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What is lip numbness?
Most of us have lip numbness after a dental procedure. But lip numbness can be caused by a number of conditions, from cold sores to low blood sugar. You may feel tingling, burning, or pins and needles, which can come on gradually or suddenly. You may also have other symptoms like swelling, blistering, or trouble breathing.
Most of the time, lip numbness is temporary and gets better on its own, but it can be a sign of a more serious condition, like low blood sugar, low calcium, or hypothermia.
When to call the doctor
Lip numbness caused by cold temperatures (frostnip and mild frostbite) or minor injuries like biting or burning your lip while eating can usually be treated at home. See your doctor if your lip numbness lasts longer than a few minutes or occurs with other symptoms like increased fatigue, facial swelling, a droopy face, or severe pain.
How do you figure out lip numbness causes?
I often ask questions like, “When did it start? How long have you experienced it? Did it start suddenly or slowly? What other symptoms do you have? What were you doing when you noticed it? Is it getting better, worse, or feels the same? Is it all over your lips or affecting a certain part?”—Dr. Petrina Craine
Should I go to the ER?
You should go to the ER if your lip numbness occurs with these serious symptoms:
- Difficulty breathing or shortness of breath
- Swelling of the face, lips, and tongue
- Problems swallowing
- Dizziness or problems with balancing or walking
- Blurry vision or loss of vision
- Problems talking or understanding others
- Muscle spasms or twitching
- Seizures
- Weakness, paralysis, or tingling in face, arms, or legs
- Confusion or lethargy
- Fever over 102°F or fever for longer than 3 days
- Depressive thoughts
- Hallucinations
- Severe pain
- Skin changes (areas that turn red, blue, white, or black)
- Sudden blistering
Causes
1. Frostnip/frostbite
Symptoms
- Lip numbness
- Changes in skin color and texture (such as developing red, white, blue-white, or gray-yellow skin or hard and waxy skin)
- Blistering (usually occurs when your skin gets warm again)
- Tingling and numbness in other areas, such as your nose, cheeks, ears, fingers, and toes
Frostnip and frostbite are skin injuries caused by exposure to cold. Frostnip, which is milder than frostbite, develops when your lips become cold but don’t actually freeze. Your blood vessels constrict, meaning less blood is delivered to the tissues beneath your lips. It is completely reversible once you warm up.
Frostnip can lead to frostbite, which is more serious. In frostbite, ice crystals form within your skin and blood flow is limited. In severe cases, freezing can affect deep tissues, which may cause nerve damage or permanent tissue death.
Treating frostbite
Frostnip and minor frostbite will go away when you return to a warm space. Severe frostbite, on the other hand, can be life-threatening and requires a trip to the ER. Therapies include pain medication, removal of damaged tissue, and surgery.
2. Hypothermia
Symptoms
- Lip numbness
- Slow heartbeat
- Confusion
- Increased sleepiness
- Shivering that may slow down or stop
Hypothermia is a dangerous condition that occurs when your body temperature drops to 95°F or lower. When this happens, your body works quickly to protect the organs in your core, so other parts of your body start to feel cold and numb. Hypothermia typically occurs when you’re exposed to cold weather or cold water, but it also occurs in temperate climates if you aren’t prepared with the right clothing.
Treating hypothermia
Lip numbness caused by minor hypothermia often goes away when you return to a warm space and take off any wet clothing. But severe hypothermia is a life-threatening emergency, so you should go to the ER. Treatments include warm IV fluids and humidified oxygen.
3. Medication/chemical exposure
Symptoms
- Lip numbness
- Skin rash may be occur around the lips
- Lip swelling may occur
Lip numbness can be a side effect of treatments like chemotherapy, radiation, anesthesia, and cosmetic lip injections. Dental procedures that use a local anesthetic or face surgeries can also make your lips feel numb for up to 24 hours. Exposure to a chemical or toxin like bleach can also make lips feel numb.
