What causes eczema on the face and ears?

Atopic dermatitis involves the skin barrier and immune system

Atopic dermatitis is a long lasting inflammatory form of eczema. Its exact cause is not fully understood: genes, the immune system, the environment and the microbes living on skin all appear to play a part. Changes in the skin barrier, the protective outer layer, let moisture escape and leave skin dry and inflamed. Scratching adds damage and increases infection risk. A family history of eczema, asthma or hay fever raises the likelihood. Atopic dermatitis is not simply an allergy, although allergens can worsen symptoms. Cold, dry air, fragrances, harsh chemicals, wool, stress and overheating can trigger flares.34

Facial eczema is not limited to babies. Infants often develop patches on their cheeks, while adults commonly have eczema around their eyes. Atopic dermatitis can begin in adulthood or return after disappearing in childhood. In children, saliva and food touching the skin can also cause dermatitis around the mouth and chin.256

Products and objects touching the skin can cause contact dermatitis

Contact dermatitis means inflammation caused by something touching your skin. Irritant contact dermatitis comes from direct irritation, such as soap or hair dye. Allergic contact dermatitis happens when the immune system reacts to a substance. Around the ears, possible culprits include earrings, headphones, phones and hair or skin care products. Cosmetic allergens commonly include fragrances, preservatives and PPD, a chemical in many permanent hair dyes. PPD reactions can affect the upper eyelids and ear rims. Shampoo and conditioner can run down the sides of the face and neck, because the word hair on a bottle is not a zoning restriction.157

An old product is still a possible cause: cosmetic allergy can develop after years of trouble free use. Strong irritants can cause symptoms within minutes or hours; weaker ones can take days or weeks. Allergic contact dermatitis usually starts more than 12 hours after exposure and peaks around 48 hours. A dermatologist can use patch testing to identify cosmetic allergens.7

Scaly patches can have other causes

Seborrheic dermatitis affects oily areas such as the scalp, nose and ears. Facial patches can look oily or dry and scaly. Its exact cause is unknown, but excess yeast on the skin could contribute. Treatment can include dandruff shampoo and medicine applied to the skin. Asteatotic eczema is eczema associated with dry skin, commonly affecting people aged 65 or older. Low humidity, winter weather, temperature changes and harsh soaps can contribute.15

What should you do next?

Cosmetics include cleansers and moisturizers as well as makeup, so skipping foundation does not empty the category.7

1. 1Check what touches the affected area, including earrings, headphones, skincare and hair products. Stop using a suspected trigger.
2. 2Wash gently with lukewarm water and a gentle cleanser. Keep bathing brief, and avoid scrubbing.
3. 3Apply moisturizer while the skin is still damp, then reapply two to three times daily. Choose products without fragrance, dyes or alcohol.
4. 4Get treatment matched to the diagnosis. Do not use hydrocortisone longer than directed; prolonged use can itself cause a facial skin reaction.

With appropriate treatment, ear eczema can settle within one to three weeks, although flares can return. See a clinician if home care does not help, symptoms worsen, or facial redness lasts more than two weeks. Seek medical assessment for pain, fever, pus, hearing changes or symptoms inside the ear canal.145