Discovering an unexpected indentation or “hole” in your cheek can be a source of concern, prompting questions about its origin. This perceived opening can stem from natural anatomical variations present since birth or conditions acquired later in life. Understanding the common reasons behind such occurrences can provide clarity. This information is intended for general understanding and should not replace professional medical diagnosis or personalized advice.
Facial Dimples
Cheek dimples are natural indentations in the skin, often becoming more noticeable when a person smiles. These charming depressions are a common inherited trait, with their formation linked to multiple genetic variants. The primary anatomical cause involves a variation in the zygomaticus major muscle, which is responsible for lifting the corners of the mouth when smiling. In individuals with dimples, this muscle may divide into two separate bundles, with one bundle attaching to the skin, creating a small depression as it contracts. This dermal attachment pulls the overlying skin inward, forming the characteristic dimple.
Dental and Oral Health Conditions
A “hole” in the cheek can sometimes originate from dental and oral health issues. A significant cause is a dental abscess, a collection of pus resulting from a bacterial infection due to severe tooth decay, gum disease, or trauma. If left untreated, the infection can spread from the tooth root and create an oral cutaneous fistula, an abnormal channel or tunnel that drains through the cheek tissue to the skin surface. This fistula appears as a small, persistent opening on the face, often near the jaw angle, chin, or cheek, and may discharge pus or a foul-smelling fluid. Such conditions require prompt dental or medical intervention to prevent further complications.
Skin Conditions and Infections
Beyond dental issues, various skin conditions and infections can lead to a “hole” or indentation on the cheek. Ruptured cysts, such as epidermoid or sebaceous cysts, are a common example. These benign fluid-filled lumps beneath the skin can become infected, leading to inflammation, pain, and eventual rupture. When a cyst ruptures, it may drain its contents and leave behind an opening or a noticeable depression.
Severe forms of acne, including inflammatory nodules and cysts, can damage deeper skin layers, resulting in atrophic scars, commonly known as pockmarks. These indentations occur when collagen and underlying tissue are lost during healing, creating a concave appearance. Bacterial skin infections like boils or carbuncles can form painful, pus-filled lumps that, upon rupture and healing, may leave a persistent opening or scar tissue.
When to Seek Professional Advice
It is important to seek professional medical advice if you discover an unexplained “hole” in your cheek, especially if accompanied by certain warning signs. Consult a healthcare professional if the area is painful, red, swollen, or warm to the touch. Immediate evaluation is advised if there is a discharge of pus or foul-smelling fluid, if the opening is growing in size, or if you experience a fever or general unwellness. Any sudden appearance of such an opening, particularly after an injury or illness, warrants prompt medical attention. Persistent or unexplained cheek indentations should be assessed by a dentist or doctor, as self-diagnosis and self-treatment are not recommended and can lead to delayed care or complications.