Causes of Itching on the Face and Neck

Itchiness primarily involving your face and neck suggests a relatively short list of possible causes, compared to more generalized itching. Itchiness localized to these areas usually arises due to inflammation of the involved skin, which can develop for a variety of reasons. Some underlying causes represent short-term conditions that can usually be easily remedied. Other skin conditions that lead to itching of the face and neck are more chronic and require ongoing treatment.

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Contact Dermatitis

With contact dermatitis, skin directly exposed to an irritating or allergy-provoking substance becomes inflamed. This leads to an itchy red rash with either dryness and flaking or small blisters. Possible culprits for contact dermatitis on the face and neck include:

  • Shampoo, hair conditioner and styling products
  • Hair treatment products, including dyes, relaxers, and smoothing or permanent wave solutions
  • Cosmetics, especially foundations or powders that are applied to both the face and neck
  • Facial and neck moisturizers and anti-aging products
  • Perfume applied to the neck (the face is exposed by proximity or touching with the hands)
  • Acrylic fingernails, glues and nail polishes (the face and neck areexposed by touching these areas with the hands)

Seborrheic Dermatitis

Seborrheic dermatitis (SD) is the adult version of cradle cap, which occurs in infants. While cradle cap clears up during infancy, adult SD usually persists long term. SD affects areas of body with an abundance of oil glands, including the scalp, forehead, eyebrows, ears and the central area of the face around the nose. The back of the neck along the hairline is often involved. With SD, the affected skin characteristically appears reddened with superficial flaking, much like severe dandruff. The affected areas are also typically itch, sometimes intensely. SD can develop at any age from adolescence through adulthood, with the peak age of onset from 40 to 60. The cause of SD remains poorly understood but overgrowth of a fungus called Malassezia appears to play a key role. Treatment typically involves use of topical antifungal and anti-inflammatory medicines. Oral medications might be needed if topical therapy fails.

Acne

While pimples are the hallmark of acne, many people with this skin condition also experience itchiness. According to a 2009 review article published in the international medical journal "Acta Dermato-Venereologica," research indicates that 36 to 70 percent of people with mild to moderate acne experience intermittent itchiness. Although acne most often affects the face, the neck is also frequently involved. Additionally, people with acne often develop skin dryness and associated itchiness due to excessive washing of the face, overuse of over-the-counter acne treatments, or as a side effect of prescription acne medication.

Ringworm

Ringworm of the scalp, or tinea capitis, is a fungal infection that occurs most often in children but also sometimes affects adolescents and adults, who usually contract the infection from a child. The infection can spread from the scalp to the eyebrows and eyelashes, and causes scaly patches that often itch -- although some people do no experience this symptom. Hair loss frequently occurs in infected areas. Recommended treatment includes oral and topical antifungal medications and medicated shampoo. As ringworm is contagious, it's important to take precautions to avoid spread to others, such as not sharing combs, hairbrushes, hair accessories and hats.

Other Causes

Other skin and medical conditions can cause itchiness that might include but is rarely limited to just the face and neck. Some of the more common examples include:

  • Atopic dermatitis (hereditary eczema)
  • Psoriasis
  • Hives
  • Liver disease
  • Chronic kidney disease
  • Diabetes
  • Thyroid disease
  • Multiple sclerosis

Next Steps

See you doctor if you experience persistent or recurring itchiness of your face and neck. Seek immediate medical attention if the itchiness is accompanied by signs or symptoms that might signal a serious allergic reaction, including:

  • Swelling of the face, lips and/or tongue
  • Wheezing or difficulty breathing
  • Generalized itchiness or hives
  • Throat tightness or hoarsness

Reviewed and revised by: Tina M. St. John, M.D.

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