Facial Droop – Causes of a Sagging Face

Facial droop is sagging of the face caused by loss of facial muscle tone. This is usually caused by an impairment of nerve function that supply the facial muscles, particularly involving the facial nerve. Most cases of facial droop are one-sided (unilateral) causing a distortion of the normal face structure. This typically appears like the lips are being pulled on one side and there may be difficulty in closing the eye or impairment of the taste sensation. A number of factors can contribute to a facial droop, including trauma, infections and other systemic pathologies.

Facial droop in this context is not related to a sagging facial skin, which may occur as a result of loss of elasticity of the skin. In these cases, a sagging face may be age-related, occur after a sudden loss of weight, debilitating illness or in cases of drug abuse, like a crystal meth addiction.

Facial Nerve

The facial nerve is one of the 12 cranial nerves that emerge directly from the brain. Marked as cranial nerve 7 (VII), the facial nerve exits the brain, giving off branches along its way to the parotid gland where it divides into five smaller nerves.

The facial nerve is responsible for motor, sensory and parasympathetic functions of structures in the head.

Facial nerve palsy causing facial droop

Motor

  • Facial muscles
  • Stapedius muscle

Sensory

  • Anterior two-thirds of the tongue

Parasympathetic

  • Salivary and lachrymal glands

By controlling the facial muscles, the facial nerve allows us to change our facial expression, showing different emotions and assisting with talking and chewing to some degree. Its innervation of the stapedius muscle, a small muscle that stabilizes the stapes in the ear, allows it to control our perception of sound volume. The facial nerve’s sensory functions in the anterior two-thirds of the tongue makes it responsible for the taste sensation in this area. The salivary glands and lacrimal (tear) glands are also partly controlled by the facial nerve, which can essentially ‘turn off’ these glands when necessary.

Causes of Facial Droop

Causes of facial droop are innumerable but the ones most commonly encountered are :

Bell’s Palsy

Thi is one of the most common causes of a facial droop. Bell’s palsy is a temporary paralysis of the facial muscles caused by inflammation of the facial nerve, often due to a viral infection. It is usually a unilateral condition meaning that it only affects one side. The herpes simplex virus, which causes cold sores and genital herpes, is most often involved. Diabetics, pregnant women and people with upper respiratory tract infections are more at risk of suffering from Bell’s palsy and the incidence increases with age.

Other Signs and Symptoms of Bell’s Palsy

  • Sudden onset of facial paralysis or weakness involving one side of the face – facial droop.
  • Difficulty with smiling or other facial expressions.
  • Drooling.
  • Difficulty in closing the eye on the affected side.
  • Inability to wrinkle the forehead.
  • Pain around or in the ear.
  • Sounds seem louder on the affected side (hyperacusis).
  • Hyperlacrimation or excessive watering of the eye on the affected side.
  • Headache.
  • Impaired taste sensation.

In most cases there is complete recovery within a few weeks or months even without treatment but some residual signs of facial paralysis may remain in some people where damage to the facial nerve is severe.

Ramsay Hunt Syndrome

This condition is caused by the infection of the facial nerve by the Varicella zoster virus, the virus which causes chicken pox. This virus may lie dormant for many years after a person suffers from chicken pox and but at some point may get reactivated and infect the facial nerve. Prompt diagnosis and treatment reduces the chance of complications. Ramsay Hunt Syndrome usually causes a unilateral facial droop.

Other Signs and Symptoms of Ramsay Hunt Syndrome

  • Facial muscle weakness on one side of the face – facial droop.
  • Painful red rash with vesicles (fluid-filled blisters) on the eardrum, external ear, area around the ear, palate or tongue.
  • Loss of hearing.
  • Ear pain (otalgia).
  • Tinnitus or ringing in the ears.
  • Difficulty in closing the eye.
  • Dizziness or vertigo.
  • Impaired taste sensation.

Chances of complications are reduced if Ramsay Hunt syndrome is diagnosed promptly and treatment initiated within a week.

