Skin rashes or rashes on the face are common. Do you have problems with your facial skin, does it feel strange or are there visible spots that you cannot identify? And you don’t know what the possible cause of these problems is? These are the main types of skin conditions that cause a rash on the face: acne comedonica, acne conglobata, acne cystica, acne Vulgaris (pimples), allergic contact dermatitis, angioma senilis, angioedema, atopic eczema, basal cell carcinoma, erysipelas, dermatosis papulosa nigra, Favre-Racouchot syndrome, herpes simplex, herpes zoster, impetigo (impetigo), keratosis pilaris, lentigo maligna, melanoma, melasma (pregnancy maker), mollusca contagiosa (water warts), rosacea, seborrheic eczema, spitz nevus, tinea barbea ( trichomycosis), tinea faciei (dermatomycosis), hives (urticaria) and verruca plana (flat wart).

• Rash on the face
• Acne agminata
• Acne comedonica
• Acne conglobata
• Acne cystica
• Acne fulminans
• Acne Vulgaris (pimples)
• Allergic contact dermatitis
• Angioma senilis
• Angioedema
• Atopic eczema
• Basal cell carcinoma (BCC)
• Chronic discoid lupus erythematosus
• Dermatosis papulosa nigra
• Erysipelas (wound or bell dandruff)
• Favre-Racouchot syndrome
• Fibrous papule of the nose / of the face
• Folliculitis
• Barley grains
• Harlequin syndrome
• Herpes simplex
• Herpes zoster (shingles)
• Impetigo (impetigo)
• Keratoacanthoma
• Keratosis pilaris
• Lentigo maligna
• Blackheads
• Melanoma
• Melasma (pregnancy maker)
• Mollusca contagiosa (water warts)
• Perioral dermatitis
• Pseudo Folliculitis Barbae
• Rosacea (couperose)
• Rosacea fulminans
• Seborrheic dermatitis
• Spitz nevus
• Sebaceous gland hyperplasia
• Tinea barbea (trichomycosis)
• Tinea faciei (dermatomycosis)
• Hives (hives, urticaria)
• Verruca plana (flat wart)
• Xanthelasma palpebrarum
• Bowen’s disease
• Self-care for facial rashes
• When should you consult a doctor if you have a rash on your cheeks, chin, nose or forehead?

• Contact us directly
• Make an appointment with your GP

• Examination and diagnosis of the rash

• Physical and other examination
• Referral or treatment

Rash on the face

A rash is a noticeable change in the texture or color of your skin. Your skin may become flaky, bumpy, itchy, or otherwise irritated. There are numerous causes for rashes, including:

• Allergies;
• Medicines;
• Cosmetics;
• Certain skin conditions.

Acne agminata

Acne agminata is a rare skin condition. The symptoms of acne agminata are reddish-brown acne-like lumps and bumps on the face, especially the eyelids, forehead, cheeks and chin. Sometimes the condition also manifests itself under the armpits. It is probably a severe variant of granulomatous rosacea, which is in turn a severe variant of rosacea, characterized by firm yellow-brown pustules and bumps around the mouth and cheekbones. Treating the condition is no small feat. Medicines and laser treatment are options. In most people, the lumps and bumps disappear after a few years, sometimes leaving behind scars

Acne comedonica

Acne comedonica is grade I acne, in which closed and open comedones are in the foreground with a black plug in the middle. The forehead is greasy and shiny and there are numerous skin-colored to white-yellow pimples. Acne usually starts during puberty and is due to inflammation of sebaceous gland follicles. The choice of treatment depends on the severity of the complaints, as well as age and gender; there is therapeutic customization. The treatment naturally starts with topical (local) agents, such as benzoyl peroxide, salicylic acid or local vitamin A preparations, followed by systemic agents if necessary.

