Dermatologists Explain How to Treat Facial Eczema and Prevent Flare-Ups

While eczema (also known as atopic dermatitis) is a common skin condition — 20 percent of children and two percent of adults worldwide suffer from eczema according to Dr Catherine Borysiewicz, consultant dermatologist at the Cadogan Clinic — it's not an easy skin condition to deal with. And when when it comes to facial eczema, calming and treating it can be a little more complex and requires slightly different management than with eczema on the rest of your body. But rest assured that there are ways you can manage facial eczema, you just have to know how, when, and what to treat it with. We spoke to leading dermatologists and skin experts in the UK to explore the best ways to treat eczema on the face.

How Does Eczema on the Face Differ From Eczema on the Body?

"The reasons for developing eczema are complex and multifactorial and consist of genetic and epigenetic factors. Most of the inherited genetic factors lead to physical and immunological disruption of your skin barrier," said Dr Borysiewicz. But while the skin condition and its causes are the same, eczema on the face should be treated a little differently to eczema on the body. "The skin on the face is more fragile, so should be treated differently from the rest of the body, especially around the eyes and the neck," said Dr Amélie Seghers, consultant dermatologist at London's Cadogan Clinic and author of Eczema, How to Ditch the Itch. The basic principles of calming eczema down remain the same as the body (if you want more information on eczema advice for the body, read up on this guide with tips from five leading experts), which includes avoiding fragrance and soap products and replacing them with products containing ceramides and glycerin.

However, unlike the body, when it comes to the face, you've also got to avoid clogging pores and causing breakouts whilst treating your dry, itchy skin. "With combination skin, very heavy moisturisers may bring on breakouts of acne. In this situation, an oil-free moisturiser should be used instead," said Dr Sharon Wong, leading UK-based consultant dermatologist and hair specialist. Dr Seghers recommended using lighter moisturisers, especially on the T-zone, as this will avoid clogging pores and, in turn, prevent spots.

You will also find that the strength of steroid creams used to settle patches of eczema will be weaker on the face when compared with the body. This is because the skin on the face is much thinner, Dr Wong explained, so it requires a lower-strength formula.

A Dermatologist-Recommended Skin-Care Routine For Someone With Facial Eczema

You might be wondering what a skin-care routine looks like when you've got eczema on your face, and the good news is it doesn't have to be overcomplicated and expensive. "The creams don't have to be expensive; just reputable, safe brands with effective ingredients and minimal irritants," said Dr Ismat Nasiruddin, doctor at the Pulse Light Clinic.

Dr Wong broke down a simple skin-care routine for someone with eczema. "Remove makeup with a double cleanse method, first using micellar water, followed by a cream-based emollient wash. Next, any prescribed steroid creams or ointments should be applied on the patches of eczema and left for 20-30 mins before any moisturiser is applied," she explained.

"For sunscreen, choose a mineral rather than chemical formula, as it works better for sensitive eczema-prone skin. However, do not apply SPF during an eczema flare up," and avoid over exposure of the sun.

How to Treat Eczema on the Lips

Eczema on the face also includes, you guessed it, the lips. "Eczema affecting the lips can be particularly uncomfortable, causing redness, dryness, and flaking," said dermatologist Dr Emma Wedgeworth. "Eczema on the lips develops for two reasons: firstly, the skin dries out excessively, and secondly, immune cells which cause inflammation result in redness and irritation."

There are two causes: external triggers, including cold weather, skin-care irritation, indoor heating, and air conditioning. Or, your skin doesn't hold water as well and your immune system produces more inflammatory cells. Despite its challenges, there are ways you can help stop soreness caused by eczema on the lips. Dr Wedgeworth noted the first thing to try and avoid is repeatedly licking your lips, as this just exacerbates the problem. Then, you should consider potential allergies, "the most common culprits being lipstick, toothpaste, metals in dental implants, and even unusual causes such as nail polish," Dr Wedgeworth added.

To combat dry and sore lips caused by an eczema flare-up, Dr Wedgeworth said that a moisturising lip product is essential. "Look for ingredients like lanolin and cocoa butter, which can boost your skin's natural moisturising factors. I like Blistex's Med Plus." She recommended reapplying a generous amount regularly, noting that if it doesn't help to clear the eczema up, you should visit your doctor.

Facial Eczema and Maskne

Now, we can't not mention the coronavirus pandemic's impact on eczema, because it definitely exacerbates the condition, particularly when it comes to wearing a mask. "Maskne (mask acne) is a thing," said Dr Wong. "Acne breakouts around the lower cheeks and jaws due to the moisture, friction, and heat from mask wearing has become a common problem; as has allergic contact dermatitis from some components of the masks," she explained.

So, how can we resolve the issue? It's important to first note that you should continue wearing your mask because it's essential protection against COVID-19. "Before wearing a mask for prolonged periods, make sure the skin is cleansed with a soap-free, fragrance-free, and oil-free product, followed by an oil-free moisturiser to protect the skin barrier," Dr Wong recommended. She also suggested avoiding wearing makeup (specifically foundation) that may clog your pores (we love Oxygenetix to provide coverage with zero clogging). "If you have active eczema on your face, it's important to remember that your skin barrier is not as protective, which means bacteria and viruses can enter the skin more easily," said Dr Seghers. Because of this, it's vital that you wash your reusable mask often.

If you have more severe acne and dermatitis, Dr Wong recommended seeing your GP or dermatologist, as you may need specific prescription medications to settle the condition.