Holistic treatment for eczema on the face

What should your daily routine look like?

Moisturizer is the daily foundation of care, not an audition for the most elaborate bathroom shelf. Apply moisturizer in the morning, after washing while your skin is damp, whenever it feels dry and before bed.4

1. 1Wash gently with warm water and a soap substitute. Avoid repeated washing, which can dry the skin. Keep baths and showers to 5 to 10 minutes.
2. 2Apply a fragrance free moisturizer while your skin is still damp to help seal in moisture. Creams and ointments generally hydrate better than lotions.
3. 3Before adding a new skincare product, test it on a small patch inside your arm daily for 7 to 10 days. Use it more widely only if the test area stays clear.

For adolescents and adults, facial skincare needs a lighter touch than body care: heavy emollients, meaning moisturizing treatments, can provoke acne or a rash around the mouth. Choose a lighter cream if rich ointments cause problems. Fragrance free and dye free products designed for sensitive skin are useful options; ceramides and other lipids help support the skin barrier.14

Which everyday changes help?

Look for patterns around makeup, soaps, detergents, dry weather, dust, pollen and overheating. Avoid the triggers that repeatedly cause trouble rather than trying to remove everything from your environment. Choose fragrance free products, including laundry detergent; unscented products can still contain fragrance. Makeup can irritate facial eczema and delay healing, so leave irritating products out while your skin settles.24

Stress can aggravate atopic eczema, so adequate rest and stress reduction belong alongside skincare. If your diagnosis is nummular eczema, daily meditation, yoga or biofeedback are options for reducing stress, and a humidifier can help when indoor air feels dry. These measures complement treatment rather than replace it.15

Should you change your diet?

Broad elimination diets are not a routine treatment for atopic eczema and can leave you short of nutrients. Food allergies can aggravate eczema in some children, but that is different from assuming food causes every flare. If there is a strong suspicion of food allergy, a clinician can assess it and arrange a controlled food challenge or limited elimination trial.1

Do supplements and alternative treatments work?

Alternative treatments have limited evidence of benefit, despite the word alternative doing a considerable amount of promotional work. Results for evening primrose oil, borage oil, fish oil and Chinese herbs are inconsistent. Acupuncture, homeopathy and salt baths have insufficient evidence of effectiveness. Some probiotics and other complementary treatments have shown possible benefits in children under 14, but confidence in those benefits is low and safety remains uncertain. There is no established supplement choice or dose for treating facial eczema.36

When do you need medical treatment?

A flare can take several weeks to clear, even with treatment. Facial eczema sometimes needs an anti inflammatory cream, such as a topical steroid or a calcineurin inhibitor. Ask your clinician which medicine, strength, amount and frequency are appropriate rather than choosing a facial steroid regimen yourself. Seek care if symptoms worsen, do not improve after several weeks or cause emotional distress. If a moisturizer or medication causes a rash or pain, contact your clinician about the reaction. Persistent symptoms can also warrant testing for contact allergy or infection.4