Stroke or Cerebrovascular Accident (CVA)

A stroke occurs when blood supply to a part of the brain is disrupted due to any cause. This causes death of the brain cells by depriving them of oxygen. The symptoms depend upon the area of brain that is affected and the degree of brain tissue damage.

Signs and Symptoms of a Stroke

  • Sudden numbness, tingling sensation, or weakness of the face, accompanied by similar symptoms in the arms and legs, generally on one side of the body.
  • Loss of movement on one side of the body.
  • Sudden confusion and difficulty in speaking or understanding.
  • Drooling.
  • Sudden visual disturbances in one or both eyes.
  • Difficulty in walking or standing.
  • Loss of balance, dizziness or vertigo.
  • Severe headache with no apparent cause.

Facial droop caused by stroke may be differentiated from that due to Bell’s palsy by the following signs and symptoms.

  1. The eye can be closed on the affected side in a stroke.
  2. Wrinkling of the forehead is possible in a stroke.
  3. Paralysis or weakness of muscles on one side of the body does not only affect the face in a stroke.

Facial Nerve Palsy

Facial nerve palsy is a nervous system disorder which occurs due to damage to the facial nerve, affecting movement of the facial muscles as well as sensation in the ears and taste sensation in the tongue. It is often caused by a tumor pressing on the nerve. Other causes may include HIV/AIDS, Lyme disease or sarcoidosis, but in some cases no cause can be identified.

Signs and symptoms of a Facial Nerve Palsy

  • Drooping of the corner of the mouth.
  • Drooping of the eyebrows.
  • Facial asymmetry.
  • Loss of forehead wrinkles and nasolabial folds (the deep folds which run from side of the nose to the corner of the mouth).
  • Inability to close the eye.
  • Excessive watering of the eye.
  • Inability to keep the lips tightly closed. This may cause problems with keeping food in the mouth.
  • Wasting or atrophy of the facial muscles in the later stages.

Tumors

Facial droop may occur from tumors arising from the facial nerve or from tumors which arise in the vicinity and secondarily affect the facial nerve. In a facial palsy caused by tumors, the signs and symptoms are more likely to be of gradual onset and there will be additional symptoms depending upon the type and site of the tumor. Headaches, seizures and hearing loss are more likely to occur.

A malignant parotid tumor is the most common tumor affecting the facial nerve and causing facial paralysis. Symptoms are gradual in onset and along with other features of facial palsy there will be a painful mass within the parotid gland. If treatment is delayed, the tumor can enter the brain via the adjacent nerves or may spread to the lungs (metastasis).

Benign and malignant tumors such as meningiomas, paragangliomas, chondrosarcomas, and chondromas may develop within the skull and affect the facial nerve. Each tumor will have its own particular manifestation as well as causing a facial droop.

Benign tumors, called schwannomas, arising from the facial nerve are not so common. If present, they may cause symptoms of facial twitching and facial muscle weakness.

Trauma

Trauma to the facial nerve may be caused by skull fractures, facial injuries or penetrating injury to middle ear. Severe head trauma can cause brain injury and thus affect the facial nerve fibers along its course in the brain and brainstem. Fracture of the temporal bone (the skull bone containing part of the ear canal, middle ear, and external ear) following physical trauma is a common cause of facial paralysis causing facial droop. In addition, there will be signs and symptoms such as hemotympanum (blood behind the tympanic membrane or ear drum), vertigo, deafness, or blood coming out of the external ear.

Surgery

Another form of trauma is iatrogenic injury which is caused by any form of surgery along the course of the facial nerve. This includes surgery of the parotid gland, acoustic neuroma resection, or tumor resection anywhere along the course of the facial nerve. Mastoid surgery, tonsillectomy, mandibular block anesthesia, or some dental procedures may also result in damage to the facial nerve and subsequent facial droop.

Damage may occur to the facial nerve during cervicofacial rhytidectomy (facelift operations or plastic surgery of the face).

Facial drooping, as well as other signs and symptoms of facial palsy which occurs after injury or surgery, points to trauma being the cause of facial droop.

