When we think about inflammatory skin conditions, acne tends to be top of mind. But eczema should be right up there, too: Over 30 million Americans suffer from the condition, according to the National Eczema Association. And eczema tends to be a chronic condition, often developing as infants and carrying through a person's entire life. It's also, according to recent research, increasing in children, with one in five children developing the condition (the scientists are unsure of the cause of the rise at the moment). Additional research suggests it's increasing in adults, too.
What is facial eczema, and what causes it?
Eczema, facial or non, is characterized as inflamed, dry skin. It usually appears as itchy, scaly patches, which can pop up anywhere from cheeks and scalp to knuckles and elbows. Facial eczema is often singled out because of the sensitive nature of the face: Not only is it more visible, but the skin tends to be thinner and more reactive.
Eczema is a chronic condition, but what triggers flare-ups is different for everyone. A few common triggers include dry environments, cold weather, irritating personal care products, and allergies. But internal factors can also be at play: Research shows1 that stress is also a common trigger for the disease. The most important thing to remember here is that your skin is unique, and while there are general guidelines you can follow for eczema, you should always listen to your body.
What are the types?
Eczema, you might know, is an umbrella term with many variations that can occur. But there are seven main types of eczema that can affect the face, according to the National Eczema Association. Board-certified and holistic dermatologist Alan Dattner, M.D., who is also the author of Radiant Skin From the Inside Out: The Holistic Dermatologist's Guide to Healing Your Skin Naturally, notes that face-only eczema, meaning you never get patches elsewhere, is usually the result of an allergy or irritant, as people who have systemic atopic eczema typically have it in multiple locations.
- Atopic eczema/dermatitis: The most common form of childhood eczema, this typically appears on the cheeks, knees, and elbows and appears pretty quickly after birth. (It can also appear elsewhere on the body, but they note that the cheeks are usually the first signs.) Kids with eczema typically continue to have sensitive skin into adulthood, when eczema can reappear.
- Seborrhoeic eczema/dermatitis: This is a milder form of eczema and is most common in adults. It's found around the scalp, eyelids, eyebrows, and ears. Dandruff is a common example of the condition; in babies, it's commonly called "cradle cap."
- Allergic contact eczema/dermatitis: Since the face is exposed to many environmental aggressors, sometimes allergens can irritate the skin on the face leading to an eczema flare-up. These can either be existing allergens or allergies that develop over time. Common culprits are fragrances, synthetic or natural included, and certain preservatives like methylparaben or butylparaben.
- Irritant contact eczema/dermatitis: This is usually triggered by personal care products, like harsh soaps, old beauty products, or unwashed makeup brushes. This is similar to allergic contact dermatitis but perhaps more of a one-off instant rather than a regular, recurring problem.
- Light-sensitive eczema/dermatitis: Some people report improved eczema conditions in sunny weather; others find it exacerbates their flare-ups.
How can you treat it naturally?
Treating eczema usually takes a preventive and reactive approach, meaning you should make lifestyle changes to keep flare-ups at bay but also have quality, gentle moisturizers on hand to treat any breakouts that come up.
Identify your triggers.
Perhaps the most obvious step is to avoid things that cause flare-ups. The tricky part, however, is identifying these—especially given that people can develop new triggers at any point in their life. However, Dattner says this is the most important part of treating eczema: If you develop a flare-up, he suggests evaluating everything you've done or come into contact with for the past 48 hours, from products to plants to food. Consider starting a trigger diary, where you can log your skin care chronicles; this will help you identify patterns.
Pare back your personal care routine and household cleaners.
Those with eczema should look closely into what ingredients are in their personal care and household items. As a general rule of thumb, the more bland, the better. This means be on the lookout for fragrances, strong actives (like AHAs or retinols), potent surfactants (like sulfates), and certain preservatives (like those mentioned above). And remember, "natural" doesn't mean it's eczema-safe: Many essential oils, for example, are too fragrant for some.
Keep your skin moisturized with natural emollients.
Emollients are ingredients in moisturizers that soothe and soften the skin, making them ideal for inflammatory skin conditions. Finding one that works for you might take a little guess-and-test, says Dattner. "You never know what your trigger is going to be, so you might have to experiment," he says. "I usually recommend oils. Creams are obviously sensorily appealing, but you just want to make sure that you're not allergic to the preservatives in those. Again, most people aren't, but you need to know your own skin."
There are quite a few at-home, natural remedies that have received anecdotal praise, from honey face masks2 to oatmeal baths3. These ingredients are emollients and have skin-soothing properties—and even some smaller clinical studies pointing to their positive effects but no sweeping conclusions from the research community. But overall, the advice remains the same from Dattner: Spot-test first, and remember that everyone is different. Just because it was effective for someone you follow on Instagram doesn't mean it will work for you.
Use the right makeup products.
Makeup products can be challenging. Liquid foundations and mascaras can be common triggers, likely due to the higher levels of preservatives. Opt for mineral-based options, and try natural mascaras (this isn't to say these can't be irritating for some; remember to test these out first to make sure they're compatible with your skin. Also consider looking for labels that are hypoallergenic). Also: Toss your old makeup and clean your brushes at least every two weeks. Both are a breeding ground for bacteria, and you can easily trigger irritant contact dermatitis. For severe flare-ups, you might be instructed to skip makeup entirely.
Use microbiome-friendly products.
The emerging research on the skin microbiome suggests that having a balanced skin flora is essential to limiting flare-ups. Two strains in particular—Staphylococcus aureus4 and 4Staphylococcus epidermidis4—are shown to be associated with the condition, although more research needs to be done. (For our selects on the best microbiome-boosting products, check out this list. However, be sure to read the individual ingredient labels and spot-test, as noted above. As everyone has different triggers, you'll want to ensure there are no additional ingredients that are irritating to your skin; everyone is different.)
Visit a doctor or dermatologist.
As with any skin condition, you should consult with your health care provider. Dattner says that for eczema conditions, find a dermatologist who also does patch-testing for allergies. He also recommends coming prepared with your skin's history—suspected triggers, length of flare-ups, your regular diet, and so on—which will help the dermatologist.
Remember: Sometimes flare-ups are unavoidable.
"I think most people think that if they work really hard at it—skin moisturization, diet change, allergen avoidance—they can control eczema and eliminate flare-ups," says double-board-certified dermatologist Latanya Benjamin, M.D, FAAD, FAAP. "Initially, I teach my families to expect occasional flare-ups, despite their best care. Even when the skin is under better control, eczema can still flare for many reasons, including catching a common cold, battling a skin infection, or becoming overheated during play."
Bottom line: You can listen to your body and do your best, but if you still get a flare-up here and there, be kind to yourself.
Alexandra Engler is the beauty director at mindbodygreen and host of the beauty podcast Clean Beauty School. Previously, she's held beauty roles at Harper's Bazaar, Marie Claire, SELF, and Cosmopolitan; her byline has appeared in Esquire, Sports Illustrated, and Allure.com. In her current role, she covers all the latest trends in the clean and natural beauty space, as well as lifestyle topics, such as travel. She received her journalism degree from Marquette University, graduating first in the department. She lives in Brooklyn, New York.