Eczema affects approximately 17 percent of the population, and is defined by Drugs.com as a chronic skin disorder involving scaly and itchy rashes. It is caused by a hypersensitivity reaction similar to an allergy and results in chronic inflammation. Itching and scaling skin lead to scratching, making the skin thicken and become tough. Environmental irritants such as dry air, temperature changes, stress and allergies worsen symptoms. Eczema can occur anywhere on the body, including the face. Facial creams to help cure or relieve symptoms include topical steroids, pimecrolimus, tacrolimus and coal tar.
Steroid Creams
According to the New Zealand Dermatology Society, topical steroid creams are the mainstay of treatment for mild to moderate eczema and are very effective if used correctly. The Cleveland Clinic states that corticosteroids suppress lymphocyte activity in the skin, thus decreasing inflammation. The skin is thin on the face and it will readily absorb topical steroids. The lowest strength and smallest quantity should be used only once daily. Mild eczema can be cleared within one to two weeks, while a moderate case may require several weeks of treatment. The National Prescribing Service classifies topical steroid creams from mild hydrocortisone to very potent betamethasone.
Pimecrolimus Cream
Pimecrolimus cream, or the trade name Elidel, is a calcineurin inhibitor and is most effective when used at the earliest sign of eczema. It is described by the National Prescribing Service as an immunosuppressant and a second line cream for facial eczema. Pimecrolimus does not cause thinning of the skin, so it is useful for facial eczema and other thin-skinned areas. The Journal of European Dermatology reports that pimecrolimus cream was shown to effectively control eczema when applied twice daily and was particularly useful to treat delicate body regions such as the face. A three month study showed treatment success on the face in 81 percent of patients.
Tacrolimus Cream
Tacrolimus cream, trade name Protopic, is also a calcineurin inhibitor. The Cleveland Clinic defines this as a an inhibitor that binds calcineurin and blocks the activation of T cells, which halts the inflammatory response that leads to eczema. The Mayo Clinic says that tacrolimus ointment or facial cream is used to treat moderate or severe eczema by suppressing itching, redness and inflammation. It is often used when other types of treatment such as topical steroids are not working. The cream comes in a 0.03 percent to 0.1 percent strength and is applied twice daily. This cream makes the facial skin very sensitive to sunlight, and can cause other side effects from the drug's absorption into the skin.
Coal Tar Lotion
According to Drug Information Online, coal tar lotion is used for relieving redness, dryness, itching and irritation of the skin caused by eczema. It is a keratolytic, which means it slows bacterial growth and loosens crusty scaly skin. It is not as recommended as topical steroid creams and calcineurin inhibitor creams for the face, as it can stain hair and skin and it should not get into the eyes, nose or mouth. It may also increase the skin's sun sensitivity. The New Zealand Dermatology Society states that coal tar creams do reduce itching and inflammation, but can be smelly and messy, and not as effective as topical steroids.
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