Facial Droop of the Newborn

Birth trauma

Facial droop can occur as a result of birth trauma during a difficult delivery, such as in forceps delivery or a ‘big’ baby.

Mobius syndrome

This is a rare condition where facial droop is present at birth. It is usually bilateral (on both sides) and occurs due to developmental deformities of the brain and the facial nerve. Other cranial nerves may be affected too.

Newborns with facial paralysis may have signs and symptoms such as :

  • Facial droop.
  • Asymmetric facial movements.
  • Inability to close the eye completely.
  • Problems with feeding.
  • Presence of other congenital defects.

Lyme Disease

Infection with Borrelia burgdorferi via tick bites (deer ticks) results in Lyme disease, where facial droop is one of the features. The other associated signs and symptoms may be an expanding red rash, fever, general ill health, fatigue, muscle and joint stiffness, and headache. In later stages it can affect the heart and nervous system which can lead to heart failure or a facial nerve palsy.

Acute or Chronic Otitis Media

Otitis media is caused by an infection of the middle ear and this may lead to a facial palsy if the infection spreads to the facial nerve. Due to inflammation, there is compression of the nerve in its canal. There may be associated symptoms of discharge from the ears, ear pain and loss of hearing.

Gradual onset of facial palsy may occur in a cholesteatoma, which is a cyst-like growth of skin in the middle ear which may develop as a result of chronic ear infection.

Sarcoidosis

Sarcoidosis occurs due to an abnormal reaction of the immune system. Granulomas or small lumps develop in certain organs of the body, such as lungs, lymph nodes, liver, brain, skin or other tissues. The cause of the disease is not known but tends to occur more frequently in persons of certain age and ethnicity.

When granulomas develop in the brain, spinal cord or the facial nerve, symptoms of facial paralysis may occur.

Other Signs and Symptoms of Sarcoidosis

Depending on the organs involved the other symptoms may include :

  • Fever
  • Shortness of breath
  • Cough
  • Skin rash
  • Enlarged lymph node
  • Enlarged liver or spleen
  • Seizures
  • Bleeding from the nose
  • Burning or itching of the eyes
  • Discharge from the eyes
  • Joint stiffness

Guillain-Barre Syndrome

In this rare disorder, the body’s immune system attacks part of the peripheral nervous system. It starts as weakness and numbness in the extremities and progresses rapidly to paralyze the whole body. It can develop into a medical emergency hence prompt diagnosis and treatment is essential. Facial paralysis with difficulty in eye and facial muscle movement may develop.

Diabetes Mellitus

Patients with diabetes are more likely to suffer from facial palsy such as Bell’s palsy.

Side Effects of Drugs

Certain medicines have been implicated in causing facial paralysis as a side effect.

  • Tretinoin is a drug which is primarily used to treat acne but is also given to reduce skin damage caused by sun exposure. Facial paralysis has been reported as a rare side effect of this drug.
  • Dofetilide is an anti-arrhythmic drug used to treat atrial fibrillation and atrial flutter. Facial paralysis may occur as an adverse side effect.

Bilateral Facial Droop

In most cases, a facial droop is unilateral (one-sided). However a bilateral or facial droop affecting both sides is possible although uncommon. Bilateral facial paralysis is more likely to have some systemic pathology, such as :

  • Lyme disease
  • Guillain-Barre syndrome
  • Sarcoidosis
  • AIDS
  • Leprosy
  • Tuberculosis
  • Poliomyelitis
  • Pingback: Causes of Droopy Eyes and Ptosis | Current Health Articles 2009()

  • Pingback: Lip Twitching | Current Health Articles 2009()

  • Shelley butterworth

    Ive come on this site for info as I’ve had a chronic ear infection that has been on and off for the past six and half years now it’s resulted in me having to go in for surgery the 29th of march this year to remove the infected damaged bone but the only problem is I’m not prepared to take a risk in having Facial nerve damage as the result of having the operation. How accurate is the operation as I don’t want to go a head without knowing the facts as I’ve been told the disease is advanced and the only way is remove it downside is loss of hearing nerve damage.

