Eczema on the Face: What Treatment Is Available?
Eczema on the face is visible, often very itchy, and can affect confidence. Facial skin is also thinner and more sensitive than skin elsewhere, so treatment needs to be both effective and carefully chosen.
Why facial eczema is different
Facial skin is thinner, so it absorbs creams more readily.
It is exposed to weather, sun, cosmetics, fragrance and shaving.
Common sites include the cheeks, around the mouth, the eyelids, the forehead and behind the ears.
In babies, the cheeks are often the first place eczema appears.
Treatment options
Moisturisers and gentle cleansing. Use a fragrance-free moisturiser several times a day and wash with a soap substitute rather than soap or facial cleansers.
Mild topical steroids. Used correctly, for limited periods, mild-strength steroids are safe and effective on the face. Stronger steroids are generally avoided on the face except under close medical supervision, because of the higher risk of skin thinning and other side effects with prolonged use.
Steroid-free anti-inflammatory creams. Calcineurin inhibitors (tacrolimus ointment and pimecrolimus cream) are licensed for eczema and do not thin the skin. They are often used on the face and eyelids, and for maintenance. They can sting for the first few days.
Treating bacteria. Weeping, crusting or a flare that will not settle may indicate bacterial involvement, which needs to be treated alongside the inflammation.
Individualised combination treatment. At eczema-doc, facial eczema is treated with a carefully tailored plan that uses a lower steroid strength for the face than for the body, combined with barrier and bacterial care, and closely reviewed.
Things that can make facial eczema worse
Fragranced skincare, make-up and hair products
Hair dye and some sunscreens (contact allergy)
Wind, cold and heat
Hot showers and harsh cleansers
Touching and rubbing the face
If eczema is limited to the face, or appears where products touch the skin, contact allergy should be considered.
Is it definitely eczema?
Other conditions can look similar on the face, including seborrhoeic dermatitis, rosacea, perioral dermatitis and fungal infection. Some of these are made worse by steroids, which is why an accurate diagnosis matters.
Seek urgent care if…
there are painful blisters or sores on the face, especially near the eyes, or the eye itself becomes painful, red or sensitive to light.
Book a video consultation for facial eczema.
This article is for general information and does not replace individual medical advice.