There are often friends and acquaintances who send photos to consult about facial skin allergies, and there are also many friends who leave messages on the WeChat platform asking about facial dermatitis. Although facial skin only accounts for 1% of the body surface area, it is a matter of face, and some patients even have trouble sleeping and eating because of it. Therefore, in this issue, we will learn about facial dermatitis and related skin care to maintain our “face”. What is dermatitis facialis? First of all, there is no such disease in the textbooks!
So what is facial dermatitis?
Simply put, facial dermatitis is a dermatitis that occurs on the face. The name only describes a skin manifestation and does not diagnose the characteristics or causes of facial dermatitis, so the next step is for a professional dermatologist to look for the cause of facial skin inflammation and make a more precise diagnosis. The initial diagnosis of “fever” can be made when the body temperature exceeds 38 degrees, but the cause of the fever may be a bacterial or viral infection, or it may be an autoimmune disease or tumor causing the fever, which requires further testing to clarify.
What are the causes of facial dermatitis?
1. Atopic dermatitis/eczema
Atopic dermatitis in infancy occurs most often on the cheeks and often shows oozing and crusting in addition to skin erythema. In older children, eczema often appears around the eyes, mouth, and ears as dry flaking on erythematous patches. Because atopic dermatitis patients’ skin is more sensitive to environmental factors, some patients will have recurrent facial dermatitis into adulthood.
2, seborrheic dermatitis
The facial follicles are rich in sebaceous glands and are a good site for seborrheic dermatitis, which appears as erythematous, greasy or dry scales around the arch of the eyebrows and nose, as well as in other seborrheic areas such as the scalp, chest and back, armpits and groin. seborrheic dermatitis is one of the most common causes of facial dermatitis in male patients over the age of 20, and the condition has a chronic course of flare-ups-remission-episodes.
3, irritant contact dermatitis
Some of the ingredients in the various cleansing and washing products used on the face can easily cause skin irritation, especially various soaps, cleansing foams, exfoliating products, skin softeners and toners, makeup products, sunscreens and shaving foams. For patients with sensitive facial skin or dermatitis, these products may cause skin irritation, which can manifest as tingling, burning, dryness and tightness, and in severe cases, visible redness and edema. Sometimes hot and humid environments, overly dry environments, cold winter winds or atmospheric pollution (PM10 or PM2.5) are also potential irritants. If dermatitis recurs around the mouth, the irritants to be considered may originate from various foods, saliva, bad habits of licking the lips or toothpaste, etc.
4.Allergic contact dermatitis
Allergic contact dermatitis is a common cause of facial dermatitis. Allergens most often originate from cleaning and skin care products, with fragrances (both natural and synthetic) and preservatives added to various products being the most common, and ingredients in hair dyes and nail polish also being more common. Allergic contact dermatitis usually does not occur at the first contact with the allergen, but requires a period of exposure to the sensitization process. Dermatitis mostly occurs at the site of direct contact and is accompanied by significant itching symptoms. Sometimes allergens floating in the air can also cause allergies, such as volatile chemicals in the air or aerosols, which are more often seen in occupational exposure.
5, photosensitive dermatitis
The face is a light-exposed area. If you find that facial dermatitis is often aggravated after sun exposure or in spring and summer, it may be related to ultraviolet light. Some patients with facial eczema or seborrheic dermatitis may also have a rash that worsens after UV exposure. Facial dermatitis may also occur in some patients exposed to sunlight after taking photosensitizing medications or ingesting photosensitive foods.
6, Rosacea
Rosacea can present early as episodes of flushing, midface or perioral erythema, and is often diagnosed as facial dermatitis. The main cause of rosacea is a dysregulation of the vascular response of the face and inflammation of the sebaceous glands of the hair follicles, and in severe cases there will be papules and pustules, treatment is based on internal medication, the course of treatment is longer, and facial inflammation is prone to recurrence.
7.Hormone withdrawal dermatitis
Sometimes also called “hormone dependent dermatitis”, it is mainly a local side effect caused by long-term irregular external use of glucocorticoids or the use of non-compliant skin care products that may contain hormones, manifesting as skin thinning, capillary dilation, and folliculitis.
