Facial Eczema with Dr Lynn Chiam: What Rashes are on my Face? Part 2

Dr Lynn Chiam, a consultant dermatologist who subspecializes in paediatric skin conditions

This is a series focused on facial eczema, with the privilege of having Dr Lynn Chiam, of of Children & Adult Skin Hair Laser Clinic, to help explain further the type of facial rashes, its treatment options and daily facial care. Dr Lynn is a consultant dermatologist who subspecializes in paediatric skin conditions at Mount Elizabeth Novena Specialist Medical Centre, Singapore. Apart from paediatric dermatology, her other subspecialty interests include adult pigmentary conditions and laser dermatology. More on Dr Lynn can be found here.

What are these Rashes on my face? (Continue from Part 1)

Irritant Contact Dermatitis

What it is: Irritant contact dermatitis occurs when external chemical or physical agents damage the skin. Common culprits include detergents, solvents, acids, water and friction. The severity of the rash depends on the amount and strength of the irritant, the length of exposure and the individual’s skin susceptibility. People with atopic eczema are more susceptible to irritant contact dermatitis.

What it looks like: Irritant contact dermatitis causes a well demarcated rash which is red and itchy and there can even be swelling and blisters. It can occur anyway in the body where the agent is in contact with the skin. In infants, the rash can occur around the mouth as a result of frequent contact with saliva.

Who gets these rashes: Anybody who gets in contact with an irritating agent can develop rashes. Patients who suffer from atopic eczema are more susceptible to irritant contact dermatitis as their skin’s protective barrier is damaged. People working in certain occupations like dishwashers, metal welders, hairdressers and cleaners are more prone to irritant contact dermatitis as they are often in contact with strong chemical agents. Infants who are teething can also be affected as their saliva is irritating to the skin.

Allergic Contact Dermatitis

What it is: Allergic contact dermatitis occurs because of an immune reaction to a substance which had been in contact with the skin and to which that particular individual is allergic to. Unlike irritant contact dermatitis, a small amount of the substance can lead to development of a rash. Allergic contact dermatitis does not occur in everyone in contact with the particular substance, it only affects people who are allergic to it i.e. those who develop an immune reaction to the substance. Irritant contact dermatitis, on the other hand, may affect anyone provided they have had enough contact with the irritant.

What it looks like: The rash caused by allergic contact dermatitis normally develops a few hours after being in contact with the substance. It is normally confined to the site where the skin had been in contact with the allergen though in severe cases, the rash can extend outside of this area and can even be generalized. The rash is red, itchy, swollen and blistered.

Allergic contact dermatitis on the face is often due to allergens found in skin care products or cosmetics. Other common sites are the ears and the neck secondary to nickel containing costume jewellery.

Who gets these rashes: Anyone can get allergic contact dermatitis as long as they are in contact with substances to which their body mounts an immune reaction to.

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