Facial Rash

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Introduction

What is a facial rash?

A facial rash is an inflammatory reaction of the skin of the face. Facial rashes can be caused by a wide variety of mild to serious diseases, disorders and conditions. In some situations the presence of facial rash is a warning for other problems elsewhere in the body, such as systemic lupus. Facial rashes can affect a small to large area of the face and can occur in all age groups and populations.

Facial rashes can vary greatly in appearance, location and severity depending on the underlying cause. Facial rashes may or may not be itchy and can be red, white, purple or silver in color. The texture of a facial rash can be flat, raised, bumpy, or scaly and include flaking off or peeling of skin cells. Facial rashes can appear as dots or spots or occur over a large, solid continuous area.

Common causes of facial rashes include acne, dermatitis, mild allergic reactions, and inflammatory disorders. Many facial rashes do not cause any permanent harm and can be treated successfully by following the treatment plan outlined by your health care provider.

A facial rash of purple spots (petechiae) with a fever and stiff neck can indicate a serious, potentially life-threatening condition, such as bacterial meningitis. A facial rash that is associated with allergies combined with shortness of breath, wheezing, or swelling of the face, lips or tongue is a symptom of a serious, potentially life-threatening allergic reaction called anaphylaxis. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms.

Symptoms

What other symptoms might occur with a facial rash?

A facial rash can occur by itself or with other symptoms, which vary depending on the underlying disease, disorder or condition. Other symptoms can affect the digestive tract, respiratory system, nervous system, reproductive system, cardiovascular system, or immune system. For example, you may have a fever and other flu-like symptoms if the rash is due to infection or inflammation.

Skin symptoms that may occur with a facial rash

A facial rash may occur with other symptoms affecting the skin including:

  • Bleeding (from broken skin)

  • Blistering

  • Burning

  • Cracked skin

  • Dry skin

  • Itching

  • Pimples or pustules

  • Redness, irritation or inflammation

  • Scaling, flaking or peeling skin

  • Swelling or puffiness around the rash

Other symptoms that may occur with a facial rash

In some cases, a facial rash may occur with symptoms related to other body systems including:

    Serious symptoms that might indicate a life-threatening condition

    In some cases, a facial rash may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have these serious symptoms:

    Causes

    What causes a facial rash?

    Facial rashes can be caused by a wide variety of diseases and conditions, including infection, inflammation, allergic reaction, and autoimmune processes. A sudden or acute facial rash may be due to an allergic reaction or sensitivity to a particular substance, such as a facial moisturizer, food, or medication.

    A chronic or long-term facial rash may be caused by such conditions as acne or an inflammatory disorder, such as rosacea. Rosacea is characterized by facial flushing, particularly on the cheeks, and raised bumps that can resemble acne. The precise cause of rosacea is not known, yet effective treatments to control rosacea are available.

    A facial rash in an infant may be caused by trapped dead skin cells (milia) or baby acne, although other causes are possible. A facial rash in children can be a sign of many different conditions, including eczema, allergies and viral diseases.

    In all age groups, more serious causes include a severe allergic reaction with anaphylaxis (tightening of the airways), bacterial meningitis, and cellulitis (an invasive skin infection that can be caused by streptococcal or staphylococcal bacteria, also called erysipelas).

    Infectious causes of facial rashes

    A facial rash may be caused by an infection including:

    Allergic causes of facial rashes

    A facial rash may be caused by an allergic reaction including:

    Autoimmune and inflammatory causes of facial rashes

    A facial rash may be caused by an autoimmune or inflammatory disorder including:

    • Acne

    • Baby acne (skin inflammation triggered by maternal hormones)

    • Dandruff (seborrheic dermatitis, which can affect the face and neck as well as the scalp)

    • Rosacea (chronic inflammatory skin disorder)

    • Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues)

    Other causes of facial rashes

    A facial rash may also accompany the following conditions:

    • Anxiety or stress

    • Erythema toxicum (benign, noncancerous skin condition common in newborn babies)

    • Heat rash

    • Methamphetamine abuse

    • Milia (tiny white bumps of dead skin cells and other debris)

    Life-threatening causes of facial rashes

    In some cases, a facial rash may accompany a serious or life-threatening condition that should be evaluated immediately in an emergency setting. Serious or life-threatening conditions include:

    • Allergic purpura (an autoimmune bleeding disorder)

    • Anaphylaxis (a life-threatening allergic reaction)

    • Erythema multiforme (a type of allergic reaction)

    • Meningitis (infection or inflammation of the sac around the brain and spinal cord)

    • Toxic epidermal necrolysis (skin and mucosal loss due to a severe medication reaction)

    Questions for diagnosing the cause of a facial rash

    To diagnose the underlying cause of a facial rash, your doctor or licensed health care practitioner will ask you several questions about your symptoms. Providing complete answers to these questions will help your provider in diagnosing the cause of your facial rash:

    • What does the rash look like?

    • When did the rash appear?

    • Does the rash appear on only one specific region of the face?

    • Have you had the rash before?

    • Is the rash spreading to other areas?

    • What is your medical and dental history? Do you have any diseases or conditions?

    • What medications, supplements or herbal drugs are you taking?

    • Have you been in recent contact with any unusual substances or environments, such as exposure to chemicals or unusual plants, taking new medications or supplements, or traveling to a foreign country?

    • Do you have any other symptoms?

      What are the potential complications of a facial rash?

      In some cases, a facial rash can lead to complications, especially if there is severe itching and scratching that leads to breakdown of the skin. Scratching can introduce bacteria or fungus in the layers of skin, resulting in infections.  Complications include:

      • Bacterial or fungal infection of the skin

      • Cellulitis (an invasive bacterial or fungal infection of the skin and surrounding tissues)

      • Open sores and lesions

      • Permanent change in skin texture

      • Permanent skin discoloration

      • Scarring

      Serious complications of underlying causes of a facial rash, such as measles or meningitis, can also occur. You can best reduce the risk of complications of a facial rash and its underlying causes by following the treatment plan you and your health care provider develop specifically for you.

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      Medical Reviewer: William C. Lloyd III, MD, FACS
      Last Review Date: 2018 Nov 26
      1. Skin rashes and other changes. FamilyDoctor.org. http://familydoctor.org/online/famdocen/home/tools/symptom/545.html
      2. Atopic dermatitis. DermNet NZ. http://www.dermnet.org.nz/dermatitis/atopic.html
      3. Folliculitis. DermNet NZ. http://www.dermnet.org.nz/acne/folliculitis.html
      4. Rashes. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm
      5. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
      6. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.
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