Eczema on the face: Causes and treatments

The term "eczema" refers to a group of conditions that cause skin to become dry, inflamed and itchy. Atopic dermatitis is the most common form of eczema. It mostly affects children, though it can also occur in adults. Eczema presents as red, dry, scaly and inflamed patches of skin that may itch, ooze or be crusty. If you scratch the affected skin, it can get thicker, darker or become infected.

Eczema can affect any part of the body, including the face. In babies and toddlers, eczema often appears on the cheeks and chin. Adults can also have eczema on the face, such as on the eyelids, for instance. Most of the time, eczema on the face responds well to treatment. Get the details on what causes eczema and how to manage it here.

The cause of eczema is still being investigated, but it appears to be triggered by both genetic and environmental factors. In eczema, the immune system reacts to a trigger, specifically to an allergen or irritant outside the body, which sets off a response. This causes symptoms of eczema on your skin. Symptoms tend to come and go over time. When you have active signs of eczema, it's called a flare-up.

If you have red patches, small bumps, dry spots or other symptoms of eczema on your face, see a dermatologist (skin care doctor). While there is no known cure for eczema at this time, there are ways to manage the condition. The goals of treatment are to help ease symptoms, decrease the risk of flare-ups and prevent infections. Treatment involves avoiding eczema triggers, having a good skin care routine and using medication.

The first line of defense is knowing what causes your eczema to worsen and then avoiding exposure to those triggers. Common eczema triggers include:

• Low humidity, as eczema is often worse during the winter months when the air is drier
• Dry skin
• Bathing too often without moisturizing
• Heat and sweating
• Irritants, such as itchy fabrics and harsh soaps and detergents
• Infections
• Emotional stress and anxiety
• Allergens, such as pollen, dust or pet dander, as well as certain foods, may contribute to symptoms, although there is a lack of evidence that interventions restricting exposure to these are helpful in reducing the severity of eczema  or preventing eczema flares

Keep in mind that specific triggers may be unique to you. What causes your eczema to get worse may not bother another person with eczema.

Washing and moisturizing your skin each day can help control eczema. People with eczema have an imbalance in the top layer of skin, which causes dry skin. Cleansing and moisturizing regularly can help trap moisture in the skin and reduce the frequency of flare-ups.

Cleanse your skin with a gentle, fragrance-free face wash. Use cool or warm water rather than hot water so you don't dry out your skin. After you wash your face, gently pat your skin dry with a towel, and then hydrate your skin with a fragrance- and preservative-free cream or ointment. Lotions have a high water content and evaporate quickly, which can make dry skin worse. Apply a moisturizer at least twice a day, and put it on right after washing your face or bathing. Some studies show that moisturizers containing emollients, humectants or occlusives work better than other ingredients for eczema. Your pharmacist or healthcare provider can recommend an eczema face wash, cream or ointment.

It's also important to avoid itching or rubbing affected skin. Scratching can break the skin, which can make eczema worse and may lead to infection. Use these tips to help keep babies and children with eczema from itching their skin:

• Keep nails short. Trim your child's nails often so they cannot break their skin when they scratch. Make checking their nails for sharpness a regular part of your routine, such as during bath time.
• Use eczema mittens or eczema sleeves. If your baby tries to scratch their skin, the mittens can keep them from causing damage.
• Cover itchy skin. If your child has eczema on another part of their body, cover the exposed skin with loose-fitting clothing made of natural fibers, such as cotton, silk or bamboo. Kids may be less likely to itch their skin when it's covered with clothing.

Over-the-counter and prescription medications are available to help treat eczema. Topical medications can ease itching, dryness, redness and rashes on the affected areas of your skin. Corticosteroids are often the first medication that's used for eczema, but these medicines can irritate facial skin in some cases and shouldn't be used in sensitive areas, including around the eyes. Instead, your healthcare provider may recommend using topical calcineurin inhibitors for eczema on the face. These medications work by blocking chemicals that cause eczema to flare up. They can be used on your face, including on the eyelids, neck and skin folds. If topical treatments don't improve your symptoms or if you have more severe eczema, your healthcare provider may suggest other treatments.

While eczema on the face can be bothersome and unsightly, know that it often responds well to lifestyle changes, good skin care and medications. If you have eczema on your face and want treatment, consider seeing a dermatologist. Together, you can find the best plan to control your eczema.

Clinically reviewed and updated by Julie McDaniel, MSN, RN, CRNI September 2023.