  • Dr. Chris

    Hi Shelley

    These are questions that should be directed at your doctor and ENT specialist. We avoid commenting on these type of questions as patients may use our comments as a justification to avoid undergoing specific procedures. Ultimately this amounts to interfering with your doctor’s treatment on our part. Remember that much depends on the skill of the surgeon. Always seek a second opinion when in doubt.

  • Abeer Asif

    hi, i have to ask a question

    My baby fell down from sofa when he was 5th months old , a drop of blood came from right nostril and bruise on nose .. his x ray was normal .. doctor gave him nasal spray for cleaning nose .. he was not fainted was just crying . Then after 1 week he started facial twitches, which we ignored for 1 month then it started irritating us .. i consult to a pediatric neurologist she suggested for EEG which was normal she said that she had doubt about facial tics but there is no sign of it… my baby still twitching his right side .. i also consult for ophthalmologist if might be eyesight issue but his eyes are fine… what to do with those Facial twitches.. plz guide me

  • Char Fox

    My daughter has been experiencing stroke-like symptoms for awhile. She is 30 and in the last few years has experienced two episodes, one sitting home watching TV and another yesterday as a passenger in a car, where the right side of her face starts to droop like it’s melting and she can’t talk. She ends up partially paralyzed on her right side and can’t walk for a few days. ICU gave her something last night that they typically give stroke patients and within 20 min she had improved. The droop is gone and she can talk but she still has a massive weakness on her right side and can barely move her arm or leg, and her right hand is badly swollen.

    She has had other times on several occasions where she would stand or reach above her head and suddenly droplease to the floor passed out.

    They have done CTs, MRIs, EKGs, etc. Today they did an MRA and some cervical test. The cervical test shows pressure on C7 which has shown before. She suffered a broken neck about 13 years ago that healed improperly. But all other tests say there was no stroke. They keep trying to say it’s stress but I have found nothing online that suggests stress causes facial droop and paralysis. We have seen this happen. Paramedics have watched this drooping happening.

    There is a history of stroke on dad’s side, I was born with heart problems ultimately requiring surgery and my uncle had a massive stroke due to a blood clot at the base of his brain.

    I am having serious doubts about the medical profession in our state. Doctors aren’t beating down doors to practice here and they’re not able to diagnose this except to pin a stroke label on it and send her home to have another one.

  • Hi Char. Stress is very unlikely to cause facial drooping. We would say impossible but with the human body you can just never say for sure. However, it is worth looking at other possible causes. The fact that these symptoms arose so suddenly and persisted for short periods only to resolve completely does point towards a TIA (transient ischemic attack). These attacks can occur for months or years before a stroke occurs.

    Low blood pressure, arrhythmias (irregular heartbeat), Bell’s palsy and so on would also be a considered but as you said she responded to stroke medication, which we assume are anti-clotting agents. Her age group does mean that she is not usually considered high risk for a stroke but it can nevertheless occur.

    At this point your daughter should be consulting with a neurologist for further investigations and a proper diagnosis. Remember that when you go to the ER or use emergency medical services they are only focused on stabilizing the patient and ensuring that there are no fatal consequences. After that you will have to see your family doctor and get a referral to a specialist so that this condition can be assessed and managed in the long term.

  • Char Fox

    Thanks for getting back to me. It seems we ended up at the same solution. She already had a neurology appointment set for Feb. 2. They’re concerned though that she’s still having focus and balance issues. She was in the hospital 4 days but is home now. After reading all the reports from the hospital, they have ruled out conversion disorder (I gather a fancy way of saying hypochondriac), and have NOT ruled out a stroke since there was some slight difference in the MRI. They gave her TPA? Not sure what it is. But the report also shows that she responded in 20 minutes which is another reason they haven’t ruled out stroke, even though a stroke isn’t showing on the MRI. Now they’re looking towards possibly the left brain stem? All we know is these episodes have been happening for several years and they’ve never narrowed down the cause, so hopefully they’re finally getting close to something and may be able to do something to relieve this.

