What to use for eczema on your face

Which moisturizer should you choose?

Start with a mild cream or ointment without fragrance or perfume. Keeping eczema prone skin moisturized helps relieve discomfort and reduce flares. For children, moisturizing ointments such as petroleum jelly are an option, and creams containing ceramides can help restore the skin barrier, the outer layer that helps protect skin. Choose products made for eczema or sensitive skin, avoiding alcohol, scents and dyes.15

Avoid aqueous cream as a moisturizer left on the skin because it can irritate eczema. If a treatment seems to cause another reaction, or the pattern of your facial eczema changes, have the treatment reviewed. Allergic contact dermatitis, a skin reaction to something touching it, is one possibility a clinician can assess.6

How do you treat eczema on your face?

1. 1Wash with an emollient, a moisturizing treatment suitable for washing, instead of ordinary soap. Avoid products you already know make your eczema worse.
2. 2Apply your moisturizing cream or ointment generously. For children, pat the skin dry after washing and apply moisturizer immediately while the skin is still damp.
3. 3Moisturize at least twice daily, such as morning and evening, and more often as needed. Continue when the eczema improves rather than waiting for another flare.
4. 4Use any prescribed treatment in the amount and at the frequency your clinician specifies. Do not increase a child's medicine or apply it more often than directed.

Keep cool because heat can increase itching, and keep nails short to limit damage from scratching. Use a pump dispenser or a clean spoon rather than putting fingers into a moisturizer pot, and do not share emollients. Avoid smoking or naked flames: moisturizer residue on clothing and bedding makes those fabrics catch fire more easily.4

Can you use eczema cream on your face?

A mild moisturizing cream and a medicated eczema cream are different decisions. Moisturizers are daily care; steroids reduce inflammation during flares. Hydrocortisone is usually a mild steroid, but speak to a pharmacist or doctor before using it on your face because it can damage skin there. A tube labeled for eczema is not automatically permission to use it anywhere.2

When hydrocortisone is approved for your facial eczema, follow the specific strength and course you are given. It is usually applied once or twice daily in a thin layer over the affected area. Wash your hands before and after application. Do not apply it to cuts or wounds, cover it with a dressing, or use it for more than seven days unless a pharmacist or doctor directs you to.2

Facial skin needs particular care with steroid strength. A clinician can prescribe a mild steroid such as hydrocortisone 1%, with stronger facial treatment limited to a short course when needed. For facial eczema that does not respond adequately, prescription tacrolimus or pimecrolimus are options. These medicines regulate the skin's immune response and can also be used intermittently for maintenance under medical direction. Initial stinging is common and tends to improve with continued use; they should not be used on infected eczema.56

Hydrocortisone is unsuitable for some facial conditions, including rosacea, cold sores and inflammation around the mouth. If pregnant or breastfeeding, check with a pharmacist or doctor first. Most types can be used during pregnancy, with small amounts for the shortest possible time advised where appropriate. Seek advice about persistent side effects such as skin thinning or a new rash, and urgent help for vision problems. Difficulty breathing or a swollen tongue or throat needs emergency help.2

What can you use for baby eczema on the face?

Use a fragrance free thick cream or ointment twice daily, or as often as necessary for relief. These textures are generally more effective than lotions or oils for babies. During bathing, use lukewarm water and a mild, fragrance free cleanser only on dirty or smelly areas. Avoid scrubbing, keep baths to five to ten minutes, and moisturize immediately afterwards.7

Have a dermatologist choose any steroid treatment for your baby. Babies are more sensitive to corticosteroids than adults, so the amount, frequency and duration need specific instructions. When prescribed as part of this bathing routine, apply the steroid after the bath and before moisturizer. Do not borrow an adult's treatment plan.7

Saliva can trigger eczema around a baby's mouth. If that is happening, apply plain petroleum jelly around the mouth before feeds and naps. Other possible triggers include sweat, fragranced soaps, shampoos, wipes and laundry products. Identify what actually worsens your baby's eczema rather than changing everything at once. Do not change your baby's diet, or your own diet while breastfeeding, unless a doctor advises it.47

What should you expect from treatment?

Treatment can ease symptoms and lead to clearer skin, but atopic eczema has no cure. There is no single recovery timetable: eczema can improve and worsen over time, and some people have it for life. Many children improve as they grow older, although their skin can remain easily irritated. Daily skin care helps prevent flares and, in children, can reduce the need for medicines. If treatment is not helping, arrange a review rather than repeatedly extending a steroid course.135

When does facial eczema need urgent help?

Get urgent medical advice if eczema becomes painful, warm, swollen, blistered, crusty, leaks fluid or develops pus. Sudden worsening, spreading skin changes, fever or feeling generally unwell also need urgent assessment. A sudden cluster of similar painful blisters or open sores can signal eczema herpeticum, a herpes virus infection that requires emergency treatment. For a baby, contact their clinician at the first signs of infection.456