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Eczema on your face: Symptoms, treatment and more

Eczema on your face: Symptoms, treatment and more
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Eczema is an itchy skin condition that affects children and adults. For most people, symptoms tend to affect the hands, fingers, wrists, neck, elbows and knees. However, eczema can also affect the scalp and face.

What are the symptoms of eczema on your face?

Skin affected by eczema is itchy, dry and sore – no matter where it appears on the body. It might crack and flake, or become wrinkled or creased. If you have light skin, affected areas might look pink or red. If you have dark skin, affected areas might be darker in colour, or take on a purple or grey tinge.

With facial eczema, any skin on the face can be affected. However, it’s quite common for eczema to develop around the eyebrows, ears and eyes. Sometimes permanent folds under the eyes show up – this is a genetic condition known as Dennie-Morgan folds.

If you have a type of eczema known as contact dermatitis, symptoms will develop where your skin came into contact with an irritant or allergen. As an example, you might develop dry and itchy skin around your lips after wearing a new lipstick.

Symptoms of an infection

If an area of skin affected by eczema becomes infected you might notice fluid oozing from it, or a yellow crust or small white spots on the skin. The area might feel swollen and sore, and you might feel hot and shivery.

Symptoms in babies and children

Facial eczema is often the first symptom of atopic eczema in babies. If you notice dry, red, sore patches on your baby’s cheeks or neck folds, there’s a good chance it’s atopic eczema. However, there are some other conditions that can cause similar symptoms, including slapped check syndrome.

Babies can also experience a type of eczema known as seborrhoeic dermatitis, which causes cradle cap: greasy, yellow-brown scales across the scalp.

In older children, eczema can affect the whole face, including the eyelids. This is even more likely if your child also has hay fever.

What causes eczema on the face?

Atopic eczema

Atopic eczema is the most common type of eczema. It’s known to be related to the immune system and if you have allergies, you’re more like to have atopic eczema. This type of eczema can be triggered by exposure to certain things, including foods you’re allergic to, pet fur, pollen, and liquid soaps and detergents. Symptoms can also be set off by illness, stress and environmental conditions.

Seborrhoeic dermatitis

Seborrhoeic dermatitis is a type of eczema that affects areas of your body that produce more sebum – a natural substance that keeps your skin moist and soft. It’s thought that with this type of eczema, the sebaceous glands “overreact” to a harmless yeast on your skin called Malassezia and become inflamed.

If you have seborrhoeic dermatitis you’ll probably have patches of dry, scaly skin around your eyebrows and in the creases of your ears. You might also have dandruff. For some people, though, symptoms are more widespread across the face and body.

Contact dermatitis

Contact dermatitis is a type of reactive eczema that’s triggered by exposure to certain substances. It causes dryness, irritation, blistering and cracking in the affected area of skin – sometimes directly after one exposure, or sometimes after repeated exposures.

Contact dermatitis is normally categorised as “irritant” or “allergic”. Irritant contact dermatitis is where your skin reacts to an irritating substance like soap, detergent, perfume, disinfectant, or industrial materials like cement, acids and solvents.

Allergic contact dermatitis is where your body develops an allergy to a certain substance, causing your immune system to react every time you’re exposed to it. It’s quite common for allergic contact dermatitis to be caused by cosmetics, metal jewellery, rubber, glues, textiles and topical medicines.

If you have contact dermatitis you’ll notice eczema developing in the area where your skin was directly exposed to the irritant or allergen.

How to treat eczema on the face

Treating eczema on the face can be a bit more complicated than treating it on your body. This is because the skin on the face is more sensitive and vulnerable to damage.

It’s a good idea to visit your GP if you’re experiencing eczema on your face, as they can  help you figure out what type of eczema you’re experiencing, or what is triggering your flare-ups. If they’re unable to help, they should be able to refer you to a dermatologist for specialist help.

Topical treatments for facial eczema

The standard treatment for eczema involves emollients and topical medications.

Emollients are moisturisers that should be applied to the skin frequently to counteract dryness. They should also be used to clean your skin instead of soap. The drier your skin, the greasier the emollient should be. You may need one containing antiseptic if your skin is prone to infections

Topical medications for facial eczema include steroids and calcineurin inhibitors, which help to reduce inflammation. They should be applied carefully to affected areas only. Steroids are the more common treatment for eczema, but they can cause the skin to thin so they have to be used very carefully on the face. Calcineurin inhibitors don’t cause skin-thinning, which is why they’re a good alternative to steroids for facial eczema.

Other treatments for facial eczema

If you’re experiencing seborrhoeic dermatitis on your face or head, you might need an anti-yeast cream, ointment or shampoo.

Other treatments for eczema include antiseptics and antibiotics (to prevent or treat infections), and tablet medications like oral steroids. Phototherapy can also be helpful for some people with eczema.

Tips for managing facial eczema

The National Eczema Society recommends the following:

  • Stop using any products on your face that seem to be triggering symptoms or causing additional irritation.
  • Cleanse and moisturise the skin on your face with emollients – not standard cosmetics cleansers .
  • Avoid products containing soap, detergents, exfoliants or toners.
  • Be careful with make-up as it can be irritating – try to use mineral-based products for sensitive, reactive skin.
  • Be careful in the sun if you’re using calcineurin inhibitors as they can make your skin more sensitive to light – use them at night or make sure you apply sunscreen if you’re using them during the day.
  • Avoid scratching!
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