Eczema On The Face - Types, Stages And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Eczema on the face

Eczema on the face is an inflammation of the skin that is chronic and of a neuro-allergic nature. The disease is accompanied by the appearance of polymorphic rashes on the face, passing through several stages.

Eczema is an extremely common disease, which among all skin diseases is diagnosed in 15-40% of cases. Eczema is not a contagious disease, it is not transmitted from one person to another. Both men and women suffer from eczema alike. In childhood, eczema in one form or another is diagnosed in every 15 children.

Types and stages of eczema on the face

There are several types of eczema on the face, the most common of which are:

1. True (idiopathic) eczema. This type of eczema is characterized by a chronic course, has a tendency to frequent exacerbations. The foci of inflammation are symmetrical.

   The stages of true eczema are as follows:

   • The skin of the affected area becomes very red and swollen.
   • Small bubbles and nodules (papulovesicles) appear on the skin.
   • Papulovesicles open after a short time interval, leaving behind pinpoint erosion.
   • Serous exudate begins to stand out from erosions, eventually forming an extensive weeping area of the facial skin.
   • The exudate tends to dry out, forming yellow-gray crusts.
   • A new epithelium is formed under the crust.
   • The affected skin is itchy and flaky.

   The whole process, from hyperemia of the skin and ending with the formation of a new epithelium, occurs in waves. Repeatedly repeated, eczematous lesions lead to tightening of the skin of the face, strengthening of the skin pattern on it, and the formation of infiltrated areas.

   Apart from the face, true eczema often affects the skin of the feet and hands. Subsequently, the disease spreads to the trunk, to the lower and upper limbs.

2. Seborrheic eczema. This type of eczema also quite often affects the skin of the face and scalp in general. The rashes are mainly located on the forehead, in the eyebrows, along the hair growth zone, in the folds of the nasolabial triangle behind the ears, around the mouth. Even if seborrheic eczema is localized only on the scalp, it will still over time capture the hair growth zone and forehead. In this case, the red border, which experts call the seborrheic crown, will stand out as a bright stripe. (read also: Causes and symptoms of seborrheic eczema)

   In addition, seborrheic eczema of the scalp also affects the neck with folds behind the ear. After draining, a large lesion is formed, which is called an eczematous helmet.

   The stages of seborrheic eczema of the skin of the face are as follows:

   • At the beginning, pinkish-yellow nodules appear on the skin of the face. They are small in size.
   • As the disease progresses, the nodules merge with each other, forming infiltrated plaques. The plaques are disc-shaped.
   • The size of the plaques can reach 10 mm, from above they are covered with fatty skin scales, which fit tightly to each other.
   • If the scales are removed, a damp surface will be found under them.
   • No pronounced wetness is observed.

   • Seborrheic eczema does not acquire clear boundaries, has uneven edges.
   • If the initial stage of the disease is characterized by a dry surface of eczema, then later it becomes greasy.
   • Resolution of seborrheic eczema occurs from the middle of the lesion. As a result, plaques form in arcs or rings.
   • When eczema is treated correctly, the patient's skin does not undergo any radical changes and is completely restored.

   For seborrheic eczema, itching is not characteristic, if it does appear, it does not cause severe discomfort to the patient.

   In addition to the facial skin, seborrheic eczema can affect the chest, armpits, elbow and knee folds, the back area, and the skin between the shoulder blades.

3. Microbial eczema. Considering microbial eczema with localization on the face, it is worth noting separately the sycosiform type of the disease. It is this shape that most often affects the beard and upper lip.

   The disease goes through the following stages:

   • There is a pustular lesion of the hair follicles, which is often provoked by Staphylococcus aureus.
   • The skin swells and turns red, itching appears.
   • The hyperemic areas, covered with pustules, begin to get wet.
   • As the disease progresses, the inflammatory process may exit the areas of hair growth.

   Often, microbial eczema on the face occurs against the background of an already existing sycosis.
4. Other forms. Occupational eczema, atopic eczema and other forms of microbial eczema (nummular, varicose, etc.) on the face are extremely rare.

Treating eczema on the face

Treatment for facial eczema will depend on what type of disease the patient has been diagnosed with.

Treatment for true eczema on the face

When a patient seeks help from a specialist with acute true eczema, the doctor, first of all, will prescribe first generation antihistamines to him. These can be drugs such as: Mebhydrolin, Chloropyramine, Promethazine, Akrivastin. Then, as the inflammation fades away, the transition to third or second generation drugs is carried out: Ebastine, Cetirizine, Loratadin, Terfenadine and others.

