What to know about facial eczema on skin of color

People with darker skin tones and those with lighter skin tones may share some common eczema symptoms. The affected skin can become:

• inflamed
• itchy
• dry
• painful or uncomfortable

Symptoms may last for a short period and resolve on their own. In some people, eczema symptoms on the face may last for longer.

When facial eczema first appears in people with darker skin tones, the affected areas often appear darker than the surrounding skin due to the effect of inflammation on the pigments. As the eczema goes away, the affected area of skin may appear lighter than the surrounding areas.

A person may also develop wrinkled skin due to rubbing their eyes. People with atopic dermatitis may develop permanent folds under their eyes. This is a genetic condition known as Dennie-Morgan folds.

In infants, the first sign of eczema may appear around the cheeks. It may then spread to the mouth and other areas of the body. In infants and children with skin of color, the affected areas will appear darker and be itchy, flaky, or weepy.

Find out more about eczema in children.

The exact cause of eczema remains unknown. However, experts believe it may result from genetic and environmental factors. People with eczema tend to have overactive immune systems that respond to environmental triggers.

Triggers are any factors that cause a person’s eczema symptoms to flare up and worsen. Some common triggers of eczema flare-ups include:

• environmental effects, such as sunlight and changes in temperature
• contact with soap, detergents, makeup, or other products used on the face
• exposure to smoke, pet dander, or other airborne substances
• exposure to certain chemicals
• contact with different materials, such as latex or wool

Types on the face

“Eczema” is an umbrella term that refers to several different types of skin conditions. Seborrheic dermatitis is one of the most common forms affecting adults. This subtype typically appears on oily patches of skin, such as the scalp and the face.

Sunlight is a common trigger that often affects atopic dermatitis and seborrheic dermatitis. Limiting exposure may help prevent a flare-up.

Another common type of eczema to affect the face is contact dermatitis. This typically occurs due to contact with a specific chemical, material, or allergen.

In children, the most common type of eczema is atopic dermatitis.

The skin on the face is generally more sensitive to topical treatments, which can make treating facial eczema more difficult. Doctors typically need to consider the possibility of an allergic reaction to treatment when managing facial eczema.

Proper diagnosis of the type of eczema can help guide treatment. Eczema is a chronic condition with no cure. Treatment typically focuses on preventing flare-ups and managing symptoms when they occur.

Treatment may involve the use of topical steroids to reduce symptom severity. However, due to the skin’s sensitivity, doctors typically only use low to moderate concentrations.

To help prevent flare-ups, a doctor may recommend using topical calcineurin inhibitors.

There are no specific treatments for the skin lightening that may occur after eczema heals in people with darker skin tones. Over time, the skin should start to return to its previous tone.

Management will involve the use of moisturizers to help prevent dryness and sunblock to limit sun exposure. A person may also try:

• avoiding products that may trigger the facial eczema
• using gentle soaps or emollients when washing the face
• applying emollients twice a day to help soften the skin
• applying sunblock and wearing hats when going outside
• keeping the skin moisturized
• patting the skin dry
• removing makeup thoroughly and discontinuing use if it may be irritating the skin
• removing nose or lip rings that may be causing a reaction

It is not always possible to prevent flares, but a person can take steps to help keep eczema symptoms from returning or being as severe.

Some steps to help prevent eczema flares on the face include:

• using topical calcineurin inhibitors as directed
• applying sunscreen when going outside
• keeping the skin on the face moisturized
• avoiding known triggers, which may include certain cosmetics or soaps, or exposure to smoke, dust, or other chemicals or allergens
• carefully and fully removing any makeup at the end of the day
• using products labeled as natural, dermatologist tested, or hypoallergenic to help avoid allergens
• avoiding toners and abrasive scrubs on the face

Eczema on the face is a chronic condition. A person may experience severe symptoms that last for a while and reduce their quality of life, or they may experience only mild symptoms that last for a few days or weeks.

Once eczema clears, a person can manage triggers and help prevent new flares from occurring.

People with darker skin tones should remember that as eczema clears, the affected skin may become lighter than the surrounding areas. Although no specific treatment exists for this, the skin tone should even out over time.

Eczema on darker skin tones can appear darker than on lighter skin, or it may appear gray, pink, or purplish-red. A person will also likely experience dry, itchy, and uncomfortable patches.

When eczema begins to clear, a person may notice that the affected area becomes lighter in color. This should return to the previous skin tone over time.

Eczema on the face is more challenging to treat than on other areas due to the skin’s sensitivity. A person can typically use lower concentrations of steroids and preventive medications. They may also manage their eczema by using a careful selection of skin care products, moisturizing daily, avoiding triggers, and wearing sunscreen.

With management, a person may be able to reduce the severity of their flare-ups and help prevent new flare-ups from occurring.