Skin rashes can occur anywhere on the body and are a common medical problem. Some may be mild and barely a problem while others can be severe and affect life in various ways. However, we often worry more about even mild rashes on areas like the face as it has an important social and aesthetic functions unlike other areas of the body. While many different types of rashes look similar, the underlying cause can be very different.
Itching and Rashes on the Face
We often assume that itching is synonymous with a rash but this is not always the case. Itching can occur on its own even without any visible skin rash. Similar a skin rash may be present yet it may not be itchy. Itching is due to stimulation of specialized nerve endings (itch receptors) in the skin. Usually the stimulation is associated with irritation or damage of the tissue and ensuing inflammation. However, these nerve endings may be stimulated despite the lack of inflammation at the site.
A rash is where the skin becomes red, dry, cracked, peel, rough or have different lesions like papules erupt. Most of the time the rash is due to some underlying inflammatory process. However, there are instances where a defect on the skin that is termed as a rash is not associated with any inflammation. Rashes can be itchy or painful but when inflammation is absent, a person may not experience either of these symptoms. Rashes may not always be overtly visible. Sometimes it can be felt but not seen.
The face is prone to rashes and itching as the facial skin is relatively unique in certain ways. It is constantly bombarded by the elements of the environment since most people do not cover their face under normal circumstances. It is also the area of the body subjected to the most amount of skin care regimens from topical applications like creams and makeup to procedures like beauty facials and hair removal. Furthermore we tend to touch our faces, often unnecessarily, more than we do with other parts of our body.
Causes of Facial Itching and Rashes
There is a number of conditions that can cause facial itching with or without a skin rash. The more common causes have been discussed below.
Acne vulgaris is one of the more common facial conditions that tends to affect adolescents and young adults. It can also occur in older adults. Acne is due to the excess of skin oils (sebum) which mixes with skin cells and dust to block the follicles from where tiny hairs emerge. It typically results in the formation of pimples. The area is more commonly affected due to the high concentration of oil-producing glands, as is the case with the shoulders, chest and back. It is mainly due to hormonal factors.
Contact dermatitis is another common yet often unknown skin condition. As the name suggests, the skin is inflamed (dermatitis) due to contact with substances. These substances may then irritate the skin (irritant contact dermatitis) or cause allergic reactions (allergic contact dermatitis) due to hypersensitivity in certain individuals. A range of substances my be responsible, from sweat, soap and water to makeup, creams, lotions and hair dyes that drain down the face.
Atopic dermatitis, commonly referred to as eczema, is more often seen in children and associated with other allergic conditions like asthma and allergic rhinitis. It arises due to hypersensitivity to certain substances and may be linked to food allergies in children. The exact reason why it occurs is unclear but it is believed to be due to a genetic predisposition although there is now more evidence that breast milk can help minimize the chances of atopic dermatitis and related allergic conditions. The skin is typically dry, itchy and red and may at times ooze.
Although it is one of the more ignored causes of itchy skin anywhere on the body, dry skin is a common cause of itching and skin rashes. The skin has its own mechanism for maintaining moisture, mainly through the action of oil-producing glands. However, if these glands are inactive, the climate has a pronounced drying effect or if skin care applications are used that dry the skin then dryness may be quite significant. The medical term for dry skin is xerosis and can be easily remedied with suitable moisturizers.
Sunburn is another common cause of itching of the face. Without proper sun protection, the skin is easily irritated and damaged with strong sunlight exposure. Sometimes the sunburn may not be as obvious as the typical sunburn that most of us know. The skin may not be extremely red, tender or painful. Instead there may just be mild redness which is barely visible and itching. It can be minimized by using a sunscreen with sufficient UV protection.
Folliculitis is a condition where the follicles of the skin become inflamed usually due to a bacterial infection. It can arise for a number of reasons but is more likely to occur when the hair is removed from the follicles like during waxing which leaves the follicle temporarily open to invasion by bacteria that may live on the skin. Staphylococcus aureus is one of the common bacteria to cause folliculitis. People with weakened immune systems are more prone to this condition.
Fungal infections are less common but can occur especially when the skin is dry and poorly maintained. Tinea versicolor typically causes a whitish type of rash and is caused by yeasts unlike most other fungal skin infections. A fungal infection of the face with dermatophytes is known as tinea facei while tinea barbae occurs with fungal infections of the bearded area of the face usually associated with hair removal. Fungal infections can be transmitted from one to person to another by sharing personal items like razor blades.
A range of other skin conditions may also be responsible such as:
- Herpes simplex virus (HSV) infection
- Seborrheic dermatitis
- Insect bites
- Allergic drug reactions
- Childhood infections like chickenpox
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