HEALTH NEWS

What Is the ‘Triangle of Death’ on Your Face?

Written by Kimberly Holland on August 22, 2017

New warnings are issued after a woman developed cellulitis after popping what she thought was a pimple on a sensitive part of her face.

facial skin

You’ve likely been told since the first zit cropped up on your chin that you need to leave pimples alone.

Popping them can cause scarring and make the bump worse, you were warned.

But that didn’t stop you, right?

The guilty pleasure of popping is all too real for many people.

Now, a new tale just might make you think twice before putting a bump in the crosshairs of your tweezers or fingernails.

A deadly spot on the face

Last month, Katie Wright began picking at what she thought was a pimple under the skin of her eyebrow.

Within an hour, her face was swollen and painful.

She sought medical treatment and learned that what she believed was a bothersome pimple on her face was in fact a severe infection.

It was a type of infection that could have been deadly had she not received treatment quickly.

“I went to the emergency room and they said it was a very serious case of cellulitis, which is a version of a staph infection, but instead of having a head like staph, it effects the deep cellular tissues with no main source to attack," she wrote in a social media post. “Since it was on my face, there was a huge risk of it spreading to my brain or my eyes, causing me to go blind.”

Wright’s infection, which was likely caused by a dirty makeup brush, was in an area of the face known as the “triangle of death.”

Doctors pay special attention to infections in this area.

That’s because infections in this region, which includes the upper lip and nose, can quickly become severe, even deadly.

A plea to not pop

“The triangle of death is a colloquial term for an area of the face that includes the region of the nose and corners of the mouth,” Dr. Amesh A. Adalja, a board certified infectious disease physician at Johns Hopkins Center for Health Security in Pennsylvania, told Healthline. “This area is connected via blood vessels to areas of the skull where infections can spread very rapidly and become more serious.”

If the skin inside this triangle is broken — from a cut or popped pimple, for example —bacteria can enter your body.

A staph infection is one of the most common types of infection on this area of the body.

These bacteria can quickly enter your body and cause an infection, and because of the proximity to critical portions of your brain, the infection can lead to serious complications quickly.

“While infections of this area are rare — due to antibiotics — the triangle of death is a particular area of the face that if the skin is broken and the inside of our body is exposed to bacteria, it can invade and have access to the body’s control center,” Heather Free, PharmD, a spokesperson for the American Pharmacist Association, told Healthline.

Directly beneath the nose and mouth are four major cranial nerves that control functions in and around the face.

Depending on which of these nerves is infected, you can develop paralysis in several parts of your face, including the eyes lids and mouth, and motor functions can be impaired, too. Vision loss can also occur.

A condition called cavernous sinus thrombosis can develop in the sinus cavity as a result of the infection. This condition can lead to blood clots, which increase the chances of stroke and death.

“Bacteria in this area have a smaller distance to travel to do bigger damage to the body vs. a break in the skin in the leg,” Free said. “It has access to our control center.”

The skin around your face, and especially in the triangle of death, is a first line of defense against invading bacteria.

Your mouth and nose are teeming with bacteria, but your body is designed to protect against them. If you break that barrier, that’s when things can turn deadly.

“If there is a break in the skin barrier, cellulitis — an infection in the skin — furunculosis [boils], or infections in the hair follicles, can occur,” Dr. Dina Strachan, a board certified dermatologist in New York, told Healthline. “Infection in this area can often spread from manipulation, such as nose picking, plucking nose hairs, or anything that breaks the skin barrier.”

If a pimple looks or feels different, leave it alone, and observe it. Seek medical treatment if you’re unsure.

The treatment possibilities

“Like most skin infections, if a person sees a swollen patch of skin that has pus, it is likely a person has an infection,” Mohamed A. Jalloh, PharmD, an assistant professor of clinical sciences at Touro University California College of Pharmacy, told Healthline. “While a pimple and a sign of infection could physically look the same, a triangle of death patient may have more symptoms. For example, if a patient would have an infection in the nerves or brain, a patient may say they feel confused or have a stiff neck or feel unusual tingly or sharp pains on the body.”

A cellulitis or staph infection is treated with antibiotics, but it has to be caught early because of the risk of serious problems.

That’s why it’s important to seek out medical attention if you notice a deep bump or cyst under the skin in this area of the face.

The best-case scenario is that it’s a benign cyst that is easily drained. The worst-case scenario is that it’s a severe infection, which can lead to deadly complications if left untreated.

“The earlier the diagnosis and treatment, the better,” Jalloh said.

This type of infection can also be prevented with better hygiene practices.

“Avoid picking the nose, plucking nose hairs, popping pimples, and use a sterile technique if you have your nose pierced,” Strachan said.

Wash makeup brushes regularly, and avoid hands touching the face.

Use a tissue to clean your nose, and clean any cuts or sores with a first-aid astringent like hydrogen peroxide.

Lastly, if the fear of deadly infection isn’t enough to persuade you to stop the pop, keep in mind the lasting physical damage pimple popping can cause.

“Popping pimples can cause scarring, hyperpigmentation or dark marks, and infection,” Strachan said. “It’s best to get your acne treated.”

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