Tingling in the face can be caused by a number of conditions, some of which are of little concern, and some of which could be serious.
There are two types of abnormal nerve sensations:
- Paresthesia describes abnormal burning or prickling sensations
- The sensation is usually painless and may be described as tingling, numbness, skin crawling, or itching
- Temporary paresthesia is common and may be described as “pins and needles,” that can occur, for example, when a person falls asleep with their face pressed against a pillow in an unusual way
- When the pressure is relieved, the sensation goes away
- Chronic paresthesia can be a symptom of an underlying neurological disease or traumatic nerve damage
- Central nervous system disorders
- Stroke and transient ischemic attacks (TIAs, or mini-strokes)
- Multiple sclerosis
- Transverse myelitis
- Encephalitis
- Tumors or vascular lesions pressed up against the brain or spinal cord
- Nerve entrapment syndromes, such as carpal tunnel syndrome
- Central nervous system disorders
- Dysesthesias are types of chronic nerve disorders caused by nerve damage
- Feels like prickling, burning, stabbing, ice cold, or electrical sensations
- Can interfere with daily activities, sleep, and quality of life
- May be caused by:
- Autoimmune disorders
- Diabetes
- Lyme disease
- Drug or alcohol withdrawal
- Peripheral neuropathies
- Certain type of stroke (thalamic infarct)
- Alcohol or drug withdrawal
- Chemotherapy
What Are Symptoms of Tingling in the Face?
Symptoms of tingling in the face depend on whether it is a paresthesia or dysesthesia. The main difference between the sensations of paresthesia and dysesthesia is the severity.
Paresthesia is usually painless, may be temporary such as “pins and needles” or chronic, and sensations can be described as:
- Tingling
- Numbness
- Itching
- Skin crawling
Dysesthesia is chronic and can be painful, and sensations can interfere with daily activities, sleep, and quality of life. Dysesthesia symptoms may be described as:
- Prickling
- Stabbing
- Burning
- Electrical sensations
- Ice cold
- Cold feels hot or hot feels cold
- Pain with only light touch
How Is Tingling in the Face Diagnosed?
The cause of tingling in the face (paresthesias and dysesthesias) is diagnosed based on a medical history and a physical examination, and after skin (dermatological) disease has been ruled out.
Blood tests to diagnose causes of tingling in the face may include:
- Angiotensin-converting enzyme (ACE)
- Antibodies to Borrelia burgdorferi (found in Lyme disease)
- Antineutrophil cytoplasmic antibodies (ANCA)
- Antinuclear antibody (ANA)
- C-reactive protein (CRP)
- Complement (C3, C4)
- Glycosylated hemoglobin (HBA1c)
- Heavy metal levels
- Human immunodeficiency virus (HIV)
- Iron, folate, vitamin B12, vitamin E
- Viral hepatitis
Other tests to diagnose causes of tingling in the face may include:
- Cerebrospinal fluid (CSF) analysis
- Magnetic resonance imaging (MRI) of the brain and cervical spine
- CT scan of head
- Nerve conduction studies
- Skin biopsy
- X-rays of the cervical/thoracic spine
What Is the Treatment for Tingling in the Face?
Treatment for tingling in the face depends on the cause and the severity of symptoms.
Medications to treat tingling in the face may include:
- Local numbing (anesthetic) patches
- Capsaicin cream
- Antidepressants
- Antiepileptics
- Carbamazepine
- Gabapentin
- Pregabalin
- Antipsychotic medications
- Pimozide
- Venlafaxine
- Propranolol
- Cannabinoids
Other treatments for tingling in the face may include:
- Botulinum-A injections
- Physical barriers to reduce scratching and rubbing, such as gloves, night-time thermoplastic facemask, and night-time arm splinting
- Transcutaneous electrical muscle stimulation (TENS)
- Physiotherapy
- Narrow-band ultraviolet radiation
- Intralesional steroid injections
From 
Brain and Nervous System Resources
Image source: iStock Images
https://www.ninds.nih.gov/Disorders/All-Disorders/Paresthesia-Information-Page
https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Pain
https://www.diabetes.co.uk/diabetes-complications/sensory-neuropathy.html
https://www.cdc.gov/lyme/signs_symptoms/index.html
https://dermnetnz.org/topics/cutaneous-dysaesthesia/
http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/OxaliplatinColdDysesthesia_Patient_Handout_1Jan2015.pdf