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Dermatology (Expert Forum)
Rash on face, on chin, around nose
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
Rash on face, on chin, around nose
by nikkilynn143, Aug 24, 2002 12:00AM
I am an 19 year old female, and I have a rash on my face. I got it around March of this year. It started out not being very bad, but it got worse. I think it is at it's worst right now. I was taking Desogen birth control when it started, and I have since switched to Ortho-tricyclin, because I thought it was the birth control that caused it. While I was off of it, it was still occuring, and now that I am on the ortho (for a week now) it's really bad.
The best way I can describe it is it's very very red, it's on my chin, and there are little bumps throughout it. It also occurs on the corners of my nose, spreading out a bit past my mouth. It didn't used to itch when it wasnt too bad, but it's starting to. It sortof resembles poison ivy, however I know that's not what it is. I have been to the doctor numerous times, but they have not been able to offer very much help. The first time i went, they gave me Bactroban cream, because they thought it was a bacteria. This did not work, so i went back and they gave me Cultivate cream, which from what i understand is a steroid cream, and it drastically reduced the redness and spreading. I used up all of the sample sizes, and it came back full force, and went back to the doctor who told me that it had to do with blood vessels pushing my skin out (which i know is not true) and she gave me 2 big tubes of cultivate, and told me not to use it more then 3 weeks. However, I can not go without using it. If I do the rash gets terrible. Right now I havent used it for two days, and I look really really really bad. I called the doctor this morning and they gave me a perscription for Westcort 0.2% which has not helped at all. I go to the dermatologist on tuesday, but I am extremely scared that he is going to tell me there is nothing he can do, and my face is going to explode with this, all over. It's a terrible sight. It's actually starting to show up in between my eyebrows. What do you think it is, and what could I do?
Here is a picture
http://www.geocities.com/xvnicolevx/rash.jpg
Thank you in advance for your advice
The best way I can describe it is it's very very red, it's on my chin, and there are little bumps throughout it. It also occurs on the corners of my nose, spreading out a bit past my mouth. It didn't used to itch when it wasnt too bad, but it's starting to. It sortof resembles poison ivy, however I know that's not what it is. I have been to the doctor numerous times, but they have not been able to offer very much help. The first time i went, they gave me Bactroban cream, because they thought it was a bacteria. This did not work, so i went back and they gave me Cultivate cream, which from what i understand is a steroid cream, and it drastically reduced the redness and spreading. I used up all of the sample sizes, and it came back full force, and went back to the doctor who told me that it had to do with blood vessels pushing my skin out (which i know is not true) and she gave me 2 big tubes of cultivate, and told me not to use it more then 3 weeks. However, I can not go without using it. If I do the rash gets terrible. Right now I havent used it for two days, and I look really really really bad. I called the doctor this morning and they gave me a perscription for Westcort 0.2% which has not helped at all. I go to the dermatologist on tuesday, but I am extremely scared that he is going to tell me there is nothing he can do, and my face is going to explode with this, all over. It's a terrible sight. It's actually starting to show up in between my eyebrows. What do you think it is, and what could I do?
Here is a picture
http://www.geocities.com/xvnicolevx/rash.jpg
Thank you in advance for your advice
Doctor's Answer
by Alan Rockoff, MD, Aug 25, 2002 12:00AM
, Aug 25, 2002 12:00AM
Thanks for the picture, which corroborates the lovely description you've given of steroid rosacea. Not everyone gets this response to steroids on the face, but when they do, they get a rash just like yours. Every time you try to stop, the rash gets redder and angrier, so you start again. Some people call this "steroid addiction."
However, you are going to be totally fine. Your dermatologist will tell you the same thing, then ask you to use an antibiotic cream, probably one containing metronidazole, and also probably suggest an antibiotic like doxycycline.
For the first few days your face will get worse. Your skin will be calling, "Give me steroids!"
Don't listen!
Instead, stay the course (maybe 3-4 weeks), and you're going to clear up completely, with no lasting effects whatsoever. This is NOT the prelude to long-term, middle-age rosacea.
And in future, if you get a facial rash, avoid the steroids. Some people can use 'em, but not you.
Take care.
Dr. Rockoff
However, you are going to be totally fine. Your dermatologist will tell you the same thing, then ask you to use an antibiotic cream, probably one containing metronidazole, and also probably suggest an antibiotic like doxycycline.
For the first few days your face will get worse. Your skin will be calling, "Give me steroids!"
Don't listen!
Instead, stay the course (maybe 3-4 weeks), and you're going to clear up completely, with no lasting effects whatsoever. This is NOT the prelude to long-term, middle-age rosacea.
And in future, if you get a facial rash, avoid the steroids. Some people can use 'em, but not you.
Take care.
Dr. Rockoff
He gave me a shot of Celestone in my hip, a bar of cetaphil, a prescription to Doxycicline, and Klaron Lotion 10%. Since I went, the rash really started to go away. I think it was the shot. I have a followup appointment in two weeks to see the progress.
I just want to say thank you for this website! Reading it really helped me figure out what i had, and once i figured it out, i felt SO much better about it, because at least then i could give an explaination when someone asked! Keep up the good work!
Nikki
I have been having the same problem as you (almost word for word - spooky). My rash started at the beginning of this year and got steadily worse. It also got much worse after using the steroid cream and then stopping. I am now a steroid cream junky! My face looks like your picture if I don't use it. Please keep your comments up to date so that I can see what the outcome is. I am also waiting to see a dermatologist, but, as with all doctors, I would like to give them a helping hand. I will also let you know what happens with me. Maybe, between us we can discover a new disease? Good luck. PS the main point of this rambling note is to let you know there are "others" out there and to let you know how grateful I am to know there is someone else with the same problems.
After stopping the antibiotic cream (its been about 2 weeks now) it got worse, for about a week, worse and worse, and it looked terrible. the dermatologist prescribed me to Doxycycline and this stuff called Klaron lotion, and the klaron lotion made it worse and cracked and really red, so i stopped using it. After almost 2 weeks of taking the doxycycline, the rash spread a bit, but got very less noticeable! you can only see it if you look close, it's just a little darker then the rest of my skin. there is hope! i would reccoment printing out some pages on perioral dermatitis, take them to your family doctor ASAP and ask them to put you on doxycycline. tell them you know someone that it's working for! it really is, i'm very happy about it too. whatever you do, stop using the steriod cream soon! go to clinique and get the city base compact foundation to cover it up for now, and use cetaphil to wash your face. but get to the doctor soon! email me
-nikki
I came up with Perioral Dermatitis too, but It took me 3 months to figure that out. I've been treating it for a little over a month. My derm. first put me on Doryx which I took for about 2 weeks and found out the hard way that I was terrible allergic to it. I was also on Klaron, which made my face real dry and red, so I stop using it. Then my doctor told me to stop using the Doryx and gave me Nicomide, which is a vitamin for POD. She also told me that I need to use the Klaron, even just a little because it would help with the bumps. I've been on the vitamin and Klaron twice a day for about a month and I've seen a great improvement. The Klaron is really good to get rid of the bumps. But my chin is still very red from the rashes. I'm not exactly sure on how to get rid of it. I read about sodium lauryth sulfate. So I'm going to change my toothpaste and shampoo to see if that makes a difference. I also read that you shouldn't use waxed floss, cinnamon and spirement gum or candy, alcohol, caffine,and spicey foods. I don't know if that's all true it's just something I found in an article. I guess it's just different strokes for different fokes.