Treatment Options for Eczema on the Face
Medically reviewed by Casey Gallagher, MDMedically reviewed by Casey Gallagher, MD
Eczema (atopic dermatitis) can occur anywhere on the body but can be exceptionally irritating when it appears on the face, around the eyes, or on the lips.
Eczema is a skin condition that causes red, itchy, and dry skin. Food allergens, skin irritants, changes in outside temperature, stress, or hormonal changes can trigger eczema flare-ups.
This article explains the most common treatments for eczema on the face, including lifestyle changes and home remedies, creams and oral medications, and procedures.
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Home Remedies and Lifestyle Changes
Research suggests that people with eczema have a gene mutation that affects the skin barrier. Certain substances trigger an immune response because the skin cannot effectively block allergens or irritants.
Many people can effectively manage their eczema by identifying and avoiding triggers and through good skin care practices.
Avoid Eczema Triggers
Environmental triggers can play a big role in eczema flare-ups. Allergy testing can help identify particular triggers.
Common eczema triggers include:
Certain soaps, lotions, personal care products, makeup, perfumes, or cleaning products
Some metals (often nickel) and fabrics, like polyester or wool
Pet dander, dust, mold, pollen, cockroaches, cigarette smoke, or other environmental allergens
Extreme temperature changes, like cold, dry winter air or hot, humid summers
Certain foods, which may include cow's milk, gluten, nuts, fish, eggs, or soy
Some skin infections, like staphylococcus aureus (staph), yeast infections, the molluscum virus, or herpes simplex (which can also cause cold sores)
Stress and lack of sleep
Hormonal changes, including those associated with the menstrual cycle
Related: Causes and Triggers of Eczema
Gluten and Eczema
In one study, researchers failed to find a link between gluten and eczema among 63,443 people diagnosed with eczema. Speak to your healthcare provider if you are concerned about your diet and eczema symptoms.
Lifestyle Changes
Sometimes, small lifestyle changes can improve eczema symptoms. Some lifestyle changes include:
Using hypoallergenic cleaning and personal products
Avoiding scented products or perfumes
Swapping polyester or wool products for 100% cotton or silk
Using a humidifier in the winter and applying moisturizer when the air is dry
Checking sunblock or insect repellents for irritating ingredients in the summer
Washing away sweat, chlorine, or saltwater promptly and reapply moisturizer and sunblock
Cleaning your home regularly to remove dust or dander
Using dust-mite covers on pillowcases and mattresses and washing bedding weekly
Avoiding foods that trigger eczema symptoms
Intense itching at night can make it hard to sleep. Anxiety or stress about flare-ups on the face can increase cortisol, a stress hormone, making it harder to treat eczema. That's why it's also important to manage stress while treating eczema.
Related: Coping With the Emotional Impact of Eczema
Eczema-Friendly Skin Care
People with eczema should follow basic skin care guidelines to minimize flare-ups. Eczema-prone skin is more likely to lose moisture and natural oils, so it's especially important to use products that help replace lost moisture.
Other skin care tips for eczema on the face include:
Use products labeled sensitive, hypoallergenic, and fragrance-free.
Avoid harsh soaps or cleansers.
Use warm—not hot—water for bathing. Choose showers over baths.
Pat the skin dry gently and avoid scrubbing.
Apply cream moisturizers at least twice a day.
Choose makeup that is fragrance-free, hypoallergenic, or designed for sensitive skin.
Look for sunscreens with zinc oxide or otherwise made for sensitive skin.
Related: Best Moisturizers for Eczema and Scaly Skin
Sun Exposure
Sun exposure can help improve symptoms for some individuals with mild-to-moderate eczema. This may work by triggering the release of certain compounds in the skin that reduce inflammation and minimize the impact of bacteria, fungi, or viruses on the skin.
Sun exposure might not work for all eczema, and too much sun can worsen symptoms. It's also important to use sunscreen to block harmful UVA and UVB rays.