Acne conglobata

Acne conglobata concerns grade III acne with severely inflamed papulopustules (red inflamed bumps) on the cheeks, chin and forehead that partly merge into extensive red spots that hurt, so-called infiltrates. Furthermore, closed (white) and open (black) comedones or blackheads are visible. Residual phase with scar formation. Due to increased sebum production, the skin shines. Treatment is by systemic therapy, either with antibiotics or with isotretinoin, a drug prescribed for severe, treatment-resistant forms of acne.

Acne cystica

Acne cystica is a severe form of acne with large papulopustules, confluent into inflamed cysts, with infiltrates and scarring, requiring an active systemic approach. The cyst will be surgically removed at a quiescent, non-inflamed stage.

Acne fulminans

Acne fulminans is a very severe and rare form of acne, a subtype of acne conglobata, in which very severe inflammation of the sebaceous glands is prominent. Acne fulminans is characterized by intensely inflamed pustules that very quickly develop into open wounds and ulcers. It is mainly boys and young men between the ages of 13 and 22 who are sensitive to this type of acne.Acne vulgaris on the forehead / Source: Roshu Bangal, Wikimedia Commons (CC BY-SA-4.0)

Acne Vulgaris (pimples)

Acne vulgaris can occur on the face, among other things. The treatment of pimples depends on the severity of the acne, the type of acne, but also on the skin type, age and gender of the person with acne. Local, external treatment will often suffice.

Allergic contact dermatitis

Contact eczema is an inflammation of the skin that occurs when the skin comes into contact with certain substances. It mainly occurs on the hands, feet or face. On the face it can be caused after using sunscreen or night cream. In the acute variant, highly itchy and burning fluid-filled blisters may develop, together with a diffuse, red and fiery swelling. Treatment consists of avoiding the responsible substance and locally applying corticosteroids. In the event of an extensive reaction or a serious course, systemic treatment is provided.Angioedema face: swelling of the eyelids / Source: James Heilman, MD, Wikimedia Commons (CC BY-SA-3.0)

Angioma senilis

This age-related hemangioma is a benign, bright red, flat to convex, red-shiny, firm-elastic, 1-6 mm nodule. They are common, especially after the age of 40. Dozens of such lesions usually develop. They can occur all over the body, except the mucous membranes, including the face. The cause is unknown. Treatment is not necessary, but if it is experienced as cosmetically disturbing, one can – depending on size and location – proceed to electrocoagulation, vascular laser or excision (cutting away).

Angioedema

Sudden severe swelling, especially around the eye, which may be accompanied by itching. Most often, angioedema is caused by an allergic reaction to certain foods, such as nuts or strawberries. Less often, drug allergy is the cause, but it can also occur after an insect bite.

Atopic eczema

Atopic eczema, also called atopic eczema, is a form of eczema that mainly occurs in childhood, with mainly red, flaky areas and small bumps.Nodular basal cell carcinoma: a smooth, glassy nodule with a pearly sheen, sometimes with blood vessels / Source: Klaus D, Wikimedia Commons (CC BY-3.0)

Basal cell carcinoma (BCC)

Basal cell carcinoma is considered a form of skin cancer, but can be cured in almost all cases. Basal cell carcinoma usually takes the form of a skin-colored bump, with a raised, shiny edge with vasodilations (small blood vessels). The center may be somewhat collapsed and ulcerated. Basal cell carcinoma can be removed surgically.

Chronic discoid lupus erythematosus

Chronic discoid lupus erythematosus (CDLE) is a fairly rare skin disease that belongs to the group of so-called ‘connective tissue diseases’. CDLE is a form of the autoimmune disease lupus erythematosus (LE). In an autoimmune disease, your own immune system is disrupted and the immune system turns against your own body. In LE, disease symptoms can occur in various organs and the skin, but in CDLE the disease is normally limited to the skin, usually causing red spots on the face.

