Dear Doctor
I have a problem with my neck and face. What will I do to treat my skin problem.
On the left are the rashes on my neck and on the right is on face (cheeks). The rash in face started more than 2 weeks ago. And on the neck it started also more than 2 weeks ago. I scratching it because it was very itchy.
On my neck, is that eczema? And on my face what is that? Please help me. I cannot go out because I am very shy to what happened on my face. Thank you.
Dear Patient
Your symptoms are suggestive of neck and cheek contact dermatitis.
Cheek Contact Dermatitis Causes
The causes of cheek contact dermatitis include:
1. Ingredients like preservatives in blushes and other cosmetics applied on the cheeks.
2. Fragrances from makeup, soaps, lotions used on the face.
3. Skin care products applied to the face with ingredients like Balsam of Peru
4. Shampoos, conditioners, detanglers and perm solutions which are rinsed from the hair and flow down the face
5. Nickel from makeup tools which come in contact with the cheeks like brushes.
6. Jewelry like dangling earings made of nickel, leather and other materials if they come in contact with the cheeks.
7. Medications applied on the face like the antibiotic neomycin
8. Fabrics and clothing which may also have irritating fibers or fragrances
9. Mobile phones with nickel and chromium especially if the rash is on one side of the face in front of the ear.
10. Rubber from applicators used to apply makeup to the face.
Cheek Contact Dermatitis Treatment
The treatment of cheek contact dermatitis involves:
Identify the causative substance and avoid it
Go through all the products that you are using on your face and hair to identify the one that you began using 2 weeks ago when this allergic reaction begun.
The fact that the contact dermatitis affects the cheeks and neck suggests it might be something you are using on both areas like a lotion or fragrance which you spray on the neck but it gets in contact with your cheeks.
Hair care products like shampoos, conditioners, detanglers and perm solutions are also strong suspects since they can cause dermatitis on the face and neck after they are rinsed off the scalp and run down from the scalp.
If you are not able to identify the substance causing the allergic dermatitis, you can visit your nearest dermatologist to do patch testing.
Use mild cleansers
Clean your face with mild cleansers like Aquanil and Cetaphil instead of soap which can dry it.
Apply topical corticosteroids
Mild corticosteroids like hydrocortisone can be applied on the cheeks twice a day for 10 days to treat contact dermatitis since they have anti-inflammatory properties.
Apply moisturizers
Moisturizers should be applied on the face to moisturize it and prevent dryness and cracking. Use bland barrier creams with dimethicone like Cetaphil or those which contain ceramide like Cerave to restore the epidermal barrier. 100% pure petroleum jelly, can also be used. They should be applied several times during the day to keep the skin well moisturized. Avoid alcohol based moisturizers which can be drying and use those which are fragrance-free since fragrances can irritate the skin.
Take systemic antihistamines
Anthistamines can be taken by mouth to reduce the itch. Examples include the non-sedating fexofenadine (Allegra) and loratadine (Claritin) as well as the less sedating cetirizine (Zyrtec). The sedating diphenhydramine (Benadryl) and hydroxyzine (Atarax, Vistaril) are also used to reduce the itch especially if it disturbs sleep.
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