When the inflammatory process does not subside, and eczema continues to progress, a specialist may recommend taking oral corticosteroids: Betamethasone, Prednisolone.

If the inflammation process is very pronounced, and the exudative manifestations do not subside, then the doctor prescribes intramuscular injections of Calcium gluconate.

Local therapy is reduced to the use of astringents. For this, patients can be recommended lotions with a solution of Tannin or with a solution of Resorcinol. These funds help to reduce the formation of exudate, forming a protective film, do not allow external stimuli to have a negative effect on tissue repair.

Furacilin solution will help to relieve inflammation and promote disinfection of the affected area.

Doctors do not recommend applying ointments that have an antibacterial effect and contain corticosteroids on the face, unless the disease is complicated by a secondary infection and is not severe. The need to use such powerful agents can only be confirmed by a specialist after a diagnosis. Such funds include: Advantan, Belogent, Beloderm, Hydrocortisone, Prednisolone ointment, Lorinden S, Elokom, Fucidin, Photocort, Sinaflan, etc.

When the inflammation has been relieved, physiotherapy treatment is possible. Effective techniques are: phototherapy, laser therapy, cryotherapy, PUVA therapy, ozone therapy, magnetotherapy. It is imperative to adhere to a dietary diet, which provides for the rejection of salty and spicy foods, from fatty foods, from smoked meats and other potential allergens. A dairy-based diet is a priority for true facial eczema.

Vitamin therapy helps to speed up the process of tissue repair. For this, the patient is prescribed a course intake of vitamin B1 (up to 15 days), vitamin B6 (up to 60 days), vitamin C (up to 10 days).

Treatment of seborrheic eczema on the face

Treatment for seborrheic eczema on the face will depend on the severity of the condition. If it is mild, then it is enough to use only local therapy. When the disease is severe, systemic therapy is indicated.

The doctor may recommend treating the face with antimycotic compounds in the form of ointments, creams. Sometimes the use of combined agents with corticosteroid hormones and antibacterial components is required. Treatment can continue for a month.

• Such face products as Nizoral cream, Nystatin gel, Eplan, Bepanten, Panthenol, Exoderil, Elidel, Videstim and others are effective.
• Facial skin treatment can be carried out with the help of such means as: salicylic ointment, white mercury ointment, sulfur-resorcinol ointment.
• The head must be washed with shampoos containing an antimycotic component: Keto plus, Mycozoral, Nizoral, Sebozol, etc.
• No less important is the diet, which involves the exclusion of fatty, spicy, sweet, fried foods from the diet. This will help to reduce sebum production and get rid of the disease as soon as possible.
• Patients with seborrheic eczema should refuse to visit steam rooms, baths and saunas. Means for skin and hair care should be selected with great care, it is better to consult a dermatologist beforehand.
• Physiotherapy procedures such as laser therapy, darsonvalization, cryotherapy, and manitotherapy have proven themselves in the fight against eczema.

If the disease is complicated by a secondary infection, then the use of antibacterial drugs, both systemic and local, is indicated. Vitamin therapy is reduced to taking vitamins B6 and B1.

On the subject: treating seborrhea at home - 6 most effective recipes

Treatment of microbial eczema on the face

If sycosiform microbial eczema is detected, then the patient is prescribed antibacterial drugs. To make the treatment as effective as possible, it is necessary to pre-sow the flora. This will determine the sensitivity of the causative agent of sycosiform microbial eczema.

Most often, second-generation cephalosporins, macrolides, fluoroquinols and aminoglycosides are used for treatment.

For local treatment, the following antimicrobial agents can be used: Tetracycline ointment, Erythromycin ointment, Levomekol ointment, Gentaxan, Baneocin, Isotrexin, Fuziderm, etc.

Often, a microbial infection is complicated by a fungal infection. In this case, the intake of antimycotics inside and the application of antimycotics topically is indicated. Sometimes, preliminary therapy is required for the patient's sycosis. With extensive lesions, it is necessary to introduce a staphylococcal vaccine, autohemotransfusion.

It is worth remembering that self-treatment of any skin lesions is unacceptable, especially when it comes to such a serious disease as eczema on the face. Seeking help from a specialist (dermatologist) is mandatory.

The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist

Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).