How to Treat Facial Atopic Dermatitis: A Step-by-Step Guide

A form of eczema, atopic dermatitis is a chronic skin condition characterized by splotchy patches of red, itchy, dry, and flaky skin. Facial atopic dermatitis, which is what we’re talking about today, shows up specifically on—you guessed it—the face. While it can occur anywhere in this area, it’s often worse in spots that crease or experience friction—like around your eyes and mouth. 

Ahead, we’re covering what causes this skin condition, signs to look for, and how to treat facial atopic dermatitis so you can feel more comfortable and enjoy clearer skin. 

What Causes Facial Atopic Dermatitis 

Facial atopic dermatitis flare-ups are ultimately caused by a compromised skin barrier, explains Kiran Mian, DO, FAAD, a medical and aesthetic dermatologist at Hudson Dermatology and Laser Surgery. 

“Our skin is a protective and selective barrier that keeps the good stuff in (like moisture) and the bad stuff (like irritants and pollution) out,” Dr. Mian says. “People with atopic dermatitis are missing certain proteins in their skin that are involved in maintaining the integrity of their skin barrier.” 

Because the barrier’s not as robust, those with this form of eczema have sensitive skin and are more apt to deal with triggers and flare ups. 

Be on the lookout for the following common signs of facial eczema:

• Redness
• Itchiness 
• Sensitivity and irritation
• Dry and flaky patches
• Small bumps (particularly on dark complexions)
• Clear liquid oozing from the patches  
• Darkened areas of skin where flare ups occur (hyperpigmentation)
• Crusting 
• Bleeding when scratched 

Can You Cure Facial Atopic Dermatitis? 

While facial atopic dermatitis isn’t considered a “curable” condition that goes away 100%, it’s absolutely something you can—and should!—manage. Good treatment regimens help reduce uncomfortable flare ups and can minimize symptoms if your skin does get triggered.

“Without management, atopic dermatitis can become quite uncomfortable,” Dr. Mian says. “It can be like a snowball or fire—starting off small—but without treatment can spread and become worse.” 

She adds that a flare can lead to dry, cracked skin that becomes painful and susceptible to infection. Once that inflammation subsides, it can then cause post inflammatory hyperpigmentation (PIH) and even scarring. That said, preventing flare ups and treating them as they occur is essential to maintaining healthy skin. 

How to Treat Facial Atopic Dermatitis 

Good news! Mild cases of facial atopic dermatitis can be managed at home. Here’s the ideal skincare regimen to follow: 

Step 1: Use a Gentle, Hydrating Cleanser 

Cleansing your skin is a must, but make sure you’re reaching for a facial cleanser formulated for sensitive, dry, eczema-prone skin. “Using an overly harsh cleanser can strip the skin of natural oils and worsen atopic dermatitis,” notes Carmen Castilla, MD, FAAD, a New York City-based board certified dermatologist and clinical instructor at Mount Sinai. She recommends washing no more than twice per day. 

Step 2: Apply a Thin Hydrator 

While your skin is still damp, apply a thin humectant such as hyaluronic acid, glycerin, or ceramides to help draw moisture to your skin. (FYI—this is a longtime dermatologist hack that went viral after getting a buzzy name: skin flooding). A skincare essence, serum, or toner is great for this. Dr. Mian says this step helps your skin hold onto moisture. 

Step 3: Follow Up With a Thick Moisturizer

Once your light moisturizer is absorbed, Dr. Castilla says to follow up with a very thick moisturizer or ointment that’s also suitable for sensitive skin. “If your eyelids are affected, a thin layer of [ointment] on top can be helpful,” she says. You can do the same for any other “hot spots” or patches. 

Step 4: Avoid Aggressive Exfoliating Products 

People with dry skin or facial atopic dermatitis may feel tempted to exfoliate their skin to buff away the dry and flaky patches. Dr Castilla says this isn’t a good idea and can potentially make things worse. “Do not exfoliate,” she warns. “Dry skin is an indicator of a compromised skin barrier, so exfoliating dry skin will only lead to more problems.”

Step 5: Steer Clear of Triggers

Along with following a gentle and hydrating skincare regimen, do your best to stay away from products or ingredients that can trigger an atopic dermatitis flareup. Major culprits include fragrances, dyes, alcohol, and harsh detergents. 

When to See a Professional 

Mild to moderate cases of facial atopic dermatitis can be managed with the above skincare regimen. However, if you’re dealing with a lot of pain or discomfort—or can’t get ahead of the flare ups—it’s time to see your doctor. 

“Seeing a professional allows you to come up with a plan on how to manage your atopic derm to minimize flare ups and what treatments to use when it does flare,” notes Dr. Miah. “This can help prevent frustration and the condition from becoming out of control.” 

Everyone’s experience with facial atopic dermatitis is different from the next, and some simply need a professional’s touch for better management. From there, you’ll be able to get ahead of the condition and continue managing at home.