8.Psoriasis
Psoriasis occurring on the head and face is often confused with seborrheic dermatitis, which manifests as erythema at the hairline of the scalp, forehead, and around the nose, with thin flaking on the surface. Typical psoriatic lesions can sometimes be seen on other parts of the body such as the lower legs, elbows, or lumbosacral region and can aid in the diagnosis. Sometimes skin biopsy pathology may also be needed to help with the diagnosis. There are actually many other skin conditions that cause facial skin inflammation, and the above are the various conditions most commonly seen in outpatient clinics. When a doctor has diagnosed facial dermatitis, he or she should also look further for possible causes and make a more precise diagnosis.
How is facial dermatitis treated?
Since there are many causes of facial dermatitis, some patients may also have two or even more causes at the same time. For example, patients with facial seborrheic dermatitis may develop allergies to certain product ingredients during the use of facial skin care products and gradually or suddenly experience an increase in seborrheic dermatitis, when allergic contact dermatitis is another cause in addition to seborrheic dermatitis. Therefore the treatment of facial dermatitis due to different causes will vary, and usually the doctor will develop a treatment plan based on a judgment of the cause of the dermatitis. (Note: This is why many patients send photos online to inquire about how to treat facial dermatitis, and we cannot give the most suitable treatment plan because the etiological judgment cannot be made based on a photo alone.)
Of course for facial dermatitis, there are some general treatment principles.
1. different treatment options for different causes. In most cases, patients with facial dermatitis have more sensitive skin and therefore need to avoid various irritants such as spicy foods, alcoholic beverages, hot and overheated environments, sun exposure and complicated skin care procedures.
2, the correct skin care method, do a good job of basic skin care three links: cleaning – moisturizing – sunscreen. Recommend the choice of medical skin care brands with simple functions and safe ingredients.
3, the treatment of various facial dermatitis topical drugs are mainly weak glucocorticoids, this type of drug is usually safe to use within 2 weeks of continuous use, it should be noted that some over-the-counter weak hormone products have added mint or camphor-like ingredients, the purpose of which is to quickly relieve itching symptoms, but may cause the hormone ingredients to be more easily absorbed due to vasodilation. Sometimes doctors will prescribe strong topical hormones according to the condition, so it is important to follow the doctor’s instructions and follow up on time, and use them correctly under the doctor’s guidance in order to avoid the local side effects of hormones.
4. When there is dermatitis around the eyes and glucocorticoids need to be used, you must tell the doctor whether you are suffering from cataract or glaucoma. Long-term use of glucocorticosteroids in the periocular area may cause an increase in intraocular pressure or aggravation of cataract, so be sure to follow the doctor’s instructions for regular follow-up in dermatology and ophthalmology.
5. Non-hormonal anti-inflammatory drugs (tacrolimus and pimecrolimus) are also effective for facial dermatitis and usually require a doctor’s prescription based on the condition and efficacy before they can be used, avoiding exposure to the sun during medication and following medical advice for regular follow-up.
6, cold wet compress is sometimes a way to relieve itching, skin redness, it is recommended to use cold (can be placed in the refrigerator freezer) saline (not their own salt prepared with salt), pure water or distilled water for cold wet compress, mineral water or tap water in the mineral may be in the wet compress after the residual in the skin surface aggravate skin dryness, not recommended. Be sure to use a safe medical moisturizer after the cold wet compress.
Practical care tips for patients with facial dermatitis
1, cleaning helps to remove dirt, scales, etc. from the skin surface. It is recommended to wash the face every day with a mild soap-free cleansing product, or you can choose some leave-on cleansing products with moisturizing effects.
2, after washing the face to use a clean towel or paper towel to gently pat dry or dip the skin dry, rather than force dry skin.
3. Avoid using soaps, alkaline cleansers, exfoliating scrubs or toners, etc. applying topical medical moisturizer at least twice daily to tight, dry areas of facial skin.
4. Avoid using moisturizing cosmetics that contain more potentially allergenic ingredients and recommend using medical skin care products with better safety.
Skin care products labeled as “natural”, “pure plant”, “dermatologist tested” or “hypoallergenic” are not 100% safe. They are not 100% safe and may cause irritation or allergic contact dermatitis in some patients with very sensitive skin. Makeup may aggravate dermatitis, especially liquid foundation, mascara, etc. Avoid using it on dermatitis areas. Sometimes the hands may act as a medium to cause facial allergies, for example, allergens in nail products may get on the face through the hands.
If you suspect that the skin care products you use may aggravate your dermatitis, stop using all products, or choose new medical skin care products with a better safety profile, and add one product at a time for two weeks to confirm whether it will aggravate your dermatitis.