Facial Eczema: Images, Symptoms, Causes, and Treatments

Eczema can affect any part of the body. And it can be especially frustrating when it happens on the face.

Because it’s so visible, facial eczema can have a significant impact on daily life. Knowing your triggers and how to avoid them can help you manage your skin symptoms.

Symptoms of facial eczema

Eczema on the face has similar symptoms to eczema anywhere else on the body. Symptoms typically include:

• Changes in skin color, including lighter and darker patches of red, brown, or violet skin 

• Skin that’s flaky, rough, and thick 

• Bumps on the skin

• Weeping and crusting

• Painful, itchy, and sensitive skin

Facial eczema can also affect areas around the eyes. You may notice:

• More lines around the eyes

• Swollen eyelids

• Red and irritated eyes

What does eczema look like on the face?

Sometimes it can be difficult to picture what symptoms look like just by reading written descriptions. Here are some images to help you see how facial eczema can appear on different types of skin.

What causes facial eczema to develop?

Eczema is caused by a breakdown of the skin barrier. The skin acts as a barrier to protect you from infections, irritants, and allergens. The skin also keeps your body’s moisture inside, so you don’t get dehydrated. But sometimes this skin barrier breaks down. This can happen because of a person’s genetics, environment, or a combination of both. 

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• Rash around the eyes: There are different causes of a rash around the eyes. Not all are serious, but because the skin around the eye is thin and delicate, most rashes under or around the eye need treatment.

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When the skin barrier is broken, the skin dries out faster and becomes easily irritated. This can lead to eczema flares.

What triggers facial eczema?

There are many triggers for eczema on the face, and these triggers vary from person to person. 

Some common triggers for facial eczema (and eczema on other parts of the body) include:

• Weather changes (extreme cold and hot temperatures)

• Stress (both physical and emotional)

• Sweating

• Skin friction (like hats or headbands on your skin)

• Excessive skin washing with soaps and detergents

• Excessive skin exfoliation and rubbing

Other triggers for eczema are things you come into contact with or are exposed to, including:

• Contact with skin irritants (like bleach and chlorine)

• Contact with skin allergens (like nickel and fragrances)

• Exposure to environmental triggers (like pollen, pets, and various grasses)

• Fragranced skin care products

People who have eczema often have asthma and seasonal allergies. And sometimes people have an eczema flare with an asthma or allergy flare.

How do you treat eczema on the face?

Treatment for eczema on the face is mostly the same as eczema treatment on the rest of the body. But the skin on the face is much thinner and more sensitive than skin on other parts of the body. That’s why many strong treatments that are safe to use on the body are not typically used on the face.

For example, steroid creams or ointments can cause issues on the face — especially if used for more than 1 or 2 weeks. Steroid creams can cause thinning of the skin or acne. 

For this reason, it’s preferable to start with steroid-free creams or low-dose steroid creams for facial eczema.

Prescription treatments commonly used for facial eczema include:

• Low-strength topical steroids, like hydrocortisone 1%

• Nonsteroidal anti-inflammatory creams, like pimecrolimus and Eucrisa

• Antihistamines, like hydroxyzine

• Systemic treatments for severe cases, like Dupixent

• Light therapy

Tips for managing facial eczema

When you have eczema on your face, good basic skin care can go a long way. Follow these steps to help protect your delicate skin barrier:

• Wash your face with a gentle cleanser.

• Avoid soaps, exfoliators, and toner. 

• Gently pat your skin dry with a soft towel. Avoid rubbing. 

• Apply a thick moisturizing cream or emollient after washing. Vaseline or Aquaphor can be useful at night.

• Minimize the number of products you use on your face — less is more.

• Makeup can irritate eczema, so avoid using it on affected areas. 

• If you want to use makeup, stick to ones that don’t have common irritants, like essential oils, fragrance, or lanolin.  

• Keep in mind that even products that are labeled “natural” can irritate eczema and sensitive skin. 

What types of rashes can look like eczema on the face?

Eczema on the face can look like other rashes. Sometimes you may need to visit your primary care provider or dermatologist to get the right diagnosis. Here’s a breakdown of common facial rashes and how you can tell the difference between them:  

• Contact dermatitis is a group of skin rashes caused by products that irritate the skin (like harsh detergents) or cause an allergic reaction (like fragrances and preservatives). Contact dermatitis can be very itchy. The rash only appears in areas exposed to the product. 

• Psoriasis is a common skin condition that causes thick pink, red, or brown skin patches with a white or gray scale. Psoriasis is also common on the scalp, behind the ears, and on many other parts of the body.

• Seborrheic dermatitis is a common skin condition that often occurs on the face, especially around the eyebrows, scalp, and inside the ears. It’s caused by a yeast that normally lives on the skin. Unlike eczema, seborrheic dermatitis usually isn’t itchy. 

• Rosacea is a chronic skin condition that leads to persistent skin flushing and acne-like bumps, especially on the cheeks and nose. It can burn and be painful. Unlike eczema, rosacea usually isn’t itchy. 

• Systemic lupus erythematosus is an autoimmune condition that can affect the skin and other organs. It commonly causes a red or violet rash on the nose and cheeks in a “butterfly” pattern. Lupus usually isn’t itchy, but it can cause skin pain and burning. 

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Written by:

Alina Goldenberg, MD, MAS, FAAD

Alina Goldenberg, MD, MAS, FAAD, is a board-certified dermatologist in private practice in San Diego. She is also an assistant clinical professor in the Department of Internal Medicine at the University of California, Riverside School of Medicine.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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