Managing Swollen Eyelids and Headaches

“Are my puffy eyes connected to my headaches or an indication of something else?”. This is likely a common question you ask yourself when trying to make sense of the symptoms that come along with your headaches. You are not alone in trying to understand why you may be experiencing swollen eyelids and headache. In fact, there actually is quite an interesting association between swollen eyelids and headaches. Tracking these types of symptoms through the CareClinic platform can also help you understand your triggers and how to manage your symptoms more effectively.

Let us start with a holistic overview of headaches. The important thing here is to understand how headaches develop and how swollen eyelids occur at a very basic level. According to research, a great percentage (approximately 70%) of people with headaches experience puffy eyelids. Although you may notice this physically distinct symptom when you look in the mirror, it is still relatively underreported. Why? Well, swollen eyelids are more commonly mistaken for being associated with allergies, flu, etc. Moreover, headaches do actually show some correlation with other additional flu-like symptoms.^[1][2]

What Does Swollen Eyelid Mean?

Some people experience swollen eyelids as an associated symptom of a headache. Research suggests that it is an uncontrollable effect on our autonomic nervous system. Some other autonomic symptoms are fatigue in the eyes, a swollen face, drooping eyebrows, and red eyes. But what is the autonomic nervous system and what does it do?

What is the Autonomic Nervous System?

This is the part of the nervous system that controls our involuntary body functions such as heart rate, blood flow, breathing, sensation, etc. With migraine headaches, people often experience more severe autonomic symptoms such as dizziness, blurry vision, nausea, and digestive disturbances. An increase in blood flow to certain areas of the body causes symptoms of facial flushing, ear fullness, swollen eyelids, or nasal congestion.

How do Puffy Eyes Develop with Headaches?

If you’ve noticed that some of these symptoms seem similar to those of the common cold or flu, you would be one step ahead of the game! However, there is the main difference; the trigger here are your pain receptors rather than a viral illness. When someone gets a headache, the pain sensors, a vital part of the autonomic nervous system, get triggered. This initiates a response similar to that of the flu. Cue the puffy eyes, swollen eyelids, nasal congestion, and facial flushing. There are many more symptoms like these that are commonly associated with cluster headaches followed by migraine headaches.^[3]

What is a Headache?

So what really is a headache? A headache is a pain experienced in any part of the head, including the scalp, upper neck, face, and interior of the head. When they occur, they can range in severity from mild to debilitating. Additionally, headaches are divided into two main types:

Primary Headaches

These are the headaches that do not occur due to some other disease. Furthermore, they are the most common type of headache and one of the most common reasons people visit doctors for. There are 3 types of primary headaches:

• Tension-type headache:  This is the most common type of headache in the general population. It is a band-like headache and is mostly mild to moderate in intensity. It does not present with distinctive features like puffy eyes, drooping eyebrows or eye fatigue.
• Cluster headache: This type of headache is less common (around 1%) and it belongs to a group of headaches that occur on autonomic factors involving a facial nerve (trigeminal nerve). This is a short-term pain that stays for about 30 minutes to one hour. The pain classically appears over the temple or around one of the eyes and is associated with flu-like symptoms such as puffy and droopy eyes, nasal congestion, and flushed face.
• Migraine headache: This type of headache affects 12-15 % of the general population and is the main cause of neurologist visits among all types of headaches. Migraines are more common in females than males and do have a genetic predisposition component. A migraine headache is typically a pulsating, and often debilitating, pain. It can be present on one or both sides of the head and is usually associated with specific triggers such as physical activity, light, smells, and sound. Nausea, vomiting, and sensitivity to light and sound are some of the associated features. Around 70% of individuals experiencing migraines, also experience autonomic symptoms including puffy eyes, heart rate disturbances, nausea, and blurry vision.

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Headaches in the Morning

These headaches mainly occur are a result of another disease or illness ranging from mild to severe. If you experience the following danger signs with your apparently benign headache, consult your doctor right away:

• Fever
• Neck stiffness
• Weakness, numbness, or loss of sensations of any part of the body
• Sudden or abrupt onset
• Older age
• Positional headache
• History of Cancer (anywhere in the body)
• Change in the usual pattern of headache
• History of immune deficiency (HIV, organ transplant recipient, etc.)
• Painkiller overuse

Most primary headaches are clinical diagnoses and do not require any investigations. Secondary headaches, however, warrant further testing, such as a CT scan of the head, a lumbar puncture (fluid removal from the spine for testing), blood tests, and some specific biopsies. The warning signs mentioned above should always be considered to rule out serious conditions as the cause of secondary headaches.

Managing your Swollen Eyelids and Headache

There are 2 branches of management when it comes to swollen eyelids and headaches: pain management and managing your swelling.

Treating Swollen Eyelids

The following steps can be taken if you have developed puffy eyes as the result of a headache:

1. Such as rinsing your eyes with water to remove any possible irritants in the eyes
2. Placing a cold compress on your eyes
3. For example, removing any foreign objects (contact lenses, etc) from your eyes

Treating Eye Swelling

Since puffy eyes are exhibited in response to pain triggers, controlling pain is an integral part of the management process. It is incredibly important to identify your triggers in order to stop the headaches in their tracks. One of the best ways to do this is by creating a headache diary to track your symptoms, pain levels, and environmental factors. 

Symptom Tracking

Maintaining a headache diary is a time-proven method of identifying and avoiding triggers. It helps you figure out specific triggers and any changes in your headache patterns. A headache symptom tracker a key tool to identify if someone’s primary headache turns into a secondary headache due to a dangerous cause. The CareClinic platform allows you to track your headaches and maintain a diary by giving you an easy-to-use objective tracker feature. Moreover, all your data is saved conveniently on your phone and can be retracted and reviewed by yourself or your healthcare provider.

Using the symptom tracker feature in the CareClinic platform, you can track any of the following:

1. Such as the time and place where the headache began
2. Location of headache (half of the head, entire head, or neck)
3. Quality of the pain (throbbing, sharp, etc.)
4. Change in intensity of the headache
5. The environment where the headaches started
6. Any changes in the routine
7. Duration of pain symptoms
8. Specific symptoms before the onset of the headache (changes in vision, changes in the sense of smell, difficulty speaking)
9. Such as associated symptoms (puffy eyes, nausea, vomiting)

Pain Management

You may use the pain scale faces within the App when recording pain before taking any medication and after. There are many painkillers that people use to combat their headaches. They can range from over-the-counter medications for milder forms of headaches to more potent prescription medications with opioids. 

Over-the-counter analgesics include:

• Non-steroidal anti-inflammatory drugs (Advil, ibuprofen, naproxen)
• Acetaminophen (Tylenol)
• Aspirin
• Caffeine combination with analgesics

Prescription Medications include:

• Such as Tylenol with codeine (Tylenol #3)
• Antidepressants (amitriptyline)
• Triptans (for migraine and cluster headache)
• Morphine (for special consideration only)

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Dr. Khadija Haris, MBBS

Medically Reviewed

Internationally trained physician from Pakistan with a decade of primary-care and emergency experience across South Asia and Canada. She serves Indigenous communities in Northern Manitoba as a Clinical Assistant and founded a free rural clinic in Punjab based on Canadian values of universal access. Dr Haris focuses on innovative models that expand care for underserved populations and writes on global health equity and culturally safe practice.