Sunken cheeks, a noticeable indentation between the cheekbones and jaw, can make the face appear hollow or gaunt, often contributing to an older appearance. While sometimes natural, they can also signal various underlying factors, from lifestyle influences to health conditions. Understanding these reasons can provide clarity.
Common Factors Contributing to Sunken Cheeks
The natural aging process is a frequent cause. As individuals age, collagen and elastin production slows, and subcutaneous fat beneath the skin around the eyes and mouth decreases. This depletion, coupled with potential muscle atrophy, leads to a hollowed appearance.
Significant or rapid weight loss can also lead to sunken cheeks. When overall body fat is reduced, facial fat pads, which contribute to facial volume, decrease in size. This loss of fat can cause the face to appear hollow, and the skin may not fully retract, potentially resulting in sagging and an older appearance.
Insufficient fluid intake, or dehydration, can temporarily diminish facial volume, making cheeks appear drawn or hollow. Water is essential for skin hydration and elasticity, so chronic dehydration can exacerbate this. Genetic predispositions also play a role, as some individuals naturally possess less facial fat or a bone structure that gives a sunken appearance.
Certain lifestyle choices can contribute to premature aging and facial fat loss. Smoking releases toxins that break down collagen and elastin, leading to sagging. Excessive sun exposure damages skin elasticity, accelerating aging. Insufficient sleep can also contribute to drier skin with less elasticity, impacting facial appearance.
Underlying Health Conditions and Sunken Cheeks
Beyond common factors, sunken cheeks can indicate more serious medical conditions. Malnutrition, stemming from insufficient caloric intake or lack of essential vitamins and minerals, results in overall fat and muscle loss, including in the face. Deficiencies in vital nutrients like vitamins C, D, E, proteins, and healthy fats directly contribute to facial volume loss.
Chronic illnesses can significantly impact facial volume. Conditions causing sustained weight loss, such as eating disorders (anorexia nervosa, bulimia nervosa), autoimmune diseases, chronic infections (e.g., advanced tuberculosis), or malabsorption, can lead to excessive fat and muscle loss, resulting in hollow facial features. Lipoatrophy, a loss of subcutaneous fat, is also associated with conditions like HIV, especially with older antiretroviral drugs.
Dental issues can also affect facial structure. Missing teeth can lead to jawbone shrinkage, which reduces support for facial muscles and skin. This can cause the lower face to look sunken or collapsed, and lips may appear thinner. Problems with jaw alignment or severe dental infections can also impact facial contour.
Some medications can have side effects including weight loss or altered facial fat distribution. Rapid weight loss from certain medications can deplete subcutaneous fat in the face and neck, causing hollowing and sagging skin. This phenomenon, sometimes called “Ozempic face” (e.g., with semaglutide), mimics aging by accelerating facial fat loss and reducing skin elasticity.
When to Consult a Healthcare Professional
While often benign, sunken cheeks warrant medical evaluation if they appear suddenly or rapidly without an obvious cause, such as recent significant weight loss. A sudden onset can indicate an underlying issue.
Consult a healthcare professional if sunken cheeks are accompanied by other concerning symptoms. These may include unexplained weight loss, persistent fatigue, fevers, appetite changes, or digestive issues. Such symptoms could indicate nutritional deficiencies, chronic illnesses, or other medical conditions.
Seeking medical advice is also appropriate if sunken cheeks cause significant distress or concern. Even without other physical symptoms, their impact on self-esteem is a valid reason to consult a provider. If common factors like aging or recent weight loss don’t explain their appearance, a medical consultation can help determine an unaddressed underlying cause.
Approaches to Managing Sunken Cheeks
Managing sunken cheeks often begins with addressing any underlying medical conditions. If malnutrition is a factor, improving nutritional status through a balanced diet rich in essential vitamins, minerals, proteins, and healthy fats can help restore facial volume. For chronic illnesses, effective management can mitigate associated weight loss and facial hollowing.
Adopting lifestyle adjustments can support skin health and facial fullness. Maintaining adequate hydration is important for skin elasticity and volume. A balanced diet provides necessary nutrients. Ensuring sufficient sleep, avoiding smoking, and limiting excessive sun exposure can help prevent premature aging and maintain facial contour.
For individuals seeking to restore facial volume, various cosmetic options are available. Non-surgical treatments like dermal fillers are commonly used to replenish lost volume and create a more youthful contour. These injectable treatments often contain hyaluronic acid, which adds plumpness and hydration. Another option is fat grafting, where fat is harvested from another body part and transferred to the cheeks. These procedures should be discussed with a qualified professional.
For some, sunken cheeks are a natural aspect of their genetic makeup or the aging process. Acceptance of this facial characteristic may be a personal choice, as not all appearances require intervention.