Photos of eczema on the face: what to look for

Where can I see photos of facial eczema?

Open the [DermNet image library](https://dermnetnz.org/images) and search for atopic dermatitis, which gives portrait browsing a distinctly less glamorous brief. Select Face under Body location, then use the age and Skin of colour filters to narrow the examples, which is unusually thorough filing for a collection of portraits. The gallery has a Face filter, so the search does not have to become a tour of every body part. Its filters also include scale, crust, dryness and cracking, which help narrow the appearance you want to compare.3

What does eczema look like on different skin tones?

Redness alone is a poor way to judge eczema in darker skin: inflammation can look purple, and its severity can be underestimated. Lighter or darker marks after inflammation are also more common and more noticeable in skin of colour. A photograph of colour change needs to be considered alongside itching, texture and the history of the rash.4

Where does facial eczema appear in babies and adults?

Babies and young children often develop eczema on their cheeks, forehead or scalp. A typical baby facial example shows slightly raised pink or red patches, especially on the cheeks. Babies can rub against blankets or other objects to relieve itching, leaving raw skin or bumps that ooze and crust. Itching can also disturb sleep.12

The [MedlinePlus atopic dermatitis page](https://medlineplus.gov/ency/article/000853.htm) has an Images section with infant eczema, a close view of eczema and atopic dermatitis on a young girl's face. The image list includes infant and facial examples.5

Adults are more likely than children to develop atopic dermatitis around their eyes, often with thickened skin darker than the surrounding area. Creases beneath the lower eyelids can occur in older children too, but also occur with asthma or hay fever. A crease by itself is not enough to identify eczema.1

Why do eczema photos look so different?

A fresh flare can be red, weeping or crusted, sometimes with blisters. Longer lasting eczema can become less red but more scaly and thickened, with cracks. Lichenification means thickening caused by repeated rubbing or scratching. Around the mouth and chin, dribble and food can cause dermatitis in children. These differences explain why one facial photograph can look quite unlike another.4

Can a photo tell me whether the rash is eczema?

Eczema is a name for several types of dermatitis, meaning skin inflammation. Atopic dermatitis is the most common type, but contact dermatitis, seborrheic dermatitis and other forms can affect the face. Eczema is not contagious. It often lasts a long time, with periods of improvement and worsening, rather than having one fixed appearance.67

Atopic dermatitis is usually diagnosed through a skin examination. Your personal and family history also matter, including when the itching began and what exposures preceded the rash. Psoriasis, seborrheic dermatitis and contact dermatitis are among the alternatives a clinician considers. Patch testing can help investigate contact allergy, particularly when dermatitis resists treatment. Some people need a skin sample or testing for infection.457

How should I care for facial eczema?

1. 1Wash gently. Use an emollient, a moisturising wash or treatment, instead of ordinary soap. Keep water exposure brief and avoid hot water, scrubbing or vigorous drying.
2. 2Apply moisturiser while the skin is still damp. Choose a product without fragrance or dyes, designed for sensitive skin. Creams and ointments are options for keeping skin moist.
3. 3Moisturise at least twice daily and continue when the eczema improves. Use a spoon or pump rather than putting fingers into a shared pot, and do not share your emollient.
4. 4Avoid your known triggers. Soap, detergent, makeup and dry weather can provoke facial flares. Keep nails short to reduce damage from scratching.
5. 5Use prescribed treatment as directed. Before starting a new medicine, ask about the dose, frequency, side effects and possible interactions.

Facial treatment can include topical steroids or topical calcineurin inhibitors, medicines applied to the skin to reduce inflammation. The choice depends on the cause and severity of the flare. Makeup can further irritate facial eczema and delay healing. If a moisturiser or topical medicine causes a rash or pain, contact your clinician.7

How long does facial eczema take to clear?

A treated facial flare can take several weeks to clear completely. Moisturising regularly and avoiding the irritants or allergens that trigger your symptoms can reduce future flares. Arrange a review if the rash worsens or does not improve after several weeks. Atopic eczema often improves as children grow older, but adults can have continuing or returning symptoms.67

Having atopic dermatitis does not automatically mean an allergy caused it. Allergies can worsen symptoms, but positive allergy tests are not the same as explaining the rash. Do not change your diet, or a breastfeeding parent's diet, without medical advice. Hormonal changes during pregnancy can also worsen atopic eczema.25

Which changes need urgent medical care?

Seek urgent medical assessment for eczema that becomes blistered, crusty, leaking or filled with pus, especially with pain, swelling, warmth, sudden spread, fever or feeling unwell. Golden or yellow crusts can indicate a bacterial infection. Blisters with fever, fatigue or swollen glands can indicate eczema herpeticum, a serious herpes virus infection requiring immediate care, particularly in babies, children and people with weakened immune systems. Do not wait for the rash to resemble an infection photograph.12

Keep away from cigarettes and naked flames when using emollients. Residue on clothing, bedding or dressings makes those fabrics catch fire more easily.2