  • HI Char. TPA breaks down clots and if she responded to it then in all likelihood there was some obstruction of the blood flow. Maybe there is no damage to the brain tissue as yet as would be the case in a stroke. But even momentary disturbances in blood flow that may not cause tissue death can still cause these stroke-like symptoms. Glad to hear that she will be seeing a neurologist shortly. Hopefully this should sort out the problem. Good luck!

  • Char Fox

    I really appreciate your taking the time to explain some of this. On another note, if you don’t mind, was wondering if you have any advice to offer me on some issues. I have suffered a tremendous amount of stress over the last four years. And in the last three, my health has deteriorated in every way imaginable. They’ve run every test, can find nothing, and so they ultimately pin a label on it. They now have me diagnosed with multiple ailments and it just seems odd to me that these would not have a common cause, a deficiency or something. But they’ve done the blood work, the MRIs, CTs, X-rays, etc. etc. It first started that I was very tired even after sleeping all night and I began to have depression. So they started treating that, and later the tiredness, even a sleep study showing I had mild sleep apnea. I was also getting worse and worse mucus problems and they diagnosed me with Non-allergic rhinitis and tried numerous nasal sprays. I now use Atrovent and I sometimes can notice a difference, but that requires twice a day and that’s not good for anyone. I use a dehumidifer, nettie pot, saline sprays, etc. Then I had jaw and ear pain on the left side, began to have tinnitis, they showed no hearing loss, nothing wrong. I had a little bleeding from that ear one morning, just a spotting. Eustacian tubes not blocked, CT of head…nothing. They said I had TMJ. Then my left foot began to feel bruised. I stopped Zumba eventually, thinking I had a stone bruise and needed to heal, but it just got worse. MRI showed joint disease in the ankle and two bone spurs, but no other explanation. It stays swollen on the inside side of it. Podiatrist thought the puffy area had a tumor, MRI said no. So…plantar’s faciitis, put me in a boot that made no difference. Plantar’s exercises weren’t helping. I recently began using compression socks and that’s the only thing seemed to help aside from three cortisone shots I’ve had. Then my right arm began to hurt from the shoulder to the fingers, with all my fingers numb. No carpal, no nerve pinching (just a bill for the testing again). Ice packs, heat, nothing helped. But again, if I wrapped that arm in an ace bandage, the compression helped. Eventually it went away. Twice my neck has severely locked up causing extreme pain. I spent 9 hours in the ER one day. Hours after a shot of Flexeril and a shot of Torredol, I could finally stop gritting my teeth and crying. My neck and shoulder blades stay in pain and heat and ice hardly help. I developed a mysterious rash that comes and goes only in two places (upper right thigh, or left breast). I can do nothing to it and it goes away eventually. I developed nail fungus…not even PRE diabetic, no explanation. Some cream for the rash and the fungus and another bill. So I now have TMJ, plantars, osteoarthritis, fibromyalgia, sleep apnea and depressive disorder? None of them linked? And all this by the age of 49. I’m just in complete disagreement with the doctor’s here and feel it’s something related and the compression should be some determining factor in this. I hope you have some ideas to offer cause I’ve been tested to death in medical bills and still stay in pain.

  • Hi Char Fox. As you have mentioned, you were very stressed for a prolonged period of time. Psychological stress can affect your body in so many ways. Some of the conditions you have mentioned can definitely be linked to this stress. For example, stress obviously contributes to depression but it can also lower the immune system which may allow for infections to set it. Unconscious clenching of the teeth is another common symptoms of psychological stress and depression. This clenching can strain the TMJ. Although fibromyalgia is not caused by depression, there is a link to physical and psychological trauma.

    Osteoarthritis is not uncommon and by the age of 75 it affects every single person. It is a condition that starts from as early as the 30s although it is usually not significant till the 50s and often only becomes symptomatic by the 60s. If you are overweight or obese then the condition can arise much faster as the joints are under greater strain with a heavier weight to bear. Many of your ailments could also be explained by autoimmune conditions as well but surely it would have been looked at by the doctors you have seen thus far. It is difficult to say for sure if all these conditions are linked or not. Sleep apnea (most common is the obstructive type) is unlikely to be caused just by stress but is linked to obesity and also with allergic rhinitis (refer to the National Sleep Foundation website for information).