Treating numbness related to medication
In these cases, lip numbness can be temporary or persistent. See your doctor if the sensation lasts for more than a few days or is interfering with everyday activities like eating and drinking. Go to the ER if the numbness and swelling are getting worse, especially if the tongue and throat are swelling, as this could lead to a life-threatening allergic reaction.
4. Lip injury
Symptoms
- Lip numbness
- You may have a cut or burn on your lip
- Teeth may be chipped, loose, or missing
Lip numbness can occur from a minor injury, such as biting your lip or a burn caused by eating food that was too hot. It often goes away in a few days as the mouth heals.
Treating a lip injury
Go to the ER If your lip numbness is caused by a serious event such as a head injury or seizure. If you bit all the way through your lip, you may need antibiotics to prevent an infection from mouth bacteria in the wound.
5. Allergies
Symptoms
- Lip numbness
- Lip or tongue swelling
- Facial swelling
- Itchy throat
- Hives
- Shortness of breath
- Wheezing
- Abdominal pain
- Nausea, vomiting, and diarrhea
Lip numbness can be an allergic reaction to dust, pollen, a medication, cosmetics, or particular foods.
Some allergic reactions are mild and only cause hives or itching. These reactions can usually be treated at home.
Other allergic reactions can be severe and life-threatening. Angioedema is when lips, tongue, and face swell, which can cause difficulty breathing. Anaphylaxis is a life-threatening allergic reaction that affects multiple body organs and it can cause dangerously low blood pressure. Symptoms may include hives, shortness of breath, and vomiting.
Treating an allergic reaction
Mild allergic reactions can be treated at home with over-the-counter antihistamines like Benadryl. These block your body from releasing chemicals like histamine that contribute to allergy symptoms.
If you have symptoms of anaphylaxis, use an Epi-pen (epinephrine), if you have one, and go to the ER.
6. Cold sores
Symptoms
- Lip numbness
- Lip burning, itching, or tingling (usually occurs before blisters develop)
- Small, round bumps or blisters that may ooze or crust (usually clustered around the corners of the mouth)
- Low-grade fever
- Pain when you eat and drink
Cold sores are tiny, fluid-filled blisters that appear on and around your lips. They’re usually caused by a virus called herpes simplex. When you’re infected with the virus, it can affect your nerve sensation and make your lips feel numb.
Treating cold sores
There is no cure for cold sores. They usually clear up in 2 to 4 weeks, but they can come back. If your cold sores are mild and don’t occur often, you can take an over-the-counter medication called Abreva to speed the healing process.
But if you get frequent or long-lasting cold sores, your doctor may prescribe an antiviral medication like valacyclovir to clear them up faster and reduce the number of future outbreaks.
Can stress cause numbness in lips?
Cold sores are often triggered by stress—whether from an illness like the flu or even from emotional stress from taking a high stakes test. It is especially important for people with recurrent cold sores to work with your doctor to identify your stress triggers in order to also help reduce and minimize recurrence. —Dr. Craine
7. Shingles
Symptoms
- Lip or skin numbness
- Painful rash on just one area of the body
- Fluid-filled blisters that break open and crust
- Burning or tingling sensations
- Pain when you eat and drink
Shingles is caused by the varicella-zoster virus (VZV). This is the same virus that causes chicken pox. Once you’ve had chicken pox, the virus lies dormant in your body and can reemerge years later as shingles, which causes a painful rash in one area of the body. The abdomen and back are common locations, but it can also occur on the face and lips.
Shingles pain usually goes away when the rash clears. But about 10% to 18% of people who get shingles develop a pain syndrome called postherpetic neuralgia, according to the CDC. This can last for weeks, months, and even years.
You can lower your risk of developing shingles by getting the shingles vaccine, which is available for people ages 50 and older.
Treating shingles
See your doctor right away if you develop shingles. If the rash is on your face, it can cause severe, permanent complications, such as blindness, if not treated right away. While the virus can’t be cured, your doctor will prescribe antiviral medications to speed healing. The sooner you take the medication, the lower your risk of complications.