Dermatosis papulosa nigra

Dermatosis papulosa nigra is a skin condition usually characterized by multiple, small, hyperpigmented, asymptomatic brown to black papules on the face and/or neck of adult humans. It mainly occurs in people with more pigment in the skin: people of Asian and black descent. It is a completely harmless condition that is not contagious. Treatment is not necessary, but electrocoagulation can be used if cosmetic objections are insurmountable.Dandruff in the ear / Source: Evanherk, Wikimedia Commons (CC BY-SA-3.0)

Erysipelas (wound or bell dandruff)

Dandruff is a serious bacterial infectious disease of the dermis and subcutaneous fatty tissue. The affected skin suddenly becomes red, warm, swollen and painful. The edge is sharply defined and raised and sometimes blisters develop afterwards, which can become dark red from the blood in them. Less severe erysipelas can be treated with oral antibiotics.

Favre-Racouchot syndrome

The Favre-Racouchot syndrome is the name for the combination of solar cysts and comedones with elastosis of the skin (= changes in the skin due to ultraviolet light). The preferred location is the face: cheeks and nose, around the eyes, sometimes on the neck or behind the ears. It is associated with cumulative, chronic, high zonal exposure and (above all) smoking.Fibrous papule of the nose / Source: M. Sand et al., Wikimedia Commons (CC BY-2.0)

Fibrous papule of the nose / of the face

A fibrous papule of the nose / of the face is a benign skin-colored bump or papule on the face, often on or around the nose or lip. The bump is about 1-5 mm. Often it involves one bump on the face, sometimes it involves more bumps. The cause is not exactly known. From a medical point of view, the bump does not need to be treated. They can be removed if they are considered cosmetically disturbing.

Folliculitis

Folliculitis refers to inflammation of the upper part of the hair follicle or hair follicle. The inflammation often occurs as a result of an infection with a bacterium, a fungus, a virus or a yeast. An unsightly pus head often appears at the location of the hair follicle. It is often accompanied by itchy, irritating or painful skin. Folliculitis usually resolves spontaneously.Barley grains on an eyelid / Source: Silver442n, Wikimedia Commons (Public domain)

Barley grains

Barley grains are relatively common. A barley grain (also called ‘milium’) is a 1 to 2 mm large cavity (cyst), which is filled with horn material. It looks like a white grain on the skin (see photo). They usually occur on the face, especially around the eyes. A barleycorn is completely benign and does not require any treatment from a medical point of view. They often disappear spontaneously over time. From a cosmetic point of view, treatment can be chosen.

Harlequin syndrome

Harlequin syndrome is an extremely rare and rarely described functional disorder of the sympathetic nervous system in the Netherlands. In harlequin syndrome, the face and sometimes the arm and hand become heavily sweaty and red on one side during exertion, emotion and in hot weather, while the other side remains pale and dry.

Herpes simplex

The contagious herpes simplex virus (HSV) causes various conditions characterized by redness, bumps and (painful) blisters on the skin and mucous membranes, later scabs, usually on or around the lips redness (cold sores) but can also occur on the cheek, or around the mouth.

Herpes zoster (shingles)

Shingles is a very painful, acute skin reaction, accompanied by small blisters and preceded by persistent pain in the affected area. It is caused by a reactivation of the chickenpox virus that causes inflammation of the nerve in the affected area.

Impetigo (impetigo)

Impetigo is a common and very contagious bacterial skin infection. This is accompanied by red spots or bumps, with yellow-brown crusts. Impetigo is treated with antibiotics. For mild cases, an antibiotic ointment or cream may be sufficient.

Keratoacanthoma

A keratoacanthoma is a relatively common and fast-growing (days to weeks) benign skin tumor. Treatment often consists of excision.

Keratosis pilaris

Keratosis pilaris is a skin condition in which there is a disorder in the maturation of the horny cells in the hair follicles. Small red, rough lesions develop where the hairs emerge from the skin, varying in color from skin-colored to red or brown.

Lentigo maligna

Lentigo maligna is an early stage of melanoma and manifests as a light brown to black, irregular but sharply defined macula. The center gradually darkens. It is asymptomatic. Treatment consists of excising the lesion.

