facies

Military service members and veterans have made sacrifices to our country, and they may face lots of different health issues. Some of the most common health problems they may have include chronic pain, sleep disorders, and mental health disorders.

But they may also face some different health risks than civilians. Serving to protect our country is a special job, and along with it comes some special risks and job hazards. These include different types of injuries and health problems from exposures.

During their service, members are at risk for various injuries. These injuries can happen during training or while in combat. Sometimes the injuries are life-threatening or serious enough to cause disability. Others may not be as serious, but they may be painful and can affect daily life.

Some of the specific types of injuries that service members may face include:

• Sprains and strains, especially in the ankles and knees. These injuries are often caused by exercise and running.
• Back and shoulder injuries, often from lifting and carrying.
• Tinnitus and hearing loss, typically from exposure to noise.
• Head injuries and traumatic brain injuries (TBIs).
• Shrapnel and gunshot wounds.
• Lost limbs.

There may also be a risk of health problems from exposure to environmental hazards, such as contaminated water, chemicals, infections, and burn pits. Sometimes the health problems caused by exposures don't develop until years later.

Some service members experience military sexual trauma (MST). This includes sexual assault and sexual harassment.

Being in combat and being separated from your family can be stressful. So can readjusting to civilian life after the military. All of this stress can put service members and veterans at risk for mental health problems, including:

• Depression
• Post-traumatic stress disorder (PTSD)
• Anxiety
• Alcohol and drug use disorders

There is also a risk of suicide. Veterans who are in crisis can get help from the Veteran's Crisis line by:

• Calling 988 and then pressing 1
• Texting to 838255
• Chatting with them online

There are health care services especially for service members and veterans through:

• TRICARE, which is the Department of Defense's health care program. It has insurance plans and other services for uniformed service members, retirees, and their families around the world.
• The Veterans Health Administration, which is part of the Department of Veterans Affairs (VA). It provides medical and social support services to eligible veterans.
• The VA 's expanded health care and benefits for veterans exposed to burn pits, Agent Orange, and other toxic substances.

To better understand and treat the health needs of veterans in the future, the VA created the Million Veteran Program (MVP). This research program is looking at how genes, lifestyle, military experiences, and exposures affect health and wellness in veterans.

Craniofacial is a medical term that relates to the bones of the skull and face. Craniofacial abnormalities are birth defects of the face or head. Some, like cleft lip and palate, are among the most common of all birth defects. Others are very rare. Most of them affect how a person's face or head looks. These conditions may also affect other parts of the body.

Treatment depends on the type of problem. Plastic and reconstructive surgery may help the person's appearance.

Face injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, speech, breathing and your ability to swallow. Fractures (broken bones), especially in the bones of your nose, cheekbone and jaw, are common facial injuries.

Certain diseases also lead to facial disorders. For example, nerve diseases like trigeminal neuralgia or Bell's palsy sometimes cause facial pain, spasms and trouble with eye or facial movement. Birth defects can also affect the face. They can cause underdeveloped or unusually prominent facial features or a lack of facial expression. Cleft lip and palate are a common facial birth defect.

Mpox, which used to be called monkeypox, is a disease caused by the monkeypox virus. This virus is in the same family of viruses as the smallpox virus.

Mpox can be spread between animals and people. It is found regularly in parts of Central and West Africa. The virus that causes it has been found in small rodents, monkeys, and other mammals that live in these areas.

Some outbreaks of mpox have affected people in many countries around the world, including the United States.

There are two types of monkeypox viruses:

• Clade I is regularly found in Central Africa. It causes more severe illness and deaths than clade II.
• Clade II is regularly found in West Africa. Infections from clade II are less severe. Most people who get this type will survive. This type is the cause of the global mpox outbreak that started in 2022.