If your shingles rash is very painful, your doctor may also prescribe pain relievers. If the pain is mild you can take acetaminophen or ibuprofen.
8. Anxiety
Symptoms
- Lip numbness or tingling
- Feeling nervous, restless, or tense
- Feeling scared, panicky, or a sense of dread
- Increased heart rate
- Hyperventilating
- Increased sweating
Anxiety can cause lip numbness if you hyperventilate, which is when you breathe so quickly and deeply that the levels of oxygen and carbon dioxide in your body change rapidly. When you hyperventilate, carbon dioxide levels in your blood can drop so quickly that it causes lip numbness or tingling.
Lip numbness caused by anxiety is often brief and goes away on its own. If you start hyperventilating, try breathing into a paper bag that covers your mouth and nose. This helps increase the amount of carbon dioxide in your body, which restores sensation to your lips.
Treating anxiety
See a doctor or mental health provider if your anxiety interferes with your daily life. Treatment may include therapy and medication. Go to the ER if you ever have thoughts of harming yourself or committing suicide.
9. Hypoglycemia
Symptoms
- Lip numbness
- Confusion or trouble concentrating
- Shaking
- Blurry vision
- Dizziness
- Sweating
- Fatigue
- Seizures
Hypoglycemia develops when your blood sugar is very low. Diabetes medications can cause low blood sugar if you accidentally take extra doses, or if your food intake is lower than normal but you take your medication normally. Other diseases such as cirrhosis and anorexia nervosa can cause hypoglycemia too.
Treating hypoglycemia
Hypoglycemia is a medical emergency that can lead to death if it isn’t treated. You can raise your blood sugar levels by eating or drinking something high in sugar, but you should go to the ER or call 911 if your symptoms are severe, or if the sugar doesn’t make you feel better. If you have diabetes, make sure that you have an easily accessible glucagon injection kit you can use for severe hypoglycemia.
10. Hypocalcemia/hypoparathyroidism
Symptoms
- Lip numbness and tingling
- General numbness and tingling (fingers and toes are commonly affected)
- Fatigue
- Shortness of breath
- Irritability
- Abnormal heartbeat (this causes chest discomfort or heart flutters)
- Confusion
- Seizures
Hypocalcemia is a low level of calcium in your blood. Calcium helps the heart and other muscles function properly and it maintains strong teeth and bones. It also supports nerve function, so when your calcium levels are too low, nerve sensations are disrupted and your lips may feel numb and tingling.
Hypocalcemia can be caused by hypoparathyroidism. This condition occurs when your parathyroid glands (located in the neck behind the thyroid gland) don’t produce enough parathyroid hormone, which is important for regulating calcium levels. Other symptoms of hypoparathyroidism include painful menstrual periods, skin changes (dry and brittle hair, skin, and nails), and feeling depressed or anxious.
Treating hypocalcemia
See your doctor if you suspect you have hypocalcemia or hypoparathyroidism. Treatment may include supplements (calcium, vitamin D, magnesium), diuretics, or injections of a medication that mimics your body’s natural parathyroid hormone.
Go to the ER if you have severe symptoms of low calcium levels, like extreme fatigue, confusion, seizures, loss of consciousness, or an abnormal heartbeat. Very low calcium levels can lead to death, so you need care immediately. Treatment may include oral or IV medications to increase calcium levels.
11. Stroke
Symptoms
- Lip numbness
- Numbness or weakness (or even paralysis) of the face, arm, or leg
- Trouble walking or balancing
- Dizziness
- Headache
- Vision problems
- Trouble speaking
- Confusion
A stroke occurs when the blood supply to part of your brain is reduced or stopped. The most common cause of a stroke is a clot in an artery, but it can also be caused by a leaking or burst blood vessel in your brain. When nerve cells in the brain lose their blood supply, they can’t communicate with the body, and you can develop muscle weakness or loss of sensation in a certain part of the body.
