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What Causes Eczema on the Face?

Reviewed on 3/23/2022
An infant with eczema on the face
The cause of eczema on the face is not known but genetics play a role and it tends to run in families.

Eczema refers to a group of skin conditions that cause itchy, red, inflamed, scaly skin. Eczema can occur on the face and also on other parts of the body, such as:

  • The front of the arms and legs, cheeks, or scalp in infants
  • Back of the neck, the elbow creases, and the backs of the knees in children and adults
  • The trunk, wrists, and forearms

Types of eczema include: 

The exact cause of eczema on the face and elsewhere on the body is not fully understood but genetics is thought to play a strong role, and people with a family history of eczema are at increased risk of developing the condition. 

Common triggers for eczema symptoms may include:

  • Emotional stress or anxiety
  • Cold or dry environments
  • Sweating
  • Rapid temperature changes
  • Exposure to certain chemicals or cleaning solutions, including soaps and detergents, perfumes and cosmetics, wool or synthetic fibers, dust, sand, and cigarette smoke

What Are Symptoms of Eczema on the Face?

Symptoms of eczema on the face include: 

  • Intense skin itching 
    • Itching may be worse at night
    • Scratching may aggravate inflammation and itching
    • Oozing, bleeding, or crusting may occur on areas that are scratched open
    • Pustules, blisters, and red-hot skin if a secondary infection occurs
    • Thickened and darkened, or even scarred, skin can occur from repeated scratching
  • Clogged hair follicles causing small bumps
  • Patches of inflamed skin/skin swelling
  • Scaly, rough patches of skin
  • Skin flaking 
  • Sensitive skin
  • Dry skin
  • Skin discoloration (especially red or pink)
  • Increased skin creasing on the palms and/or an extra fold of skin under the eye
  • Darkening of the skin around the eyes

What Is the Treatment for Eczema on the Face?

Eczema is a chronic condition that worsens (flares) periodically in between times of mild to no symptoms. Eczema cannot be cured but it may be managed with home care and medications. 

Home remedies to reduce or relieve symptoms of eczema on the face include: 

  • Identifying and eliminating triggers 
  • Keeping the skin hydrated
    • Emollients
      • Thick creams (for example, Eucerin, Cetaphil, and Nutraderm) or ointments (such as petroleum jelly, Aquaphor, and Vaseline) that contain little to no water
      • Apply immediately after bathing for the best results
      • Apply twice daily or more frequently as needed
  • Bathing
    • Lukewarm baths or showers can hydrate and cool the skin and may help relieve itching
    • Use unscented, mild soap or non-soap cleanser sparingly
    • Apply an emollient immediately after bathing or showering 
    • Avoid hot baths or showers, or those lasting more than 10 to 15 minutes 
    • Dilute bleach baths may be recommended decrease the number of bacteria on the skin that can cause infections or worsen symptoms 
      • Use one-fourth to one-half cup of bleach in a full bathtub (about 40 gallons) of water and bathe 5 to 10 minutes twice weekly, followed by application of an emollient
  • Wet dressings (wet wraps) may be used to help soothe and hydrate skin, reduce itching and redness, loosen crusted areas, and prevent skin injury due to scratching

Medications used to treat eczema include:

  • Topical steroid creams or ointments 
  • Oral antihistamines for itching 
  • Tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel)
  • Oral steroids may be used for short periods to treat severe flares
  • Injectable “biologics” such as dupilumab (Dupixent) may be indicated for adults with moderate to severe eczema that has not responded to other treatments
  • Immunosuppressive drugs may be recommended for patients with severe eczema who do not improve with other treatments
  • Ultraviolet light therapy (phototherapy) may also be used to help control eczema in patients who have severe eczema and who do not respond to other treatments, because it is expensive and can increase the risk of developing skin cancer.

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Reviewed on 3/23/2022
References
Image Source: iStock Images

https://www.uptodate.com/contents/eczema-atopic-dermatitis-beyond-the-basics?search=Eczema&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://nationaleczema.org/eczema/