Erythromelanosis folliculitis faciei (EFF) is an underdiagnosed and rare pigmentary condition characterized by asymptomatic symmetrical erythema, hyperpigmentation, and follicular papules over the face and neck. We report a case of a 13-year-old Chinese boy, with a strong atopic background of asthma, allergic rhinitis, and atopic dermatitis, who presents with cosmetically troubling asymptomatic dyspigmentation over the bilateral cheeks since he was 18 months old. The clues to diagnosis included the morphology of the persistent rash, as well as prominent keratosis pilaris over his proximal limbs. This report aims to discuss the clinical spectrum of EFF and its differential diagnoses and review existing literature on therapeutic options.