Remedies for facial eczema

How should you care for facial eczema each day?

1. 1Wash gently with an emollient soap substitute or mild fragrance free cleanser. Emollients are moisturizing treatments that reduce water loss. Avoid ordinary soap and scrubbing.
2. 2Use lukewarm water. If washing your face in the shower, keep the shower to 5 to 10 minutes rather than extending exposure to hot water.
3. 3Gently dry off, leaving the skin slightly damp, then apply moisturizer immediately. Smooth an emollient onto the skin rather than rubbing it in.
4. 4Moisturize at least twice daily, for example in the morning and evening, and whenever the skin feels dry. Continue after the eczema improves.
5. 5Apply any prescribed eczema medicine as directed. Follow the instructions for its amount, frequency, treatment area and spacing from moisturizer.

Which moisturizer should you choose?

Choose a fragrance free cream or ointment rather than a lotion. Ointments contain more oil and hold moisture in more effectively, but feel greasier; a cream can be easier to use regularly. There are plenty of moisturizers to choose from, because skincare has never mistaken a shelf for a limit. Ceramides, substances naturally present in skin that help retain moisture, are useful ingredients to look for.56

Look specifically for 'fragrance free', not 'unscented': an unscented product can contain fragrance whose smell has been covered up. For products left on the skin, avoid sodium lauryl sulphate, also called SLS, because prolonged contact can irritate dermatitis. A formula with few ingredients helps limit exposure to possible irritants.57

Before using a new skincare product on your face, apply a quarter sized amount to the inside of your arm daily for 7 to 10 days. If the skin stays clear, begin using the product. Stop an emollient that causes a reaction and ask a pharmacist or doctor for an alternative.45

What treats an active facial flare?

Moisturizer supports the skin barrier, but an inflamed flare can also need medication. Topical corticosteroids, steroid medicines applied to the skin, are a main treatment for mild to moderate atopic eczema and can quickly relieve symptoms. The strength depends on the body site and severity. A clinician usually selects the weakest effective steroid for the shortest effective course; use only the strength and amount directed for your face.17

Steroids can cause brief burning or stinging when applied. Stronger preparations and larger amounts increase the risk of side effects, including skin thinning. If treatment is not improving the rash, contact the prescriber rather than increasing it yourself.4

Pimecrolimus cream and tacrolimus ointment are prescription alternatives called topical calcineurin inhibitors, which control inflammation differently from steroids. They suit sensitive sites such as the eyelids. Other prescription options include crisaborole, roflumilast, ruxolitinib and tapinarof. The choice depends on your age, eczema severity and treatment history, rather than which medicine has the newest name.17

Regular moisturizer helps dry skin and is associated with fewer flares and less need for topical steroids. There is no single clearing time for facial eczema: treatment aims to control symptoms and maintain improvement. If medicines applied to the skin are not enough, a dermatologist can consider medical light therapy or treatment that works throughout the body.17

What if the eczema is on your eyelids?

Eyelid skin is thin and especially sensitive. Wash eyelids with plain water or a cream cleanser designed for sensitive skin, avoid rubbing, and pause eyelid cosmetics while the rash is active. Touch the area only with clean, rinsed hands. A clinician can prescribe a short course of a mild steroid or a calcineurin inhibitor when needed.2

The cause need not be something applied directly to the eyelids. Nail cosmetics, hair dye and fragrance can reach them from your hands. An allergy can develop to something used repeatedly without previous trouble, and the rash can appear one to several days after contact. For recurring eyelid eczema, a dermatologist can arrange patch testing to identify contact allergens.2

What should you avoid during a flare?

Retinol, facial acids and many acne or anti aging treatments can irritate eczema prone skin. Ask a dermatologist how to manage those concerns alongside eczema instead of adding more active products during a flare. Avoid known triggers, which can include fragrance, harsh detergents and temperature extremes. Overheating and sweat can trigger flares, while cold weather can dry the skin.56

Greasy moisturizers can leave residue on clothing or furniture, so the sofa can acquire a skincare routine without agreeing to one. Use a pump or clean spoon instead of dipping fingers into an emollient pot, and do not share it. Keep moisturizers away from smoking and naked flames: residue on clothing and bedding makes those fabrics catch fire more easily.37

Are there natural remedies for facial eczema?

Colloidal oatmeal has shown potential benefits for reducing inflammation, and unprocessed virgin coconut oil may help. Natural ingredients are not automatically gentler: citrus oils, tea tree oil and some seed oils can irritate eczema prone skin. Herbal remedies have little evidence of effectiveness and should not replace prescribed treatment. Do not cut foods out of your diet without medical advice; avoidance diets do not cure atopic eczema.467

When should you get medical help?

A pharmacist can help with small areas that are dry and slightly itchy. See a doctor if eczema is more severe or treatment is not helping. Seek urgent assessment for blistering, crusting, leaking fluid, pus, pain, swelling, warmth, sudden worsening or spreading, fever, or feeling unwell. These can signal infection or eczema herpeticum, a serious infection associated with eczema.3