Mpox spreads in different ways:

• Through close, personal contact with someone who has the virus:
  • Through direct contact with their rash, scabs, or body fluids
  • By breathing in the virus during prolonged, face-to-face contact
  • During intimate physical contact such as kissing, cuddling, hugging, massage or sex
• During pregnancy, from the pregnant person to the baby.
• From touching items (such as clothes, bedding, or towels) that were used by someone who has the virus
• From infected animals:
  • By being scratched or bitten by the animal
  • By preparing or eating meat or using products from the animal

Someone who has mpox can spread it from the time their symptoms start until their rash has fully healed, all scabs have fallen off, and a fresh layer of skin has formed. This usually takes 2-4 weeks.

Researchers have found that some people can spread mpox to others from 1 to 4 days before their symptoms appear. It is not known how often this happens.

The symptoms of mpox usually start within 3 weeks from the time you were exposed to the virus. The symptoms may include:

• A rash with sores that can look like pimples or blisters. It could be on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus. It goes through different stages, including scabs, before healing. This can take 2-4 weeks.
• Fever.
• Chills.
• Swollen lymph nodes ("swollen glands").
• Exhaustion.
• Headache.
• Muscle aches and backache.
• Respiratory symptoms, such as a sore throat, nasal congestion, or cough.

You may have all or only a few symptoms:

• You may get a rash first, followed by other symptoms
• You may have flu-like symptoms and then develop a rash 1-4 days later
• You may only get a rash

To find out if you have mpox, your health care provider:

• Will ask about your symptoms and medical history.
• Will look at your rash.
• Will take a sample of tissue from one of the sores so it can be tested for the monkeypox virus.
• May do blood tests to check for monkeypox virus or for antibodies to the virus. Antibodies are proteins that your immune system makes to fight foreign substances such as viruses and bacteria.

There are no treatments specifically for mpox, but many people get better on their own.

Since mpox and smallpox are similar, antiviral medicines that treat smallpox may also help treat mpox. Antiviral medicines may be recommended for people have severe mpox or are at risk of severe mpox, for example because they:

• Have immune system, for example from HIV or other conditions
• Are pregnant
• Are children, especially those under age 1
• Have certain active skin conditions that can cause widespread infection, such as eczema, impetigo, or psoriasis

If you have mpox, it is recommended that you stay home from the time you have symptoms until your mpox rash has healed and a new layer of skin has formed. It would be best to stay in a separate room from your family members and pets if you can.

JYNNEOS is a vaccine that can help prevent mpox (and smallpox). The vaccine is given in two doses 4 weeks apart. Getting both doses gives the best protection.

The vaccine is recommended for people who are at risk of mpox, for example because they:

• Had or think they could've had exposure to someone with mpox
• Are a man who has sex with men, a transgender person, or a gender non-binary person who in the last 6 months had:
  • One or more sexually transmitted infections
  • More than one sexual partner
  • Sex at a commercial sex venue (like a sex club or bathhouse)
  • Sex at a large public event where people had spread mpox
• Had a sex partner who is at risk of mpox
• Expect to be in any of these situations
• Are at risk of exposure at work, for example at a lab or healthcare facility

Check with your provider to see if the vaccine is recommended for you.

There are also other steps you can take to help prevent mpox:

• Avoid close, skin-to-skin contact with the mpox rash. So, while a person is sick with mpox:
  • Do not touch their rash or scabs
  • Do not kiss, hug, cuddle, or have sex with them
• Avoid contact with items that were used by someone who has mpox:
  • Do not touch the bedding, towels, or clothing of a person who has mpox
  • Do not share eating utensils or cups with them
  • If you or someone you live with has mpox, clean and disinfect your home
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially after contact with sick people.

Centers for Disease Control and Prevention

Rosacea is a long-term disease that affects your skin and sometimes your eyes. It causes redness and pimples. Rosacea is most common in women and people with fair skin. It most often affects middle-aged and older adults.

