From the Guidelines
For the treatment of face eczema, a combination of gentle skincare, topical medications, and trigger avoidance is recommended, with recent guidelines suggesting the use of emollients and prescription topical therapies as the first line of treatment. According to the American Academy of Dermatology's updated clinical practice guidelines on the management of atopic dermatitis in adults with phototherapy and systemic therapies 1, most people with atopic dermatitis can achieve control with emollients and prescription topical therapies.
Key Recommendations
- For mild cases, start with a fragrance-free moisturizer like CeraVe, Vanicream, or Cetaphil applied multiple times daily, especially after washing.
- For active flares, use a topical corticosteroid such as hydrocortisone 1% for mild cases or prescription-strength options like triamcinolone 0.1% or fluocinonide 0.05% for moderate to severe cases, applying a thin layer to affected areas twice daily for 7-14 days.
- Non-steroidal alternatives include tacrolimus (Protopic) or pimecrolimus (Elidel), which are particularly suitable for facial use as they don't cause skin thinning.
- Keep the skin clean with gentle, fragrance-free cleansers, avoid hot water, and identify and eliminate triggers like certain foods, stress, or irritating skincare products.
Advanced Therapies
The guidelines also highlight new evidence for the use of biologics and Janus kinase inhibitors, such as dupilumab, tralokinumab, abrocitinib, baricitinib, and upadacitinib, for more severe or widespread cases 1. However, the decision to initiate these more advanced therapies should be made using shared decision-making between patients and clinicians, taking into account the severity of the condition, its impact on the patient, and the efficacy, safety, and accessibility of the available interventions.
Important Considerations
During flares, avoid makeup and other potential irritants. If symptoms persist or worsen despite treatment, or if there are signs of infection (increased redness, warmth, pus, or fever), consult a healthcare provider promptly. These treatments work by reducing inflammation, repairing the skin barrier, and preventing the immune overreaction that characterizes eczema.
From the FDA Drug Label
Topical corticosteroids such as clobetasol propionate are effective in the treatment of corticosteroid-responsive dermatoses primarily because of their anti-inflammatory, antipruritic, and vasoconstrictive actions.
Face eczema treatment can be managed with clobetasol propionate, as it is a topical corticosteroid effective in treating corticosteroid-responsive dermatoses, which includes eczema.
- Key points:
- Clobetasol propionate has anti-inflammatory, antipruritic, and vasoconstrictive actions.
- It is effective in the treatment of corticosteroid-responsive dermatoses. 2
From the Research
Face Eczema Treatment Options
- Topical corticosteroids are a first-line treatment for eczema, with stronger potencies (e.g., potent, very potent) being more effective than weaker potencies (e.g., mild, moderate) for moderate or severe eczema 3
- Applying potent topical corticosteroids once a day is probably as effective as twice daily application for treating eczema flare-ups 3
- Weekend (proactive) therapy with topical corticosteroids probably reduces the likelihood of eczema relapse (flare-ups) compared to no topical corticosteroids or reactive application 3
Common Conditions Treated with Topical Steroids
- Eczema and dermatitis are the most frequently treated conditions with over-the-counter (OTC) topical steroids, with 61% of users treating eczema and 21% treating dermatitis 4
- Patients with more severe eczema are more likely to use stronger topical corticosteroids, such as clobetasone, than those with mild eczema 4
Long-Term Treatment and Safety Considerations
- Long-term treatment of atopic dermatitis may involve the use of systemic therapies, such as phototherapy, cyclosporine, or mycophenolic acid precursors, although these are often used off-label in the United States 5
- Clobetasol propionate, a potent topical steroid, can be effective in treating various skin diseases, including atopic dermatitis, but its use requires careful consideration of potential side effects, such as skin atrophy and hypothalamic-pituitary-adrenal axis suppression 6
- Maintenance therapy for atopic dermatitis typically involves liberal use of emollients and daily bathing with soap-free cleansers, with topical corticosteroids used as needed for flare-ups 7