Eczema, also known as atopic dermatitis, is an inflammatory disease of the immune system. It manifests as itchiness, inflammation, dryness, flakiness, and a red, rash-like appearance of the skin. Often developed in early childhood, eczema can lead to recurrent infections if left untreated.
In this article, I’ll discuss the types of facial eczema, and the symptoms of each. I’ll talk about how eczema is diagnosed, the treatment options are available, and offer some prevention tips.
Types of Facial Eczema
Eczema first appears as an itchiness or redness of the skin. In some circumstances, the skin may break out in tiny bumps or blisters. While it is more commonly experienced by children, adults can also have bouts of eczema due to genetic and environmental factors. Caused by dehydration of the skin, eczema is not contagious, but can leave a person more susceptible to infections—harmful substances can more easily penetrate affected skin. More than 30 million Americans have eczema.
Atopic eczema, also known as atopic dermatitis, is an irritation of the skin that creates red, dry, itchy areas. It is the most common form of eczema, usually beginning in early childhood and getting milder—or going away entirely—by adulthood. Those who suffer from asthma and hay fever often experience atopic dermatitis as well. Often hereditary, this eczema forms in the folds of the elbows, knees, or neck, It may flare up during certain seasons, or around exposure to allergens or irritants.
Seborrheic dermatitis develops on parts of the body where there are lots of oil producing (sebaceous) glands such as the face, back, upper chest, and—predominantly—the scalp. It looks like red, scaly patches or rough skin that results in dandruff.
While treatable, seborrheic dermatitis is cyclical. This means that with the right treatment, it can improve temporarily, but will return. If you suffer from seborrheic dermatitis, avoid using hair sprays, gels, and other products containing alcohol. These can irritate the skin and make your dermatitis worse.
Contact dermatitis occurs when your skin makes contact with irritants. This is when skin cells become damaged by exposure to irritating substances like detergents, soaps, bleach, solvents, makeup, skincare products, or jewelry made of nickel. Over-washing your hands with hot water or wearing scratchy fabrics can also trigger contact dermatitis.
Allergic contact dermatitis
Allergic contact dermatitis is when your skin makes contact or has repeated exposure to an allergen resulting in an allergic reaction by the immune system usually a day after initial contact. Common allergens include poison ivy, poison oak, fragrances, thimerosal, which is found in some antibiotics and vaccines, and nickel found in some jewelry.
Light-sensitive eczema, sometimes referred to as photosensitive eczema or photodermatitis, is a rare skin irritation caused by exposure to ultraviolet light (sunlight). This form of eczema is usually from a reaction to certain drugs, plants, and chemicals that can make a person more vulnerable to sun exposure.
Symptoms of Facial Eczema
Those suffering from facial eczema exhibit the following common symptoms:
- Redness or blotchiness of the skin
- Dryness and flaking
- A stinging or burning sensation, like the skin is on fire
- Tiny bumps
- Small blisters
- Swollen eyelids
- Small blisters that may weep or ooze
- Cracked skin that may bleed (in severe cases)
When diagnosing eczema, your medical practitioner will consider your medical history, and then examine your skin. In some circumstances, they may do a skin biopsy to determine what type of eczema you have, and to prescribe the best treatment for you.
Eczema can be mistaken for other common skin conditions, such as:
- Rosacea: This skin condition produces red flushing or blushing on the face. Unlike eczema, rosacea doesn’t itch.
- Acne: This skin condition can cause redness and itching, but is distinguished by pimples on the skin.
While eczema is treatable, and symptoms can improve with the right medications and lifestyle changes, it is not completely curable. Those who suffer from eczema will have flare-ups at various points in their lives. A doctor or pharmacist may prescribe one of the following medicines to help keep symptoms at bay.
- Topical Treatments: these are non-prescription, anti-inflammatory ointments that are applied directly to the affected area to ease itching. Most topicals include prescription steroids, calcineurin inhibitors, and PDE4 inhibitors.
- Allergy medications: Over-the-counter (OTC) antihistamines such as cetirizine (Zyrtec), loratadine (Claritin), or diphenhydramine (Benadryl) for allergies can help treat contact dermatitis.
- Shampoos: OTC medicated shampoos can treat seborrheic dermatitis on the scalp. They contain active ingredients that lift the seborrheic dermatitis scale from the scalp and combat the overgrowth of a type of yeast called Malassezia.
For many, treating eczema is an ongoing battle, and may require a combination of both prescribed medication and at-home remedies. If you are struggling with an eczema flareup, consider the following treatments you can do at home:
- Take a bath with oatmeal or baking soda: Add oatmeal or baking soda to a lukewarm or cool bath to help soothe inflamed, irritated skin.
- Apply a clean, damp cloth to the affected area: Keeping the skin moist can curb itchiness and reduce inflammation.
- Use honey: Honey is antibacterial and anti-inflammatory. Apply honey to the affected area to prevent infections and speed up the healing process.
- Use diluted tea tree oil: Tea tree oil has anti-inflammatory, antibacterial agents and is known to help heal wounds. Mix some tea tree oil with water and apply it to the eczema to relieve skin itching, redness and dryness.
- Wear loose, cotton clothing: Avoid tight clothing that doesn’t breathe and may rub or chafe your skin.
- Keep your skin moist: Moisturize your skin regularly with products that are for sensitive skin types. Consider using fragrance-free oils and water-based lotions.
- Take supplements: Dietary supplements such as vitamin D and probiotics can help repair dry, damaged skin and prevent dermatitis.
- Don’t use irritants: Consider using cleaning products and detergents that are unscented or suitable for sensitive skin. When using cleaning products, wear gloves to avoid direct contact with the skin.
If your child is suffering from eczema, it is advised that you speak with your pediatrician to determine the best treatment options. Eczema can flare up in the winter as cold, windy weather causes dry, chapped skin. Be sure to moisturize your child, wrap them in wet wraps, and in some circumstances, soak them for 10 minutes in a bleach bath—containing just a half-cup of bleach in a full tub of water—to kill the bacteria on their skin.
In order to combat your eczema, it’s important to first determine what is triggering the flare-ups. By avoiding triggers such as allergens or irritants, you can reduce the likelihood of your eczema worsening. Here are a few prevention tips to implement into your daily routine:
- Don’t touch your skin: Don’t pick, rub, or scratch the affected area—this can worsen your dermatitis symptoms, lead to infection, or result in the spread of dermatitis to other areas of the body.
- Avoid dry skin: Keep skin hydrated by drinking enough water daily, using mild soap, taking shorter baths or showers, and avoiding extremely hot water.
- Moisturize regularly: Frequently using a gentle, fragrance-free, water- or oil-based moisturizer on your skin can help prevent dry, rough skin.
- Manage stress levels: Dermatitis can be caused by stress. Meditation, yoga, and acupuncture are helpful ways to relax and reduce stress.
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Frequently Asked Questions
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Thimerosal & Vaccines. (2020). https://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html
Contact Dermatitis. (2021). https://nationaleczema.org/eczema/types-of-eczema/contact-dermatitis/
What is Rosacea? (2021). https://www.rosacea.org/
Malassezia. (2012). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380954/
3 things you can do when your child’s eczema gets bad. (2017). https://www.health.harvard.edu/blog/3-things-you-can-do-when-your-childs-eczema-gets-bad-2017011010996