In most cases, rosacea only affects the face. Symptoms can include:

• Frequent redness of the face, or flushing
• Small, red lines under the skin
• Acne
• A swollen nose
• Thick skin, usually on the forehead, chin, and cheeks
• Red, dry, itchy eyes and sometimes vision problems

No one knows what causes rosacea. You may be more likely to have it if you blush a lot or if rosacea runs in your family. Rosacea is not dangerous. There is no cure, but treatments can help. They include medicines and sometimes surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Shingles (herpes zoster) is an infection that causes a painful rash. It is caused by the varicella-zoster virus (VZV). This is the same virus that causes chickenpox. After you have chickenpox, the virus stays in your body. It may not cause problems for many years. But as you get older, the virus may become active again and cause shingles.

Shingles is not contagious. You cannot get shingles from someone else. But you can catch chickenpox from someone with shingles if you have direct contact with fluid from their shingles rash.

The risk of spreading the virus is low if the shingles rash is kept covered. People with shingles cannot spread the virus before their rash blisters appear or after the rash crusts.

Anyone who has had chickenpox can get shingles. But the risk of shingles goes up as you get older. Shingles is most common in people over age 50.

People with weakened immune systems are at higher risk of getting shingles. This includes those who:

• Have immune system diseases such as HIV
• Have certain cancers
• Take medicines that weaken their immune system, such as steroids and medicines you take after organ transplant

Your immune system may be weaker when you have an infection or are stressed. This can raise your risk of shingles.

It is rare, but possible, to get shingles more than once.

Early signs of shingles include burning or shooting pain and tingling or itching. It is usually on one side of the body or face. The pain can be mild to severe.

Up to several days later, you will get a rash. It consists of blisters that typically scab over in 7 to 10 days. The rash is usually a single stripe around either the left or the right side of the body. In other cases, the rash is only on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread. It might look similar to a chickenpox rash.

Some people may also have other symptoms:

• Fever
• Headache
• Chills
• Upset stomach

Shingles can cause other problems (complications):

• Postherpetic neuralgia (PHN) is most common complication of shingles. It causes severe pain in the areas where you had the shingles rash. It usually gets better in a few weeks or months. But some people can have pain from PHN for many years, and it can interfere with daily life.
• Vision loss can happen if shingles affects your eye. It may be temporary or permanent.
• Hearing or balance problems are possible if you have shingles within or near your ear. You may also have weakness of the muscles on that side of your face. These problems can be temporary or permanent.

Very rarely, shingles can also lead to pneumonia, brain inflammation (encephalitis), or death.

Usually your health care provider can diagnose shingles by taking your medical history and looking at your rash. In some cases, your provider may scrap off tissue from the rash or swab some fluid from the blisters and send the sample to a lab for testing.

There is no cure for shingles. Antiviral medicines may help to make the attack shorter and less severe. They may also help prevent PHN. The medicines are most effective if you can take them within 3 days after the rash appears. So if you think you might have shingles, contact your provider as soon as possible.

Pain relievers may also help with the pain. A cool washcloth, calamine lotion, and oatmeal baths may help relieve some of the itching.

There is a vaccine, called Shingrix, to help prevent shingles and its complications. The Centers for Disease Control and Prevention recommends that healthy adults 50 years and older get the vaccine. Your provider might also recommend the vaccine if you are over 19 and have a weakened immune system. The vaccine is given in two doses.

If you have shingles, you can help prevent spreading the virus to others by:

• Staying away from:
  • People with weakened immune systems
  • People who have not had chickenpox or the chickenpox vaccine, especially if they are pregnant
  • Premature or low birth weight babies
• Keeping the rash covered
• Not touching or scratching the rash
• Washing your hands often

Centers for Disease Control and Prevention

Temporomandibular disorders (TMDs) are a group of more than 30 conditions that affect your temporomandibular joints (TMJs). You have two TMJs; one on each side of your jaw. They connect your lower jaw to your skull.

TMDs can cause problems in your jaw joint and your muscles that control jaw movement. These problems can include pain, stiffness, and trouble chewing.

