Redness. Swelling. Drying. Eczema flares make us uncomfortable, no doubt about it–but they can also make us self-conscious. No one can be blamed for reaching for the extra-coverage foundation during an eczema flare. But could this make the flare even worse? 

The answer is yes. Your skin is already inflamed during an eczema flare, and diminished barrier function makes it more vulnerable than usual to irritants in makeup.

Not all makeup is created equal, though. Some products can be well-tolerated during a flare, and some might even offer some benefits. We’ll take a look at some things you should consider if you want to wear makeup during a flare. 

When Beauty Is a Beast: How Makeup Can Aggravate Eczema Flares

Makeup is a marvelous tool for self-expression, allowing us to turn our faces into veritable works of art. It can give us a sense of confidence, especially on days when our skin isn’t at its best. Unfortunately, it can also aggravate an eczema flare in numerous ways. 

Your skin is more prone to drying and cracking during a flare. When heavier foundations are applied, they can irritate skin that hasn’t yet had time to heal. This can worsen inflammation, which means increased itching and redness. Many people will continue to layer this makeup on to hide or to minimize the growing redness, not realizing that they are locking themselves into a vicious cycle. 

These foundations can require more abrasive removal techniques at the end of the day, further damaging fragile skin cells and contributing to transepidermal water loss. The end result is skin that is dryer, redder, and itchier. Ironically, thick makeup can also draw attention to dry, damaged skin, because it isn’t absorbed as well in these areas. 

Makeup brushes and sponges can be unnecessarily rough on the skin. They can also harbor undesirable bacteria if they're not cleaned regularly and properly. The skin’s microbiome is already unbalanced during eczema flares, making it more susceptible to infection. 

“User error” alone doesn’t account for all of the harm makeup can do during an eczema exacerbation, though. Many common (and in some cases, universal) cosmetics ingredients worsen eczema symptoms: 

• Fragrances in cosmetics are a common source of irritation for flaring skin. Fragrances can include both “natural” and synthetic ingredients–and either one can cause irritation.  In fact, one of the most highly-allergenic fragrance ingredients is Balsam of Peru, the resin of a Central American tree. Essential oils are popular, but they too can be highly irritating. Synthetic fragrances will normally not be listed singly; they’re often closely guarded, proprietary formulas, and labeling laws allow cosmetics makers a lot of opacity with labeling them.

• Metals such as nickel are found in almost all makeup products. They sometimes “hitch hike” with other minerals (such as talc) used in a product; in other cases, they are added to give dimension to pigments. The Food and Drug Administration found that powdered and highly-colored products such as eye shadows, blushes, and powders (loose or pressed)  contained more heavy metals than other types of cosmetics.

• Many suggest that “mineral” makeup is a less toxic, more natural alternative–but all makeup contains minerals. Moreover, metals themselves are minerals. Like “unscented” or “all natural,” the “mineral” label is not helpful or precise when trying to discern a cosmetic product's safety. 

• Preservatives are necessary parts of  any cosmetic preparation, added  to prevent harmful microbial growth. Some are harder on sensitive skin or damaged skin, though. These include parabens, benzyl alcohol, methylchloroisothiazolinone, urea, propylene glycol, cocamidopropyl betaine, and formaldehyde. 

Even with all these caveats, makeup isn’t inherently harmful to skin during flares. With some knowledge and flexibility, most people can continue to use cosmetics when their skin is flaring–below are some strategies to assist you. 

Start With Good Skincare 

An artist would never dream of painting an unprepared canvas–and you should never dream of applying makeup to skin that isn’t prepared.  This is most especially true during flares!

• Use a gentle cleanser. Soaps are drying, especially for eczema-prone skin, as are benzoyl-peroxide-based cleansers. CetaphilⓇ, CeraVeⓇ, and AveenoⓇ all offer gentle, dermatologist-approved cleansers. Oil cleansers are also popular; they minimize friction and drying.

• No scrubs or harsh exfoliants. Your skin needs plenty of TLC during a flare, and that means…no scrubs (I couldn’t resist). Scrubs are too abrasive for compromised skin and make eczema symptoms worse. Salicylic acid, glycolic acid, alpha hydroxy acids, and retinoids such as tretinoin can all worsen redness and drying. Avoid toners containing alcohol–it rapidly dries the skin.

• Add humectants Your skin loses moisture more rapidly during eczema flares. Humectants help your skin cells attract water. Glycerin and hyaluronic acid are well-regarded humectants, and they work well in moisturizers and serums. 

• Moisturize aggressively (but gently)  Moisturize at least twice a day. Don’t skip the morning moisturizing routine! CeraVeⓇ AM Facial Moisturizing Lotion with SPF 30 is a great option for daytime use. Consider switching to a moisturizer with a creamier base, especially at night time or prior to facing harsh weather. Cleanse and moisturize well before you apply your makeup. Give each layer of your regimen time to “sink in” before adding another, and allow your final product several minutes to permeate your skin before applying your makeup.

• Use sunscreen every day. Use sunscreen to decrease the irritating effects of UV radiation on your healing skin. Use at least 30 SPF. While “mineral” doesn’t mean a whole lot on a label for makeup, it is an important distinction for sunscreen. Mineral sunscreens block UV radiation without aggravating sensitive skin the way chemical sunscreens can (although both are effective). 

