one-sided. The irritation of the trigeminal nerve during its course in the brain can also cause tingling and burning sensation in the face. This is conceivable, for example, in the context of a Lyme disease attack of the brain.

In general, tingling is a very unspecific symptom, which can have harmless but also more serious causes; the family doctor can give an initial assessment. If a reddening in the affected region accompanies the burning sensation on the face, this can be an indication of a skin disease. Particularly dry skin and people affected with neurodermatitis tend to have reddened skin.

But also in the context of an allergic eczema (inflammatory skin change caused by an allergic reaction) redness in the facial area can occur. Shingles caused by herpes viruses also causes (unilateral) redness in the facial area. At the base of this redness many small, fluid-filled blisters are formed, which contain virus-containing secretions. How to recognize eczema and what you can do about it, you can read in our article Eczema – Causes, Treatment & more!