Over-the-Counter Therapies
Over-the-counter (OTC) therapies for eczema on the face include moisturizers and hydrocortisone cream.
Moisturizers
Moisturizers are a critical element of eczema treatment and prevention. Appropriate use of moisturizers minimizes itching and protects the skin barrier, which can reduce flare-ups and other symptoms. Some things to keep in mind when choosing a moisturizer include:
Choose thicker creams or ointments, which may provide more relief than thinner, water-based moisturizers.
Look for options with ceramides, which can help encourage healing in addition to moisturizing the skin.
Avoid products with fragrances or dyes. Look for options labeled hypoallergenic.
Apply two to three times per day, particularly after bathing or washing your face.
Hydrocortisone Cream
Hydrocortisone cream can relieve itching and swelling. This medication is a topical steroid, and it works by suppressing chemicals that cause inflammation.
Hydrocortisone should only be used for a short time, and it's important to be very careful when applying it near the eyes. Common side effects include stinging, burning, redness, and dryness. It can also cause discoloration or skin thinning, especially if overused.
Related: What to Do When Your OTC Eczema Treatment Isn't Working
Prescriptions
Prescription medications for eczema are typically reserved for more severe cases after lifestyle changes and OTC treatments fail to provide relief.
In addition to topical steroids, some of the most common prescription treatments for eczema include:
Topical calcineurin inhibitors (TCIs) work by blocking a protein that stimulates the production of inflammatory cytokines. Elidel (pimecrolimus) and Protopic (tacrolimus) are two options.
Oral steroids are reserved for severe cases or when other treatment options are limited. They should only be used for a short time to avoid the risk of serious complications.
Topical or oral antibiotics may be used in cases in which eczema compromises the skin barrier, leading to secondary skin infections. These are only appropriate for bacterial infections.
JAK inhibitors interrupt pathways that cause eczema symptoms, like itching and inflammation. These medications were only recently approved for eczema.
Topical phosphodiesterase 4 (PDE4) inhibitors work by blocking the enzyme PDE4, which regulates cellular inflammation. Examples include Zoryve (roflumilast).
Takeaway
It's important to follow your healthcare provider's directions carefully because not all medications are suitable for use on the face. Overusing certain medications, like topical steroids, can cause problems like irreversible skin atrophy, pustular psoriasis, and corticosteroid withdrawal.
Specialty Procedures
Specialty procedures may help treat eczema if lifestyle or other medications aren't enough. Some are performed by healthcare providers, while others can be used at home.
Wet wrap therapy is an option for individuals with severe, difficult-to-treat eczema. This treatment can help rehydrate the skin and improve the absorption of topical medications.
Phototherapy is usually reserved when first-line treatments fail or for cases of moderate-to-severe eczema. It is performed in a healthcare provider's office and involves exposing skin to controlled UVA or UVB light bursts.
Complementary and Alternative Medicine (CAM)
There are few proven complementary and alternative therapies for eczema. Some promising CAM options for eczema include:
Coconut oil: May help moisturize the skin and provides anti-inflammatory and antimicrobial benefits.
Vitamin D: May help reduce eczema symptoms in individuals who are vitamin D deficient, although research is still emerging on this topic.
Probiotics: May help reduce eczema symptoms, particularly products with mixed strains of bacteria.
Talk to Your Healthcare Provider
Speaking to your healthcare provider before starting any complementary therapies is essential. Your provider can ensure that any changes you make are safe and do not interfere with your treatment plan.
Related: 7 Home Remedies for Eczema
Summary
Eczema on the face can be troubling and uncomfortable. However, many people relieve their eczema symptoms by identifying and avoiding triggers, following good skin care routines, and using OTC or prescription medications for flare-ups or severe cases.
A Word From Verywell
You're not alone if you suffer from uncomfortable or itchy eczema on your face. Thankfully, many well-established treatment options can help minimize symptoms. Be sure to speak to your healthcare provider to help establish a treatment plan that minimizes exposure to eczema triggers and supports a healthy skin barrier.
Read the original article on Verywell Health.
