Acute Facial Dermatitis in a Young Woman Following Cosmetic Product Use

Case at a Glance

A 24-year-old female presented with acute onset of widespread papular eruption on the lower face following the use of new skincare products, concerning for allergic contact dermatitis.

Patient's Story

The patient reported waking up with sudden onset of extensive small white papules covering the lower half of her face, accompanied by significant erythema and textural changes. She described the appearance as 'insane texture' that she had never experienced before. The patient noted that two nights prior to symptom onset, she had used an oil cleanser (Anua cleansing oil) specifically on the lower facial area due to pre-existing textural concerns on her chin. She recalled having a negative reaction to this same product approximately one year earlier, though less severe. Additionally, she had used a collagen face mask three nights before symptom onset. The patient expressed significant distress about the appearance and sought immediate relief.

Initial Assessment

Physical examination revealed numerous small, white papules distributed across the lower face with associated erythema and altered skin texture. The distribution pattern corresponded to the area where the oil cleanser had been applied. The patient appeared anxious about her appearance and had already attempted self-treatment with an over-the-counter antifungal cream containing clotrimazole, based on her self-diagnosis of fungal acne.

The Diagnostic Journey

The temporal relationship between product use and symptom onset, combined with the patient's history of previous reaction to the same product, strongly suggested allergic contact dermatitis. The distribution pattern matching the application area of the suspected allergen further supported this diagnosis. Differential considerations included irritant contact dermatitis, acute acneiform eruption, or fungal infection, though the rapid onset and appearance were most consistent with an allergic reaction.

Final Diagnosis

Allergic contact dermatitis secondary to cosmetic product exposure, most likely related to the oil cleanser given the temporal relationship and previous reaction history.

Treatment Plan

Immediate discontinuation of all recently introduced products, particularly the oil cleanser and collagen mask. Gentle cleansing with mild, fragrance-free cleanser. Topical low-potency corticosteroid cream for anti-inflammatory effect. Cool compresses for symptomatic relief. Avoidance of the implicated products in the future. Patient education regarding patch testing if recurrent reactions occur.

Outcome and Follow-up

Patient advised to monitor for improvement over 3-5 days with treatment. Follow-up recommended if symptoms persist or worsen. Counseling provided regarding the importance of patch testing new products and maintaining a skincare diary to identify potential allergens. Patient was advised against continued use of antifungal preparations as this was not indicated for her condition.