Facial Eczema: Images, Symptoms, Causes, and Treatments

Eczema can affect any part of the body, but it’s especially frustrating when it happens on the face. Facial eczema leads to dry, discolored patches that can itch or hurt. And, because it’s so visible, it can have a significant impact on your daily life. 

Here, we’ll take a closer look at the different causes of eczema on the face. We’ll also touch on common triggers that can make it worse, along with the best treatments to help you manage your 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

Eczema around the eyes and eyelids

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

• More lines around the eyes

• Swollen eyelids

• Red and irritated eyes

Eczema around lips and mouth

Sometimes, facial eczema can involve the skin around the mouth. This can lead to:

• Dry and flaky patches 

• Painful cracking or splitting

• Itching

• Red or brown discoloration

What does eczema look like on the face?

Here are some photos of eczema on the face to help you see what it looks like on different skin tones.

What causes facial eczema to develop?

There are a few different causes of facial eczema, and all of them can cause itchy patches on your face. Here are some of the most common ones:

• Atopic dermatitis is the most common type of eczema, and it’s caused by a breakdown of the skin barrier. This is the outermost layer of skin that protects you from outside toxins and locks in moisture to keep skin hydrated. Atopic dermatitis can happen because of a person’s genetics, environment, or a combination of both. 

• Seborrheic dermatitis (dandruff) is caused by an overreaction to a yeast that normally lives on the skin. 

• Allergic contact dermatitis is when you develop an allergy to a certain product or item that touches your skin (like nickel or poison ivy).

• Irritant contact dermatitis happens when your skin becomes irritated by a specific product (like chemicals or harsh soaps). 

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What triggers facial eczema?

There are many triggers for eczema on the face. They can vary from person to person and differ based on what’s causing the eczema.

Atopic dermatitis

Atopic dermatitis triggers include anything that can disrupt the skin barrier. Here are some common ones, plus ways to prevent them from causing an eczema flare:

• Weather changes: Try to avoid going between extreme hot and cold temperatures.

• Stress: Find ways to manage physical and emotional stress.

• Skin irritation: Avoid excessive exfoliation and harsh soaps, and be sure to moisturize regularly. 

• Certain fabrics: Stick to breathable materials (like cotton and silk) and avoid rough ones (like wool or polyester).

• Irritants: Avoid fragrances, dyes, formaldehyde, and other strong chemicals in products you use. 

Seborrheic dermatitis 

Some common triggers for seborrheic dermatitis include:

• Stress

• Hormonal changes

• Some medications (like lithium)

• Harsh hair products (like some chemicals and soaps)

Allergic contact dermatitis 

Many different products and exposures can cause an allergic skin reaction. Sticking to hypoallergenic skin care products can help you avoid facial eczema. Here are some common triggers to watch out for:

• Cosmetic ingredients (like hair dye and fragrances)

• Metals (like nickel or cobalt)

• Rubber and latex

• Some plants (like poison ivy and sunflowers)

Irritant contact dermatitis

Many different products can also cause irritant contact dermatitis. Common ones include:

• Cleaning products (like bleach and chlorine)

• Water (like with frequent hand washing)

• Personal care products (like ones with sodium lauryl sulfate)

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

How do you treat eczema on the face?

Treatment for facial eczema depends on what’s causing it. For example, If you have allergic or irritant contact dermatitis, avoiding the specific trigger is usually enough to clear the eczema. 

For other types of eczema, different treatments may be needed. No matter what you use, it’s important to remember that your facial skin is thinner and more sensitive than other parts of your body. So some treatments that work on the body shouldn’t be used on the face. Here are some over-the-counter (OTC) and prescription options. 

OTC facial eczema treatments

Sometimes, OTC products are good enough to treat facial eczema. Options include:

• Thick emollients, like Eucerin cream or Aquaphor 

• Hydrocortisone 1%, a low-strength steroid cream (don’t use for more than a week because it can thin out the skin)

• Dandruff shampoo (for seborrheic dermatitis, apply to the skin in the shower and then wash after a few minutes)

• Antihistamines (which can help with the itch from atopic dermatitis)

Prescription facial eczema treatments

Sometimes, stronger treatments are needed for facial eczema. Prescription antifungal creams (like ketoconazole) can be used for seborrheic dermatitis. 

For facial eczema caused by atopic dermatitis, here are some prescription-strength options: 

• Stronger corticosteroid creams, like desonide

• Nonsteroidal anti-inflammatory (NSAID) creams, like Elidel, Eucrisa, and Opzelura

• Antihistamines, like hydroxyzine

• Systemic treatments for severe cases, like Dupixent or Rinvoq

• Targeted light therapy (the excimer laser)

Good skin care for 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 other common facial rashes and how you can tell the difference between them:

• 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. 

• 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. 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. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and 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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