A sunken or hollow facial appearance, often described as hollow cheeks, is a noticeable indentation between the cheekbones and jawbone. This typically indicates a reduction of fat in that area, which can contribute to an older or more fatigued look and may be a cosmetic concern.
Common and Everyday Reasons
Several common factors can contribute to a sunken facial appearance, often being temporary or easily addressed. Dehydration can cause the skin to lose its plumpness and vitality, resulting in a dull or hollowed look. Significant or rapid weight loss frequently leads to a reduction in facial fat pads, which support the skin. This can make the face appear gaunt or aged, with areas like the cheeks, jawline, and under-eyes being particularly affected. When weight loss occurs quickly, the skin may not have sufficient time to adjust, potentially leading to a more hollowed appearance.
The natural aging process also plays a significant role in facial volume changes. As individuals age, collagen and elastin decrease, proteins that maintain skin firmness and elasticity, contributing to sagging skin. Facial fat pads diminish in volume and may migrate downwards, leading to a hollowed appearance. Changes in facial bone structure, such as bone resorption in the jaw, cheeks, and around the eyes, can also reduce the underlying support for facial tissues.
Some individuals are predisposed to having less facial fat or a more prominent bone structure due to their genetics. A naturally thinner face or more pronounced cheek hollows can be a hereditary trait, irrespective of other health or lifestyle factors.
Underlying Medical Conditions and Lifestyle Factors
A sunken facial appearance can stem from underlying medical conditions. Chronic illnesses, such as tuberculosis, certain autoimmune diseases, or cancer, can lead to muscle wasting or severe weight loss, impacting facial volume. Conditions like Ehlers-Danlos syndrome, which involves collagen defects, can also manifest with specific facial features including sunken cheeks.
Malabsorption issues, where the body struggles to absorb essential nutrients, can result in malnutrition and facial fat loss. Digestive disorders like celiac disease or Crohn’s disease can hinder nutrient processing. Eating disorders such as anorexia nervosa and bulimia also contribute to a gaunt facial appearance due to severe nutritional deficiencies and weight loss.
Certain medications can impact facial volume. Diuretics or chemotherapy drugs may contribute to a sunken look. GLP-1 agonists used for rapid weight loss, such as Ozempic or Wegovy, have also been associated with facial fat reduction, sometimes termed “Ozempic face.” This rapid fat loss can leave the face looking aged or gaunt, as the skin may not contract sufficiently.
Lifestyle choices also impact facial fullness. Chronic sleep deprivation can affect collagen production, skin repair, and blood flow to the skin. Insufficient sleep may result in a duller complexion, more noticeable fine lines, and the appearance of dark circles under the eyes.
Excessive alcohol consumption dehydrates the skin and interferes with collagen production, leading to a loss of elasticity and firmness. Regular heavy drinking has been linked to increased midface volume loss and can cause inflammation. Smoking damages collagen and elastin, reduces blood flow to the skin, and accelerates aging. This can result in premature wrinkles and sagging skin.
When to Consult a Healthcare Professional
Consult a healthcare professional if you experience a sudden or unexplained onset of sunken facial features. This is particularly important if accompanied by other concerning symptoms. Signs such as persistent fatigue, unexplained weight loss, fever, or noticeable changes in appetite warrant medical evaluation.
Also consult a professional if the sunken facial appearance causes you distress. While many causes are benign, these symptoms could indicate an underlying medical condition requiring diagnosis and treatment. Avoid self-diagnosing for more serious health issues.
General Management and Prevention Tips
Maintaining adequate hydration is important for supporting facial volume and overall skin health. Consume enough fluids, typically six to eight glasses daily, and incorporate water-rich foods like fruits and vegetables to help keep skin plump. A balanced, nutrient-rich diet also plays an important role in skin health. Include foods rich in vitamins, minerals, antioxidants, and omega-3 fatty acids, such as fatty fish, nuts, and colorful fruits and vegetables, as these provide the building blocks for healthy skin.
Ensuring sufficient sleep, generally seven to nine hours per night, supports the body’s natural repair processes. During sleep, the skin rebuilds collagen and repairs damage, contributing to a smoother complexion. Limiting or avoiding excessive alcohol consumption and smoking can prevent accelerated aging and damage to skin elasticity and volume. Managing stress levels through relaxation techniques can also benefit skin health by reducing inflammation. While cosmetic procedures exist to address volume loss, focusing on these general wellness practices supports natural facial fullness.