    Unfortunately we cannot diagnose you as per our comment policy or offer much more insight beyond this point. It would be a good idea to consult with a specialist physician who can overlook your entire case while you periodically consult with other specialists for specific conditions.

  • Char Fox

    I’ve been to all the specialists and had so many tests, at high costs, but nothings been found. However I’ve extensively researched the Web and tried everything. Until 2 days ago when I ran across something online and found the cause that links them all. Dr is sure it could be and has ordered a special test as soon as he can get me one. Not many places run this test. I can’t elaborate more right now. But thanks for your help with this and my daughter.

  • Hi Char. Glad we could be of assistance. Good luck with this test.

  • Todd

    hey char.
    since i have also suffered from chronic fatigue syndrome and similar ailments to those you mentioned, and undergone many many tests, i was wondering about this cause that links the ailments you mentioned and this test. i’ve been trying for years to find a solution online and also tried a lot of stuff. Researching vitamin D and doing a 25vitD (Not the 1,25) levels may be of help to you too. i know i do have low vit d levels.

    I’d appreciate any input on this link and this test you mentioned.

    thanx

  • Char Fox

    Email me at chargfox at gmail dot com

  • Hi Todd. Thanks for the input. It will be very interesting to see what has been going on with the case above since the last reply. Hopefully we will get an update soon.

  • julie

    cervical dystonia can also cause eye twitching. He may have hurt his neck during the fall, and if the muscles of the neck are tight and stiffen up, this can put pressure on the nerves and cause the twitching. PLEASE have a doctor check your baby’s neck for injury.

  • Char Fox

    I could not get the test. It’s not offered in my state, not covered by insurance and is expensive. I would also need a $300 test on air quality in my home. I wanted to be sure before I made accusations. But I did recall a former neighbor who began having fatigue and checked with my current neighbors who’ve been there about 9 mo. They have signs of beginning symptoms I’m dealing with.

    Our landlord doesn’t fix leaks or replace rotten floors after a leak and we have mold. But rather than a typical allergic reaction, we have a form of toxic black mold. The test are Stachybotrys IgA level (blood test) and urine mycotoxin test. When I ran across the symptoms list I knew I found the cause. I’m in the process of moving and staying at a relatives house in the meantime.

    Some states recognize this issue but mine does not. One couple won a 32 million dollar lawsuit over it. It was in an episode of forensic files:http://m.youtube.com/watch?v=rB9ef_P-6_c.

    Search for toxic black mold syndrome and sick house. Even the EPA acknowledges sick house as an issue.

  • Melissa

    Hi char I am going through the same thing as your daughter.. they also thought I may had a tia but was not or sure have you ound out anymore yet?and I also have the problem with the swollen ear and face and head on one side my doc thought it was stress but also put me on antibiotics in case of an infection

  • Phillip C

    I had cataract surgery Dec 2013 on both eyes, which was successful. Since the surgery, I have had many inflamed left eyes, which has been investigated by specialist. Looking for another cause, I was found to have a 69% blocked ceratoid artery on my left side. I now see a noticeable drooping on the left side of my face.
    I am diabetic (controlled) and have high blood pressure. I now have a continuous balance problem, which is worse when I have a rapid pulse from exertion or higher than normal blood pressure, which also triggers the inflammation of my left eye.
    My cardiologist took me off of one blood pressure medication to see if my balance problem would improve, but that made the problem worse, caused intense headache, eye pressure and another eye inflammation. Physical exertion, caffeine or anything that raises my pulse, causes an increase in unbalance, headaches and eye inflammation. The cardiologist said that an operation on my carotid artery will not be done until the blockage is at 80% – 90% because of the danger of a stroke during surgery. WHAT TO DO???

