Can You Identify The “Triangle Of Death”?

If you heard your dermatologist talking about the “triangle of death”, you might be tempted to recommend they log out of social media and take a nice vacation – but this is no conspiracy theory. The triangle of death, less melodramatically known as the “danger triangle”, is a real term, and it refers to part of your face.

The rest of this article is behind a paywall. Please sign in or subscribe to access the full content.

The triangle in question is the nasolabial triangle. Draw two imaginary lines from the bridge of your nose to the corners of your mouth; your top lip forms the bottom of the triangle you’ve just created, and this is what we’re talking about. 

The reason for the eldritch nickname is that an infection in this part of the face can, albeit very rarely, cause complications in the brain due to the network of complex vasculature that lies just beneath the surface.

Behind the eyes lie the cavernous sinuses, spaces through which lots of important nerves and vessels pass between the brain and the face. 

“The cavernous sinus is the only site in the body where an artery (internal carotid) passes completely through a venous structure,” explains Beth Elliot for TeachMe Anatomy. Major cranial nerves also pass through the sinus itself (abducens nerve) or its lateral wall (oculomotor nerve, trochlear nerve, and branches of the trigeminal nerve). It's basically a superhighway to the brain. 

Infection in the surrounding areas is the major cause of cavernous sinus thrombosis, where a blood clot forms within the space. This is a rare but very serious condition – as many as one in three patients may die, even with prompt treatment, as the clot restricts blood flow to the brain.

It's rare, but not impossible. Dermatologist Dr Jordan Carqueville told National Geographic that the risk of bleeding and infection means that extra precautions are always taken whenever surgery is performed on this part of the face. But since you’re unlikely to be performing invasive procedures on yourself (please don’t), do you really need to be scared of the triangle of death?

You may have seen videos online warning about the risks of popping zits that appear within the danger triangle. To stretch the horror metaphor to its limit, the danger triangle is the point where the veil between two worlds – the external environment and the central nervous system – is thinnest. But while pimple popping does open a small wound in the skin, and thus risks the introduction of bacteria, the chances of this leading to a serious infection are very slim. 

“This situation of death being caused by popping a pimple in this area is exquisitely rare,” said Carqueville. 

That doesn’t mean that popping your zits is recommended, however. “Honestly, you should always avoid popping pimples,” dermatologist Dr Alok Vij told Cleveland Clinic Health Essentials. Even if you dodge an infection, you could cause hyperpigmentation or scarring. According to Vij, the best option is either to leave your spots alone, or to use a warm compress or pimple patch to help speed up the healing process in a noninvasive way. 

You don’t need to live in fear of the triangle of death, but it’s worth being aware of its existence. And if zits are bothering you, the best place to seek advice is the doctor’s office.

The content of this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.