• Add beneficial ingredients to your skincare regimen. Niacinamide, or vitamin B3, helps repair the skin barrier and brightens the skin. It can be found in cleansers, toners, serums, and creams. Ceramides are lipids that are abundant in healthy skin cells. Adding them topically can boost flagging barrier function during eczema flares. They are found in jojoba, safflower, and grapeseed oils. 

• Prebiotics help your skin maintain a healthy microbiome–a heterogenous population of microbes that affect the skin’s health. When it’s unbalanced, populations of undesirable microbes can increase and worsen eczema. Oat, pine bark extract, ginseng, and sodium sulfacetamide are all examples of prebiotics. Look for moisturizers containing these products (bonus; oat combats itching and redness).

Read the Labels

Look for hypoallergenic and fragrance-free products; “fragrance,” “perfume, “parfume,” and “aroma” all signify that a product contains fragrances. Do not be duped by claims of “all-natural” or “preservative-free” formulas; instead, look out for irritating ingredients. This includes many essential oils and fragrances, as well as the preservatives listed earlier. 

Use A Primer

Primers create a more even surface for your foundation and allow it to go on more uniformly. They also create a barrier between your skin and your foundation, which gives your skin more protection from irritation. Primers that contain humectants and brightening products such as niacinamide leave your skin healthier. 

Choose the Right Foundation 

Resist the urge to slather on the heaviest makeup available. You’re trying to heal your body’s largest organ, not spackle drywall. Also avoid powder foundations–most are drying and highlight areas of uneven texture. 

Tinted moisturizers, BB (beauty balm) creams and CC (color correcting) creams are some possible alternatives. These terms are frequently used interchangeably, but there are some differences:  

• A tinted moisturizer provides very sheer coverage while moisturizing the skin; some have a small amount of SPF. 

• BB Creams offer more coverage than tinted moisturizers but are still lightweight. They hydrate the skin and (usually) offer some degree of sun protection.

• CC Creams are not as creamy as BB creams. They are less hydrating and offer less coverage, and they’re often preferred by people with oily skin. They tend to focus on correcting uneven skin tone and are popular with rosacea patients, and they’re often paired with concealers for spot correction. 

A cushion compact looks like a pressed powder compact, but it contains a “cushion” infused with a lightweight liquid foundation. The foundation can be applied with fingers or the included sponge. They are not as sheer as BB and CC creams and tend to offer more intense hydration. 

Serum foundations give you the benefit of a serum–hydrating, brightening, and nourishing–while providing coverage that more closely resembles a traditional foundation. In fact, some cosmetic companies claim that their serum foundations offer full coverage. If you choose this route, go through your entire skincare regimen as usual–including humectant serums and moisturizers–before you finish with your serum foundation. 

Look for hypoallergenic, fragrance-free, non-comedogenic foundations. Where possible, choose foundations that are dermatologist-approved.

Only use foundation sponges and brushes that have been properly cleaned. Better yet, use your fingers, applying and blending with a gentle patting motion. 

Build coverage gradually, blending so that excess product does not crease or cake in dry, flaky areas. 

Use Water-Based Products to Add Color And Highlighting

Creamy contouring, blush, and eyeshadows are often more hydrating and less irritating than powders. Consider applying and blending them with your fingertips, just like you would for foundation. 

End With Good Skin Care

Never go to bed with your makeup on. It takes a little more effort to cleanse your skin gently when you wear makeup. Use hypoallergenic, non-drying makeup removal products. Oil-based cleansers are good for this. Patiently ensure that you’ve removed all your makeup before applying your nighttime serums, moisturizers, and treatments. 

Maintain Your Treatment Plan 

Continue with any medications your doctor has prescribed, and discuss adding SmartLotionⓇ to your treatment regimen. Developed by board-certified dermatologist Dr. Steve Harlan, SmartLotionⓇ relieves redness, itching, and swelling caused by eczema. Better yet, when used under a doctor’s guidance, it can safely be used with other medications. The eczema cream contains gentle ingredients, including the prebiotic sodium sulfacetamide, that allow a low dose of hydrocortisone to work quickly and safely. 

Apply SmartLotionⓇ to the affected skin in a thin, disappearing layer after moisturizing. Give your skin several minutes to absorb SmartLotionⓇ, then apply sunscreen and makeup as desired. Dr. Harlan usually instructs his patients to apply SmartLotionⓇ between two and four times daily for the first four weeks. He says that moisturizing regularly and frequently during flares is a part of treatment! 

Calcineurin creams like ElidelⓇ should be applied to clean skin before serums and moisturizers. 

Focus on Your Assets

Instead of using makeup to hide the symptoms of an eczema flare, use it instead to accentuate your favorite features. Use eyeliner, eyeshadow, and highlighter to make your eyes pop (if they’re not affected by eczema). Wear a bold shade of lipstick you love. Use highlighter and contouring to make the most of features like high cheekbones or a sharp jawline. 

Makeup is best used as a tool for self-care and self-expression–not as a weapon against your suffering skin. Knowing what to look for will help you choose products that both enhance your natural beauty and support your skin as it heals.

  Cee Van

  Medical Writer

  HarlanMD.com