How To Treat Eczema on Your Face

Eczema can be especially painful and debilitating if it appears on the face. You may notice itchy red patches of skin near your eyes or on your cheeks and forehead that crack, blister, bleed, or ooze. There is no specific cause of facial eczema. You might be at risk if you have allergies, asthma, or a family history of eczema. 

Treatment for facial eczema often includes topical medications, light therapy, and steroid creams. Read on to learn how to treat eczema on the face and prevent flares.

Types of Eczema on the Face

Eczema may pop up on different areas of your face, depending on the type: "The most common areas for eczema on the face are the eyelids and the lips, given how thin and sensitive the skin is in these areas," Shilpi Khetarpal, MD, a dermatologist at the Cleveland Clinic, told Health.

Atopic Dermatitis

Atopic dermatitis is one of the most common causes of facial eczema, especially in young children. You might notice dry, red patches of skin near your eyes and lips.

Contact Dermatitis

Contact dermatitis is a reaction to an allergen or irritant, such as fragrances, hair dyes, and shampoos. This type of eczema may cause symptoms on your face, head, and neck.

Seborrheic Dermatitis

This type of eczema, commonly known as dandruff, causes flaky, white or yellow scales on your face, scalp, or inside of your ears. Seborrheic dermatitis typically occurs if those areas are oily or greasy.

Facial Eczema Symptoms

Facial eczema symptoms may vary from person to person. Some of the tell-tale symptoms of eczema on the face include:

• Blisters that ooze and crust
• Bumps on the backs of your arms and front of your thighs
• Changes in skin color
• Discharge or bleeding from your ears
• Dry skin
• Marks from scratching
• Redness and inflammation near the affected areas
• Thickening of the skin

Facial eczema symptoms may appear differently in various skin colors. For example, people with light skin might have red rashes. In contrast, people with dark skin are likelier to have dark brown, purple, or gray patches of skin. People with dark skin might also notice rough, small bumps on the face.

What Causes Eczema on the Face?

Your skin typically acts as a barrier, protecting you from allergens and irritants. About 30% of people with eczema have genetic mutations that cause their skin to have less moisture than usual and small breaks.

Certain substances may trigger facial eczema in people with a weak skin barrier. Something triggers the immune system, making the skin's protective barrier dry and sensitive. Those triggers include allergens or irritants. Allergens include fragrances and some jewelry. Irritants may include soaps and detergents. Ingredients in makeup and skincare products might trigger symptoms in people with facial eczema.

People with eczema might also lack ceramides, substances that help trap water in your skin. A lack of hydration might cause dry facial skin, Amanda Doyle, MD, a dermatologist based in New York, told Health. Changes in hormones, such as estrogen and progesterone, may also lead to an eczema flare on the face.

Risk Factors

Anyone can develop facial eczema, but some people are likelier than others. Risk factors for atopic dermatitis, a common cause of facial eczema, include:

• A family history of eczema
• Allergies and asthma
• Environmental factors (e.g., stress, pollution, and tobacco smoke)
• Location
• Weak immune system

How Is Facial Eczema Diagnosed?

A healthcare provider can diagnose facial eczema by examining your skin. They may ask about your health history and whether you have had recent exposure to irritants.

You might require diagnostic tests, including:

• Allergy skin testing: This helps figure out if certain allergens are causing your symptoms. A healthcare provider will apply allergens to your skin to see if they cause a reaction.
• Skin biopsy: A healthcare provider will remove a small sample of the affected skin for testing. This test helps rule out other skin conditions.

1. Medications

There are several medications, including oral and topical options and injections, that help relieve symptoms. A healthcare provider will advise certain types of medications depending on how severe your symptoms are.

Creams and Ointments

These topical treatments help hydrate your skin and protect against irritants. You might benefit from creams and ointments like:

• Calcineurin inhibitors (TCIs): These include pimecrolimus or tacrolimus ointments. TCIs alleviate inflammation and itching and get rid of excess bacteria on your skin.
• Crisaborole ointment: This treats mild to moderate eczema and alleviates itching, inflammation, and rashes.
• Janus kinase (JAK) inhibitors: These include ruxolitinib cream, which helps reduce inflammation and itching.
• Topical corticosteroids: A topical steroid like hydrocortisone, available over the counter, may relieve short-term itching and irritation. Just do not use it for longer than two weeks, and contact a healthcare provider if your symptoms do not improve. Always avoid contact with your eyelids, said Dr. Doyle.

