6 Skin-Care Mistakes That May Worsen Atopic Dermatitis on Your Face

While atopic dermatitis (AD) can affect any area of the body, managing it on your face can be especially challenging. “The skin on the face, especially on the eyes and on the neck, is extremely thin and sensitive,” says Sandra Marchese Johnson, MD, a dermatologist at Johnson Dermatology in Fort Smith, Arkansas. As such, products and ingredients that may be tolerated on other areas of the body can sometimes cause problems on the face, making it important to take a careful approach to skin care.

Small changes to your routine can make a big difference when it comes to protecting sensitive skin on your face. Avoiding common skin-care mistakes may help reduce irritation and keep atopic dermatitis flares under control.

1. The Wrong Skin-Care Products

Skin-care products can contain numerous ingredients, including fragrances and preservatives that can trigger skin irritation. People with atopic dermatitis often have a more fragile skin barrier, which means the skin may be more sensitive to potential irritants than it would in people who don’t have the skin condition.

When it comes to skin care, the fewer the ingredients, the better, says Dr. Johnson. Simple, gentle products are often the best choice for atopic dermatitis skin. For example, Johnson recommends using petroleum jelly (Vaseline) or even vegetable oil (Crisco) to help lock in moisture. “It’s so simple and plain,” she says.

When choosing skin-care products, look for those labeled “fragrance-free,” rather than “unscented.” That’s because unscented products often still have a fragrance but also contain added chemicals to mask the scent, which can trigger atopic dermatitis symptoms.

2. Harsh Exfoliants

Physical exfoliation uses friction from tools such as loofahs or scrubs that contain abrasive particles to slough off dead skin cells.
Chemical exfoliation uses ingredients such as alpha hydroxy acid to dissolve dead skin cells.

Exfoliating may help improve skin texture and treat certain concerns, such as acne, but it can be too harsh for many people with atopic dermatitis. “When you exfoliate, you take off the top layer of your skin, which is your barrier,” says Johnson. “This sets you up for more risk for allergies (contact dermatitis) or irritation.”

That said, some people with atopic dermatitis may be able to tolerate certain ingredients in chemical exfoliators, including topical retinoids, she adds. But you still have to proceed with caution: Retinoids can cause dryness and irritation, especially when first starting them.

If you want to try chemical exfoliation, work closely with your dermatologist, choose a milder product, such as over-the-counter retinol or adapalene 0.1 percent. And start slowly by applying it once or twice weekly and then gradually increasing from there as tolerated, says Julia Riley, MD, an assistant professor of dermatology at Northwestern University Feinberg School of Medicine in Chicago.

If irritation develops, pause using the product, and allow your skin to recover before more slowly reintroducing it back into your routine, says Dr. Riley. Many people find that the “sandwich method,” where you apply moisturizer before and after retinol, can help decrease the risk of irritation, she adds.

3. A Complicated Skin-Care Routine

A basic skin-care routine is often best when you have atopic dermatitis. “Everyone wants a 10-step skin-care routine, but for people with eczema, simpler is better,” says Riley.

A routine that includes moisturizer, sunscreen, and any prescription treatments recommended by your dermatologist often provides what your skin needs without any unnecessary ingredients that may cause irritation.

4. Not Patch Testing New Products

When trying a new product, it’s important to introduce it slowly. Atopic dermatitis can increase your risk of irritation due to an altered skin barrier, says Johnson. “If you want to try a new product, give it a few days and see how you respond.”

If your skin is especially sensitive, Johnson recommends doing a “use test” on your body before applying a product to your face. This involves placing a small amount of the product on the white part of a bandage and applying it to the inside of your arm for two days. If your skin reacts, it may be a sign that the product could cause irritation.

5. Long-Term Topical Steroid Use

Topical corticosteroids are a common treatment for atopic dermatitis.

They can be used to reduce inflammation and calm flare-ups. But because facial skin is thinner and more sensitive than the skin on many other parts of the body, topical steroids generally should not be used on the face for a prolonged period of time without guidance from a dermatologist, says Riley.

“The skin on your face is thinner and more predisposed to atrophy, or loss of tissue,” she says. Over time, skin atrophy can lead to redness, visible blood vessels, and spots under the skin that appear red, purple, or brown.

Always follow your dermatologist’s instructions for using topical steroids on your face. In many cases, a low-potency steroid is prescribed only for a short period to treat a flare. For longer-term management, your dermatologist may recommend steroid-sparing medications, such as topical calcineurin inhibitors.

6. Viral Skin-Care Trends

Social media is full of skin-care advice, and it can be tempting to try a product or remedy that someone claims transformed their skin. But what works well for one person may not be ideal when you have atopic dermatitis, and some viral skin-care trends may worsen symptoms. “Trying new viral things is a common way to induce eczema flare-ups,” says Riley.

She also cautions against assuming that “natural” products are safe for your skin. “An essential oil or food-based product can still cause irritation or an allergy. It’s not always safe,” says Riley.

When it comes to managing atopic dermatitis, your dermatologist is your best resource for deciding which products and treatments are safest for your face.

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