Small red spots on my 4 year olds face itchy and have yellow heads on seem to be more today than yesterday?

Itchy red spots. Are they stabbing over? If so it's chicken pox, if not its probably impetigo, an infection of the skin. See you pediatrician for a definitive diagnosis.

Related Questions

4 year old was diagnosed with impetigo on his face and started cephalexin yesterday. He says its "itchy". What can I put on the spot to soothe it?

Wash. Try washing the area with soap/water and letting it dry out. A non-irritating skin lotion may also provide some relief. Try not to let him/her scratch the area too much!
Cortisone. 1% hydrocortisone twice a day will do the trick. If he is really scratching, then you can even try a dose of benadryl (diphenhydramine) one teaspoon for him is fine, especially if scratching at night is a problem. Hope he is better soon!
Impetigo. Wash gently with soap and water, dry well, apply a triple antibiotic ointment, cut the nails of the child to prevent excoriation.
Ask Dr or pharmacist. Ask his doctor or your pharmacist since children's skin is more sensitive but very gentle dabing (not rubbing) with a soft smooth washcloth in warm water w/ white vinegar (1 Tbs per pint) is often good to lessen itching safely. Sympathy and very short finger nails to avoid scratching may be all you can do. Ask about benadryl (diphenhydramine) and /or hydrocortisone ointment. Jergen's Ultra Healing lotion may help.