What is the treatment for facial dermatitis?

From the Guidelines

To treat facial dermatitis, start with identifying and avoiding potential triggers and use a gentle, fragrance-free cleanser and moisturizer, then consider topical corticosteroids or non-steroidal alternatives like tacrolimus or pimecrolimus for mild to moderate cases, as recommended by the most recent guidelines 1. When managing facial dermatitis, it's crucial to prioritize the patient's quality of life and minimize potential side effects.

• Identifying and avoiding triggers such as harsh skincare products, allergens, or irritants is the first step.
• Using a gentle, fragrance-free cleanser like Cetaphil or CeraVe and applying a moisturizer containing ceramides twice daily can help repair the skin barrier.
• For mild cases, over-the-counter 1% hydrocortisone cream can be applied sparingly twice daily for up to 7 days, but it's essential to use the lowest effective strength due to the thinner skin on the face and its higher propensity for steroid side effects.
• If symptoms persist or are more severe, prescription treatments may be necessary, including stronger topical corticosteroids for short-term use or non-steroidal alternatives like tacrolimus (Protopic) 0.03-0.1% or pimecrolimus (Elidel) 1% cream twice daily for 2-4 weeks, which are safer for facial use as they don't cause skin thinning 1.
• For seborrheic dermatitis, antifungal creams like ketoconazole 2% may be beneficial.
• It's also important to consider the role of oral Janus kinase inhibitors for moderate-to-severe atopic dermatitis, as they offer a highly effective and fast-onset treatment option, although patient selection is crucial due to potential adverse effects 1.
• Always apply medications to clean, slightly damp skin, and if symptoms include severe redness, swelling, pain, or don't improve within two weeks of treatment, consult a healthcare provider for proper diagnosis and management, considering the latest guidelines from reputable sources like the American Academy of Dermatology 1.

From the FDA Drug Label

ELIDEL ® (pimecrolimus) Cream 1% is indicated as second-line therapy for the short-term and non-continuous chronic treatment of mild to moderate atopic dermatitis in non-immunocompromised adults and children 2 years of age and older, who have failed to respond adequately to other topical prescription treatments, or when those treatments are not advisable. About 75% of patients had atopic dermatitis affecting the face and/or neck region. The treatment for facial dermatitis, specifically atopic dermatitis affecting the face, is pimecrolimus cream 1% (2) (2), as a second-line therapy for patients who have failed to respond adequately to other topical prescription treatments.

• Key points:
  • Indicated for mild to moderate atopic dermatitis
  • Patient population: non-immunocompromised adults and children 2 years of age and older
  • Usage: short-term and non-continuous chronic treatment

From the Research

Treatment Options for Facial Dermatitis

• The treatment for facial dermatitis involves a combination of drug and non-drug treatments to clear the skin 3
• Topical corticosteroids are the main drug treatment, but the choice of corticosteroid depends on the site of the dermatitis, and potent topical corticosteroids may be harmful on sensitive sites such as the face 3
• Topical calcineurin inhibitors, such as pimecrolimus, can be considered for sensitive sites like the face 3, 4, 5, 6, 7
• Pimecrolimus cream 1% has been shown to be effective in treating facial atopic dermatitis in children who are intolerant of or dependent on topical corticosteroids 4
• Pimecrolimus cream 1% can also be used to treat seborrheic dermatitis of the face, especially in cases resistant to conventional treatments 5
• Maintenance therapy for atopic dermatitis consists of liberal use of emollients and daily bathing with soap-free cleansers, and topical corticosteroids are used as first-line treatment for flare-ups 6
• Ultraviolet phototherapy can be used as a safe and effective treatment for moderate to severe atopic dermatitis when first-line treatments are not adequate 6

Specific Treatment Regimens

• Pimecrolimus cream 1% can be applied twice daily for 2 weeks to treat seborrheic dermatitis of the face 5
• Intermittent treatment with pimecrolimus cream 1% twice daily for 24 weeks can reduce the need for topical corticosteroids on the face in pediatric patients with mild to moderate atopic dermatitis 7
• Long-term management of facial atopic eczema with pimecrolimus cream 1% can decrease the development of flares necessitating the use of a topical corticosteroid on the face 7