Injections

Some medications that treat eczema are available as injections, including Dupixent (dupilumab) and Adbry (tralokinumab-ldrm). Those biologic medications help reduce inflammation if topical treatments fail. You might visit a healthcare provider for regular injections or perform them at home.

Oral Medications

These treatments work throughout the body to improve your skin's appearance and reduce painful symptoms. Oral medications include JAK inhibitors, like Cibinqo (abrocitinib) and Rinvoq (upadacitinib), which treat moderate to severe eczema if other treatments do not work. You might require other medications that suppress your immune system, such as azathioprine or methotrexate.

2. Light Therapy

Light therapy, or phototherapy, exposes your skin to ultraviolet (UV) light to alleviate itching or inflammation. You might require two to three treatments per week for several weeks or months. Some people visit a healthcare provider for light therapy, and others have at-home devices.

Of note: Sunlamps and indoor or outdoor tanning do not have the same effects as light therapy. Those methods increase your skin cancer risk and damage your skin.

How To Prevent Facial Eczema

A good skincare routine can help prevent facial eczema flares. Take care of your skin by:

• Avoid touching your face with irritants (e.g., rough fabrics)
• Cleanse your skin gently with an unscented cleanser.
• Do not use creams and ointments with a lot of alcohol and water. Those products may cause your skin to burn. 
• Pat your skin dry. Avoid drying it out too much before applying a moisturizer, which helps lock in water.
• Take one shower or bath per day.
• Use lukewarm water in the shower or bath. 

Facial eczema can be uncomfortable. Avoid touching or scratching at the affected areas, which worsens symptoms. Trim your fingernails short to avoid irritating your skin while applying skincare products to your face.

Living With Facial Eczema

Concealing and soothing facial eczema can be challenging since your skin in this area is often very delicate. Facial eczema might cause stress, which may trigger flares. Talk to a healthcare provider if your symptoms overwhelm you or make you anxious.

Eczema is chronic and not curable. Still, there are steps that you can take to cope with having the skin condition.

Avoid Eczema Triggers

There may be certain irritants that trigger facial eczema, so you'll want to avoid coming into contact with them. Take note of what makes symptoms appear. What triggers dry, red patches of the skin differs from person to person. Talk to a dermatologist if you are not sure about what your triggers are.

Carefully Choose Your Makeup

Use caution when applying makeup on an existing facial eczema rash, which may worsen irritation. Choose a liquid foundation instead of oil-absorbing powders if you choose to wear makeup. Those powders might exacerbate skin dryness.

"The liquid is more moisturizing, so it can help to accelerate the healing process," said Dr. Khetarpal.

Dr. Doyle recommended makeup from Clinique or bareMinerals: "These tend to be a bit more friendly to eczema patients and those with sensitive skin who are looking for coverage," said Dr. Doyle.

Have a Good Skincare Routine

You do not need to spend a fortune on an eczema-friendly moisturizer. Some of Dr. Doyle's favorites included drugstore finds, like CeraVe Moisturizing Cream and Vaseline Intensive Care Advanced Repair Moisture. Look for moisturizers that contain ceramides to add to your daily and nightly skincare routines.

Avoid scented soaps and moisturizers to protect against future facial flare. Dr. Doyle recommended Vanicream Cleansing Bar for Sensitive Skin, a mild, fragrance-free cleanser that's ideal for people with sensitive skin.

"Less is more," said Dr. Doyle. "People often want to apply all kinds of things when they get these types of rashes on their face, but it's really best to use minimal, gentle products that rehydrate the skin so it can heal itself."

A Quick Review

Eczema is an umbrella term to describe skin conditions that cause dry, itchy, red patches of skin anywhere on your body, including the face. There isn't a cure for eczema. Still, topical treatments and light therapy might reduce symptoms.

Talk to a dermatologist if you have more concerns about your skin. Try avoiding allergens and irritants that trigger flares or being careful about your skincare routine in the meantime.