Itchy Face & Facial Rash – Causes, Pictures & Treatment

Psychological Causes of Facial Itch

A person , not sure about the truth of just spoken words, rubbing his/her nose, or someone nervously touching the face all the time, are examples of psychological causes of facial itch.

Unwashed Face

Unwashed face may itch. Especially around the eyes, nose and mouth. Washing in the morning, after the meal and before bed should help.

Dry Skin (Winter Itch)

In winter, windy weather in combination with excessive indoor heating may dry off the skin. Protective moisturizing creams before exposure are mandatory.

Excessive face washing with hot water and aggressive soaps also easily dries off the skin. The same is true for inappropriate makeup, or alcohol based aftershave.

Sun, at skiing, or in summer on the beach, may easily burn the skin. Avoiding sun between 10 a.m. and 2 p.m., applying protective creams or lotions with high sun-protective factor, wearing protective hats, and using after-sun lotions.

Allergies

Face may itch due to allergy to:

• hair dyes (itchy scalp, front, eyelids, neck, and often marked face swelling)
• shampoos (itchy scalp and/or face)
• makeup (itchy face)
• food and medications (itchy lips, mouth, throat, and upper body)
• head lice (itchy scalp, neck, shoulders, face)
• pollens (itchy eyes and nose)
• jewelry (itch, and rash at the point of contact)

Beside itch, redness, rash (hives), and swelling usually appear on affected parts of skin. In severe allergy, difficult breathing, faintness, and even shock may appear.

Therapy and prevention include skin tests, avoiding culprit substances, antihistamines by mouth in mild cases, corticosteroids in profound swelling, and adrenalin (epinephrine) in severe cases with difficult breathing.

Itchy Rashes on the Face

Itchy rashes on the face may appear in:

• Insect bites. Red, itchy bump(s) 2-3 millimeters in size should disappear in few days. Eventual stings should be removed and the skin disinfected. Oral antihistamines may prevent intense itch. Persons with strong allergy to insect stings should carry Epi-pen (anti-allergic kit with adrenalin).
• Childhood viral infections such as chickenpox (Herpes zoster), measles (Rubeola virus), German measles (Rubella virus), fifth disease (Parvovirus B19). Itchy papules or vesicles appear on the face and trunk, crust over and fall off after about a week. Fever, cough, runny nose, and conjunctivitis are common symptoms. Treatment is with analgesics and sometimes with antiviral drugs.
• Acne. Pin-sized black spots (blackheads), or 1-2 mm big red bumps with occasional white centers (whiteheads), squeezable pustules, or cysts appear on the face, front, and often on shoulders, upper arms, buttocks, or thighs. Acne don’t always itch. Mild acne are treated with over-the-counter ointments, and severe acne with antibiotics and isotretinoin.
• Acne rosacea. Red papules or patches of skin, excessive flushing, and small veins, mostly appearing on the face of 30-60 old people from unknown reason. Treatment is with antibiotics, isotretionin, and anti-inflammatory drugs.
• Herpes simplex infection usually appears as a group of small, translucent, burning blisters around the mouth (cold sore). Severe infection may be treated with antiviral drugs (acyclovir).
• Herpes zoster infection (shingles). Burning or itchy rash appears over the course of a branch of trigeminal nerve, usually only on one side of the face. Recommended treatment is with Acyclovir by mouth.Picture 1. Herpes zoster
  (source: Samuel Freire da Silva, M.D., atlasdermatologico)
• Dengue feveris a self-limiting viral disease with fever, and itchy rash and small bleedings on the skin. It is transmitted from human to human by mosquitoes. It appears worldwide, except in Europe and Antarctica.
• Bacterial infections: staph skin infections (staphylococcal folliculitis), streptococcal infections (scarlet fever, erysipelas (Streptococcus al infection).
• Pseudofolliculitis barbae (ingrown hair, razor bumps). After shaving, some hairs may grow back into their own hair follicle, what causes follicle inflammation. This mostly occur in men with curly hair. Prevention is with not shaving hair close to the skin. Lotion with glycolicacid may be used at night to prevent inflammation. In resistant cases, antibiotics, or laser hair removal may be tried.
• Tinea barbae is a fungal infection of the bearded area in men, attracted from farm animals, and caused by Tinea verrucosum. Read lumps covered by rash appear on bearded area. Treatment is with anti-fungal drugs by mouth.
• Cholinergic urticaria (heat rash).
• Irritant contact dermatitis due to saliva: alkaline saliva in small children may cause rash around the mouth.
• Atopic dermatitis (eczema)appears mostly in children with asthma or other allergies. It runs in families. Rash may appear on the face or anywhere on the body, often on limbs. Treatment is in avoiding triggering substances, moisturizing creams and corticosteroid ointments.
• Seborrheic dermatitis is inflammation of the skin due to excessive activity of oil (sebaceus) glands. Greasy, yellowish, scaly clusters of shed skin cells appear on the scalp, behind the ears, on the sides of nose, and also in armpits and groin. Affected skin is itchy and red. In treatment, non-soap cleansers, topical or oral anti-fungals and steroids can be used.Picture 2. Seborrheic dermatitis.
  (source: Samuel Freire da Silva, M.D., atlasdermatologico)
• Systemic lupus erythematosus (SLE). Red skin patch in the form of “butterfly rash” extends over the nose and cheeks. Joints and vessels are often affected. Treatment is with steroid ointments and several other medications.Picture 3. Systemic lupus erythematosus.
  (source: Samuel Freire da Silva, M.D., atlasdermatologico)

  Rash also often appears in other rheumatic diseases (rheumatoid arthritis, polyarteritis nodosa, temporal arteritis etc).

• Dermatomyositisis a rare inflammatory muscle disease with skin rash. Violaceus rash and swelling around the eyes, vessels appearing around nails, and violaceus rash on the back of the fingers, on elbows or knees are characteristic.
• Melanomais highly malignant, fast growing, dark pigmented (brown, black, or bluish) tumor, from few millimeters to few centimeters in size. It usually grows in the level of the skin, but may also appear as a raised tumor. Treatment is with surgical removal. Squamose cell carcinoma and basal cell carcinoma usually appear as a crust like tumor on the face, eyelids, ears, lips, or scalp. They are treated with surgery or radiotherapy, prognosis is usually good.Picture 4. Melanoma on the cheek
  (source: Samuel Freire da Silva, M.D., atlasdermatologico)

Other Articles About Itch

Itchy Scalp
Itchy Eyes
Itchy Throat
Itchy Eyelids
Itchy Rash on the Neck
Causes of Itchy Skin
Itch – Diagnosis, Prevention, and Treatment