There are three main types of TMDs:

• Disorders of your jaw joints
• Disorders of the muscles you use for chewing
• Headaches from a TMD

Many TMDs last only a short time and go away on their own. However, in some cases they can become chronic (long lasting)

Sometimes an injury to the jaw or TMJ can cause a TMD. But in most cases, the cause is not known.

Research suggests that certain factors may play a role in why a TMD starts and whether it will be long lasting:

• Genetics
• Psychological and life stressors
• How someone perceives pain

Anyone can develop a TMD, but it is more common in women than in men. It is most common in women between 35 and 44 years old.

The symptoms of TMDs may include:

• Pain in the chewing muscles and/or jaw joint. This is the most common symptom.
• Pain that spreads to the face or neck.
• Jaw stiffness.
• Limited movement or locking of the jaw.
• Painful clicking or popping in your jaw joint when you open or close your mouth. However, clicking or popping without pain is common and is not a sign of a TMD.
• Tinnitus (ringing in the ears), hearing loss, or dizziness.
• A change in the way the upper and lower teeth fit together.

There is no standard test used to diagnose TMDs, and some other conditions can cause some similar symptoms. This can make TMDs hard to diagnose.

To find out if you have a TMD, your health care provider or dentist:

• Will take a detailed medical history, which includes asking about your symptoms. They will want to know:
  • Where the pain is
  • When you have it
  • What makes it better or worse
  • If it stays in one area or spreads to other parts of your body
  • If you have any other pain conditions such as headache or back pain
• Will examine your head, neck, face, and jaw for:
  • Tenderness
  • Jaw clicking or popping
  • Problems moving your jaw
• May order imaging studies such as an x-ray, MRI, or CT

For many people, the symptoms of TMD are temporary. To help you feel better, your provider or dentist may suggest that you:

• Eat soft foods.
• Apply heat or cold to the face and do some exercises to gently stretch and strengthen your jaw muscles.
• Take over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
• Stop clenching your jaw, chewing gum, and biting your nails.

If those do not help, your provider or dentist may suggest other treatments such as:

• Physical therapy
• Self-management and behavioral health approaches, which can include:
  • Cognitive behavioral therapy (CBT), a type of psychotherapy. It can help you identify negative thoughts and change them. It can also teach you coping skills.
  • Biofeedback, which involves using electronic devices to teach you to control certain body functions, such as your heartbeat, blood pressure, and muscle tension. For example, it can detect when you tighten your jaw muscles. You can learn how to recognize when this happens and then relax your muscles.
• Medicines such as:
  • Anti-anxiety medicines
  • Antidepressants
  • Anti-seizure medicines
  • Prescription pain relievers
• An intraoral appliance, which is a device that fits over your teeth. Types of intraoral appliances include oral splints and mouth guards. If you are going to use one, it's important to:
  • Know that there is not a lot of evidence that they improve TMD pain.
  • Make sure that the appliance you have is not designed to permanently change your bite.
  • Let your provider or dentist know if it makes your pain worse.
• Complementary treatments, which are treatments that are used along with mainstream medical care. There is limited evidence showing that they help with TMD symptoms. But some providers and dentists may recommend acupuncture and transcutaneous electrical stimulation (TENS). TENS involves using a device to send a gentle electric current to your nerves or muscles. It may help treat pain by interrupting or blocking the pain signals.

If you are still having severe symptoms from a TMD, your provider or dentist may suggest surgery, including implant surgery, or another procedure.

It's important to be careful, because sometimes surgery or another procedure may not work or may even make your symptoms worse. Before any surgery or other procedure, it is very important to get opinions from more than one provider and to completely understand the risks. If possible, get an opinion from a surgeon who specializes in treating TMDs.