Blackheads

Blackheads, also called ‘comedones’, are caused by a blockage of the skin pores due to an accumulation of sebum and horn dust. The horn accumulates in the hair follicle and mixes with sebum. A black head is formed in the widened opening of the pore, the so-called ‘blackhead’. The pigment melanin found in the blackhead provides the black color. It is also possible that the opening is narrowed and in such cases the head is white, the so-called ‘whitehead’.Melanoma / Source: National Cancer Institute, Wikimedia Commons (Public domain)

Melanoma

A melanoma can develop from an existing lentigo maligna (see above), which is a form of skin cancer that arises from melanocytes (pigment cells of the skin). There are different types of melanoma. Treatment consists of excision (first diagnostic, then therapeutic excision).

Melasma (pregnancy maker)

A pregnancy mask is a brown to dark brown discoloration of the face (forehead, cheeks, nose and around the mouth) and sometimes also the neck. It concerns a macular (spotty) hyperpigmentation with sharp boundaries, often symmetrical. It is especially common in pregnant women.Water warts / Source: E van Herk, Wikimedia Commons (CC BY-SA-3.0)

Mollusca contagiosa (water warts)

Water warts are caused by a virus and consist of skin-colored, hemispherical papules with a dent in the center.

Perioral dermatitis

Perioral dermatitis is also called ‘clown dermatitis’ because it is a dermatosis in which red small bumps occur, especially around the mouth and on the chin. Perioral dermatitis can also be seen in other places on the face: around the nose, on the forehead and around the eyes. The skin may also become red. However, the lips are not affected. The cause of perioral dermatitis is often due to the long-term use of a hormonal ointment on the face, or cosmetics (make-up) or sunscreen. The condition normally goes away on its own after discontinuing the use of the hormone ointment and cosmetics that trigger it.Complaints due to shaving your armpits / Source: Stevepb, Pixabay

Pseudo Folliculitis Barbae

Pseudo Folliculitis Barbae literally means ‘folliculitis-like abnormalities in the beard area’ and is known as razor burn, razor bumps, razor pimples and ingrown hairs. This concerns persistent irritation caused by shaving/depilation.

Rosacea (couperose)

Rosacea is a common red, acne-like, benign, chronic skin condition that affects many people from young to old, but especially middle-aged women. The etiology is unknown. The main symptoms of rosacea are red, pink, rose-red or sometimes purple-red spots on the face and small dilated blood vessels.

Rosacea fulminans

Rosacea fulminans, also known as ‘pyoderma faciale’, is a rare, severe variant of rosacea and is characterized by severe and acute bumps and pustules (papules and pustules) and redness (erythema) on the face. This unsightly skin condition mainly affects young adult women and is more commonly seen during pregnancy.

Seborrheic dermatitis

Seborrheic eczema manifests itself as greasy, yellowish flakes on limited reddish skin, often on the scalp, face and especially in the eyebrows, on the sides of the nose and behind the ears. Seborrheic eczema does not need to be treated, but in case of excessive redness and itching, a corticosteroid lotion or cream can be applied temporarily.

Spitz nevus

A Spitz nevus benign red, hemispherical tumor with smooth surface. Treatment consists of excision.

Sebaceous gland hyperplasia

Sebaceous hyperplasia is enlarged sebaceous glands, visible as lumpy bumps on the skin. Sebaceous gland hyperplasia usually involves one spot, sometimes several, often on the forehead.Tinea barbae or beard scabies / Source: Public domain, Wikimedia Commons (PD)

Tinea barbea (trichomycosis)

Tinea barbae, also called ‘beard scabies’, is a fungal disease of the beard area, with circumscribed, red, inflamed skin changes, with pustules, crustae and thickening of the skin.

Tinea faciei (dermatomycosis)

This is a superficial fungal infection of the facial skin (annular focus).

