Symptoms, Causes, Treatment and Prevention

You wake up, look in the mirror, and see red, scaly patches on your face. They’re itchy and oozy. What the heck is happening? Most likely you’re dealing with facial eczema – and yes, it can happen seemingly out of the blue. Why does it happen, though, and how can you calm your skin? Let’s take a dive into how eczema specifically affects your face, and how to look and feel better ASAP.

What exactly is eczema?

According to Cleveland Clinic, eczema, also known as atopic dermatitis (AD), affects up to 15 million Americans. It often starts in childhood, and you have a higher risk of developing it if you’re a woman, if you’re Black, or if you have asthma or hay fever. Eczema affects your skin’s ability to keep out irritants. “You’re dealing with a compromised skin barrier,” says Mona Gohara, MD, associate clinical professor of dermatology at Yale University School of Medicine. Outbreaks occur when your skin is exposed to an allergen. Factors like an overactive immune system, a family history of eczema, harsh irritants like pollution or chemicals in your environment, or carrying around lots of stress can also raise your odds of a flare-up.

What does eczema look like on your face?

In addition to obvious irritation, super-dry skin is often a sign of the condition. The American Academy of Dermatology reports that leathery, thick skin can also point to eczema. Adults with AD often have it around their eyes, causing the skin there to become thick and darker. Can you get eczema on your ears? Not so likely. “Eczema on your ears is probably psoriasis,” says Dr. Gohara. “This is because there’s less of a chance that your ears are exposed to a lot of irritants – you don’t touch your ears as much as you do your face.”

What causes eczema on your face?

Interestingly, your skin could just suddenly decide that one of your favorite products no longer agrees with it. “You might think you’re experiencing eczema on your face because, say, you’ve just used too much Retin-A one time,” Dr. Gohara says. “But a product you’ve used every day can suddenly cause a reaction. Also, there can be a delay between using a product and then developing a reaction – sometimes days or weeks.”

Surprising products can cause an allergic outbreak. “Nail polish is a very common cause of facial eczema,” Dr. Gohara adds. “You touch your face all the time without realizing it.” This is why you might notice AD on your eyelids – did you rub them after getting a manicure? Most likely.

How is facial eczema treated?

First, see a dermatologist to get properly diagnosed. Your doctor can go through the list of products you regularly use, and help you figure out what specific ingredients in your cleansers or makeup could be giving you trouble.

Patch testing of your skin can also be helpful in figuring out how to treat your AD. There are a number of medications you might try if your case is severe. “Topical steroids may be used for very short periods of time, but there are side effects, including thinning of your skin and glaucoma or cataracts with extensive use,” says Lawrence F. Eichenfield, MD, vice chair of the department of dermatology at the University of California, San Diego. “Non-steroid anti-inflammatory topical agents can be very helpful–these include pimecrolimus, tacrolimus, crisaborole and, the newest topical agent approved, topical ruxolitinib.”

Ask your doctor whether these treatments are right for you.

How to prevent facial eczema:

There are also a number of steps you can take on your own to see if your flare-ups improve:

• Decrease your use of detergent. A study from the University of Binghamton found that people who washed their hands very often due to work – healthcare workers and hairstylists, for example – suffer higher rates of eczema. The researchers think this could be because contact with detergent cleansers can wash away skin oils that can protect against irritants and allergens. Apply this logic to your face – avoid harsh soaps and cleansers.
• Steer clear of scented products. “If you have eczema, moisturizing is very important, and you might think something gentle like coconut oil or shea butter will be great to use on your face,” says Dr. Gohara. “The problem is, those products are scented, which can really irritate your skin. Just because a product is organic does not make it right for AD.”
• Take advantage of humidity. It helps lock the moisture into your skin after a shower, which shores up your skin barrier. Moisturize while your bathroom is still nice and steamy, and invest in a humidifier, too.
• Consider your diet. A study from the University of California San Francisco found that some patients got relief from AD when they removed white flour, gluten, and nightshade veggies — like tomatoes, potatoes, bell peppers, and eggplant — from their diets. Everyone is different, though: If you have food allergies, discuss whether food elimination might be helpful with your doctor.
• Think gentle at all times. Pat your face dry rather than rubbing. Use soft washcloths. Sleep on a 100% cotton or bamboo pillowcase. The easier you are on your skin, the more you reduce your chances of a facial flare-up.