NIH: National Institute of Dental and Craniofacial Research

Trigeminal neuralgia (TN) is a type of chronic pain that affects your face. It causes extreme, sudden burning or shock-like pain. It usually affects one side of the face. Any vibration on your face, even from talking, can set it off. The condition may come and go, disappearing for days or even months. But the longer you have it, the less often it goes away.

TN usually affects people over 50, especially women. The cause is probably a blood vessel pressing on the trigeminal nerve, one of the largest nerves in the head. Tumors and multiple sclerosis can also cause TN, but in some cases the cause is unknown.

There is no specific test for TN. It can be hard to diagnose, since many other conditions can cause facial pain. Treatment options include medicines, surgery, and complementary techniques.

NIH: National Institute of Neurological Disorders and Stroke

The common cold is a mild infection of your upper respiratory tract (which includes your nose and throat). Colds are probably the most common illness. Adults have an average of 2-3 colds per year, and children have even more. Colds are more common in the winter and spring, but you can get them at any time.

More than 200 different viruses can cause a cold, but rhinoviruses are the most common type. The viruses that cause colds are very contagious. They can spread from person to person through the air and close personal contact. You can also get infected when you touch something that has the virus on it and then touch your eyes, mouth, or nose. For example, you could get a cold after you shake hands with someone who has a cold or touch a doorknob that has the germs on it, and then touch your face.

The symptoms of a common cold usually include:

• Sneezing
• Stuffy nose (congestion)
• Runny nose
• Sore throat
• Coughing
• Headache

The symptoms usually start a few days after you become infected with the virus. Some symptoms can last for 10-14 days.

There is no cure for the common cold. But there are treatments that can make you feel better while you wait for the cold to go away on its own:

• Getting lots of rest.
• Drinking plenty of fluids.
• Using a clean humidifier or cool mist vaporizer.
• Gargling with warm salt water.
• Using saline nose drops or sprays.
• Taking over-the-counter pain or cold and cough medicines. But you need to be careful with certain medicines:
  • Children and teens should not take aspirin.
  • Some cold and cough medicines contain ingredients that are not recommended for children. Talk with your child's health care provider before giving your child any cold and cough medicines.
  • Some cold and cough medicines contain pain relievers. If you also take a separate pain reliever with these medicines, you could be getting a dangerous amount of the pain reliever. Read the labels on the medicines and follow the instructions carefully. If you have questions, ask your provider or a pharmacist.

Antibiotics will not help with a cold. Antibiotics help with bacterial infections, not with viral infections such as colds.

Most people who have a cold will feel better after a week or two. However, some people who get a cold may develop other illnesses, such as bronchitis or pneumonia. This is more common in people with weakened immune systems, asthma, or other respiratory conditions. Contact your provider if you or your child have symptoms that concern you, such as:

• Trouble breathing or fast breathing
• Dehydration
• Fever that lasts longer than 4 days
• Symptoms that last more than 10 days without improvement
• Symptoms, such as fever or cough, that improve but then return or worsen
• Worsening of chronic medical conditions

There is no vaccine to protect against the common cold. But you may be able to reduce your risk of getting or spreading a cold by:

• Washing your hands often with soap and water for at least 20 seconds.
• Avoiding touching your face, nose, or mouth with unwashed hands.
• Avoiding close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others if you are sick or they are sick.
• Cleaning and disinfecting surfaces that you frequently touch.
• Covering coughs and sneezes with a tissue. Then throw away the tissue and wash your hands.
• Staying home when sick.

Centers for Disease Control and Prevention

Surgeons can reshape the appearance of body parts through cosmetic surgery. Some of the most common body parts people want to improve through surgery include:

• Breasts: Increase or reduce the size of breasts or reshape sagging breasts
• Ears: Reduce the size of large ears or set protruding ears back closer to the head
• Eyes: Correct drooping upper eyelids or remove puffy bags below the eyes
• Face: Remove facial wrinkles, creases or acne scars
• Hair: Fill in balding areas with one's own hair
• Nose: Change the shape of the nose
• Tummy: Flatten the abdomen