From the Guidelines
For a spreading rash on the face, I recommend avoiding greasy creams, topical acne medications, and topical steroids, and instead using gentle, non-irritating treatments such as emollients and moisturizers to soothe the skin and reduce dryness and itching. When considering treatment options, it's essential to prioritize morbidity, mortality, and quality of life as the primary outcomes. According to the study by 1, treatments that should be avoided include greasy creams for basic care, manipulation of skin, hot blow-drying of the hair, wearing of tight shoes, topical acne medications, and topical steroids.
Some key considerations for treatment include:
- Avoiding harsh soaps, fragrances, and makeup on the affected area
- Washing with lukewarm water using a mild cleanser
- Applying emollients and moisturizers to soothe the skin and reduce dryness and itching
- Considering topical steroid preparations such as prednicarbate cream for inflammatory skin conditions like eczema and fissures
- Using systemic treatment with oral H1-antihistamines such as cetirizine, loratadine, or fexofenadine for pruritus or itching
It's crucial to seek medical attention if the rash is accompanied by significant swelling, severe pain, fever, blisters, or affects your eyes or breathing. A healthcare provider can provide a proper diagnosis and prescribe stronger medications like prescription-strength corticosteroids, antihistamines, or antibiotics depending on the cause of the rash. Facial rashes can result from various conditions, including contact dermatitis, eczema, rosacea, or infections, and proper diagnosis is essential for effective treatment. Staying hydrated and avoiding known triggers can help prevent recurrence.
From the FDA Drug Label
Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily For a spreading rash on the face, the treatment with hydrocortisone (TOP) is to apply to the affected area not more than 3 to 4 times daily for adults and children 2 years of age and older 2.
From the Research
Treatment Options for Spreading Rash on Face
- The treatment for a spreading rash on the face depends on the underlying cause of the rash. According to 3, diagnosing a red rash on the face requires assessment of symptomology, age of onset, rash morphology, and 'clinical clues' that help delineate between differentials.
- For atopic dermatitis, a common cause of facial rashes, treatment options include topical corticosteroids, pimecrolimus, and tacrolimus, as well as ultraviolet phototherapy for moderate to severe cases 4.
- For herpes labialis, a viral infection that can cause a rash on the face, treatment options include topical antiviral drugs such as aciclovir, although the addition of hydrocortisone may not provide additional benefits and may pose risks 5.
- In general, the approach to treating a generalized rash, including those on the face, involves a detailed history and physical examination to arrive at the most likely diagnosis, and treatment is tailored to the specific cause of the rash 6.
- For herpes virus infections, which can cause rashes on the face, acyclovir and its analogues are the only approved medicines, and they work by inhibiting viral DNA replication 7.