  • Martha Klinger

    I recently have developed a problem with my tongue. When I open my mouth wide it curls up high on one side and slants downward on the other with now occasional numbness of the lips on downward side . MRI was normal any thoughts on cause

  • Char Fox

    It comes and goes. They still don’t have an answer and she hasn’t had another episode yet. They last were looking at possibly pressure from a previous broken neck that healed improperly when it was missed after a car accident. A fracture or something. They thought it might be pressing against something causing this. But unless it happens again, they can’t see if that’s happening.

  • disqus_BTqPLufn7x

    Hi, I really need some help. I’ve been to the local health dept, housing, social services, etc..none said they could help. The apt. I live in was partially flooded because of a hurricane, about 5 months after moved in. This apt is on a slab and I suppose the water came in that way somehow. The manager said I’d just have to let the carpets “air dry” , refused to replace the carpet and it took like a couple of weeks for it to dry. I was kinda concerned about mold, because I am already a very highly allergic person. This apt community has rent based on income, apts and I am on disability. So I’ve been unable to afford to move. I’ve lived here for approx 6 yrs now. Last year there was yet another flooding in my bedroom. I kept telling the manager and he always said he’d come to take a look but, he didn’t for about 3 weeks. I finally had to look around myself and discovered it was coming from the water heater closet next to the bedroom which had puddles and pooling under the heater. I left messages and told him and finally he came. He said it was because the WH had a clog and he vacuumed it out. But, then I just had to wait until that flooded area air dried which also took about a week or more. In these years I’ve been here, my allergies (I have year round, and are affected by many types of things) have gotten much worse. I have mild asthma and have noticed a bit of chest “conjestion” that I didn’t have before. My neck stared to get sore and stiff ALL the time, then my knee, then my left shoulder. Under my eyes, the skin is constantly very red and then suddenly one day I noticed my face drooping and sagging (both sides). There are faint circular looking spots on my face, within sudden dark splotchy looking areas mainly on checks. I don’t know if this is any kind of bacteriaI, fungi kind of thing or not. There are also red marks and spots on my face as well and sort of uneven little skin colored bumps, indentations, etc. and my face looks a bit puffy all over sometimes with indentations where it “sags” more sometimes. I also feel more achy, stiff and fatigued all the time, now, I have depression and anxiety disorder…but the anxiety and listlessness, of an inability to concentrate ..has seemed to have gotten much worse, since I’v been here, that I’d never experienced before. Occassionally, I’ll get hives or red welts all over my body. (I don’t know if these are related) My ears ring louder constantly. For the first time, since here I got some kind of “thrush” on my tongue, a couple of times and had to go get medication for that. I’ve always had a bit of a constipation problem and now that has gotten worse. I’ve discovered. There is a strange moldy smell in my kitchen too, which I can’t seem to always pinpoint because I have nasal congestion. I have gone to a couple of dermatologists and they came in, didn’t even closely examine my face and said it’s probably because of sun exposure or ageing. I always wear sunscreen (since age 14) and have always been very sun conscious, I don’t like to be in it anyway. I can get the manager to do nothing about any issues. All the way across the front of my apt unit in the “flower bed” is green mold covering it. It also covers right next to the foundation. I have asked him to do something about this because if the water could come in there and I think so could the mold, then. I have gone to all the local “depts.” for help, but no one says they can! The manager once said that NC has no law against mold problems and wanted me to stop asking it to be checked. Not long after I moved in I noticed water going down near the kitchen faucet. I looked under the cabinet and the cheap wood board had “fanned out” from being leaked on. So possible mold. That was here when I moved in. It took me literally two years of complaining for him to even fix that. So by this time, I have gotten very worried about what may be in this apt. I recently finally found a Doctor who said the problems on my face were “premature ageing” or “sun exposure”. She said she thought it might have something to do with my liver. I told her about the apt problems and she said, “you need to move out of there immediately.” But, I can’t…because I’m on disability, have only a very small stipend and this low rent I can barely afford. I know I couldn’t afford anyplace else. But, I’m beginning to feel desperate because of all these health problems. I don’t know what to do or where to turn. Could mold be causing these problems?