Without immediate treatment, a stroke can lead to brain damage or brain death.
Another type of stroke that can cause numbness is a transient ischemic attack (TIA), also called a “mini-stroke.” TIAs occur just like a stroke, but the symptoms get better within a few minutes or a few hours. TIAs usually don’t cause permanent brain damage or brain death because blood flow is restored quickly.
Treating stroke
Go to the ER if you have symptoms of a stroke or TIA. Even though TIAs are less severe, they’re often a warning that a stroke is on the way, so it’s important to take them seriously, even if your symptoms completely go away. Treatment for strokes may include medications that thin your blood or help break apart clots. Surgery is sometimes needed to remove a large clot from a blood vessel in the brain, or if the stroke is caused by a bleeding blood vessel.
Upper lip numbness vs. lower lip numbness
Sometimes my patients who are concerned about a possible stroke or TIA think that the location of lip numbness--upper vs. the lower lip--makes a difference in determining what’s a stroke and what’s not. That’s not true! Either lip can be associated with a stroke syndrome. Lip numbness occurring completely by itself is less likely to be the result of a TIA or stroke and more likely to be caused by something less serious. —Dr. Craine
12. Peripheral neuropathy
Symptoms
- Lip numbness
- Tingling, pins and needles, or burning pain
- Muscle weakness
- Sensitivity to temperature changes
Peripheral neuropathy is caused by problems with your peripheral nervous system, the nerve connections that are outside of your brain and spinal cord. Damage to one nerve or multiple nerves most often occurs in the hands and feet, but other body parts such as the lips can be affected.
Peripheral neuropathy is often caused by diabetes and is referred to as diabetic neuropathy. But other health problems can cause it, including injuries, infections, genetic diseases, exposure to toxins or chemicals like tobacco, autoimmune diseases, and certain medications. In some cases, no cause can be found.
Treating neuropathy
Treatment includes over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol) or prescription pain medications like gabapentin. Physical therapy and regular exercise may also help. If you have diabetes, keeping blood sugar levels under control can help reduce further nerve damage.
13. Cancer
Symptoms
- Lip numbness
- Changes in lip or tongue color (like red or white patches)
- Problems chewing or swallowing
- Mouth or jaw soreness or irritation
- Bleeding from the lip, gums, or mouth
- Feeling a growth or thick spot in the mouth
Cancers of the mouth, throat, and face can cause lip numbness because they may damage nerves around your lips. You may have numbness in your entire mouth or just in certain areas.
Smoking is a common cause of mouth and throat cancers. Exposure to sun is the main cause of cancers of the lip. Any tumor in the face can cause numbness if it grows and pushes on nerves.
Treating cancer
Cancer treatment can include surgery, radiation, and chemotherapy. Lip numbness may be permanent due to damage from the cancer and the treatment.
Other possible causes
Additional causes of lip numbness includ
- Cavities in your teeth
- Autoimmune conditions
- Vitamin B-12 deficiency
- Raynaud’s disease
- Burning mouth syndrome
- Numb chin syndrome
- Food poisoning from seafood (ciguatera poisoning)
- Lyme disease
- Drug or alcohol use
- Smoking
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Treatments
At-home care
- Warming yourself if you have frostnip or mild frostbite.
- Applying petroleum jelly or lip ointments like Orajel.
- Stress-reduction techniques like deep breathing if your lip numbness is caused by anxiety.
- Using supplements recommended by your doctor to help prevent nutritional deficiencies.
- Rinsing your mouth with lukewarm saltwater or antiseptic wash if you have a mouth or lip injury.
Medication
- Over-the-counter medications can help reduce symptoms like pain and fever (Advil or Tylenol), and itching (Benadryl).
- Medications to treat infections or diseases that cause lip numbness, like autoimmune diseases, nervous system disorders, or cancer
- Behavioral therapies and medications for conditions like anxiety
- Clot-busting drugs or blood thinners for stroke
- Allergy medications
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