Hives (hives, urticaria)

Hives are a hypersensitivity reaction of the skin caused by the release of histamine and other inflammatory mediators. It often develops over a short period of time and is characterized by (ring-shaped) red or pale pink, itchy rash (bumps and raised areas), in different shapes and sizes.Xanthelasma palpebrarum / Source: Bobtheowl2, Wikimedia Commons (CC BY-SA-3.0)

Verruca plana (flat wart)

The flat wart is smooth, flat and only 1-5 mm in size. It is a light brown or skin-colored papule, always multiple, and they mainly occur on the face, arms and legs.

Xanthelasma palpebrarum

Xanthelasma is a harmless skin condition in which clearly recognizable yellow, velvety papules and flat plaques occur on both eyelids, both the lower and upper eyelids. It starts as a bump and over the months it grows into unsightly plaques. The cause of this skin condition is not known. Treatment can consist of peeling, electrocoagulation under local anesthesia, CO2 laser treatment or excision.Bowen’s disease: redness and flaking / Source: Watplay, Wikimedia Commons (Public domain)

Bowen’s disease

Bowen’s disease or Bowen’s disease is a slowly growing precursor of squamous cell carcinoma, a type of skin cancer. Bowen’s disease is characterized by chronic inflammatory features such as redness, flaking and sometimes itching. The spots look a bit like eczema or psoriasis. Bowen’s disease is mainly seen in the elderly, both men and women. The disease is named after the physician Bowen who described this skin condition in 1912.

Self-care for facial rashes

You can treat most mild forms of rashes caused by irritation yourself, but of course it depends on the cause. Follow these guidelines to ease the discomfort and hasten the healing process:

• Use a neutral ointment or cream once or twice a day. These ensure that the skin can retain more moisture and protect the skin from drying out. They also reduce itching and irritation.
• Use gentle, neutral cleaning products instead of scented soaps.
• Use warm water instead of hot water to wash your skin and hair.
• Pat the skin and rash dry instead of rubbing the skin dry.
• Let the rash breathe. So do not cover it with a scarf or other item of clothing.
• Stop using new cosmetics or lotions as they can cause a rash.
• Avoid scratching the rash as it can worsen the rash and even lead to a bacterial infection.
• Take a Dead Sea salt/mud mask. Dead Sea mud has been valued for many centuries for its therapeutic qualities and because the mud can be used pure locally, it is an excellent way to treat skin problems such as psoriasis, eczema and acne.
• Wash your hair and scalp regularly with anti-dandruff shampoo if you have dandruff with a rash.

When should you consult a doctor if you have a rash on your cheeks, chin, nose or forehead?

Contact us directly

Contact a doctor immediately if you experience a rash along with any of the following symptoms:

• Increased pain or discoloration in the rash area;
• Squeezing feeling or itching in the throat;
• Breathing problems;
• Swelling of the face or extremities;
• Fever;
• Confusion;
• Dizziness;
• Severe pain in the head or neck;
• Repeated vomiting or diarrhea.

Make an appointment with your GP

Contact your doctor if you have a facial rash accompanied by systemic symptoms such as:

• Joint pain;
• A sore throat or sore throat;
• Elevation;
• Red streaks or tender spots near the rash;
• A recent insect bite.

 Patch test or allergy test / Source: Jan Polák, Wikimedia Commons (CC BY-SA-3.0)

Examination and diagnosis of the rash

Physical and other examination

Your doctor will perform a physical examination and examine your rash. The doctor will ask questions about your rash (since when have you suffered from it, what preceded it, etc.), your medical history, your diet, recent use of products or medications, hygiene, etc. The doctor can also take your temperature. and conduct a number of follow-up studies, such as:

• Blood tests;
• Allergy test;
• Perform a skin biopsy, in which the doctor removes a small sample of skin tissue for analysis under the microscope.

Referral or treatment

If necessary, your GP can refer you to a specialist, such as a dermatologist (skin doctor), for further examination. The doctor may also prescribe medication to relieve your rash in the form of an ointment, cream, lotion, or pills. Most people can treat their rash well with medications prescribed by their doctor and self-care measures.

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