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Dermatology  (Expert Forum)
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Can't figure out facial rash
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.
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MedHelp Member's Question

Can't figure out facial rash

by lmknip67, Feb 26, 2006 12:00AM
I have been to 3 dermatologists now for this, over the last 9 months. It is a facial rash. Itchy, bumps. Not really a pimple because there is no head. I have no flushing, just irritated skin. I have been through allergy testing, nothing showed up. I have been through treatment for rosacea, nothing helped. I tried treatment for steriod rosacea, again did not help. And finally this last week I went to a dr. who said it could be a yeast rash. I was on antibiotics last year for asthma for a course of 12 weeks then 6 weeks again. The rash started in the summer after that. Now I am on the same treatment again, zithromas 750 mg weekly for 12 weeks. This derm. told me that yeast rashes on the face can happen in women and are very itchy. He also said I should finish this antibiotic treatment before we treat for that. My question is could it really be that? on my face??? I don't have yeast issues anywhere else that I know of. no rashes, or infections or nail problems.  My scalp also itches, but no bumps. I have some itchy redness to my eyes also. It has been said to not be an eczema or dermatitis. Not rosacea now. I don't have the rash anywhere else but my face, but the entire face except the nose. The bumps itch and go away in a day. But of course more pop up and are all over my face. They are small bumps. some red, some not as red. Sort of flattish, no real center. He wants to treat with an oral antifungal. I guess my question is could it be this? How common is this on the face? I have heard of skin folds etc, but it doesn't look like pictures of that. The next step if that doesn't work, he said, is to do a hiopsy. But that sounds scary and will leave a scar. I am left hoping it is this fungal thing because that sounds treatable. But I have been suffering with this for 9 months now so am still a bit hopeless.I am currently using a mild 1 % hydrocortisone cream and elidel. They both used to help but the last few days don't seem to help as much. I stopped using anything because I really wanted him to see what was happening on my face. But since stopping then restarting these things, they don't seem to help as much. I have not used the cortizone cream for 6 months until now when I was told it was not rosacea and it would be fine to use it if it helped. Thank you for any insight you can give me.
Doctor's Answer

by Alan Rockoff, MD, Feb 27, 2006 12:00AM
There is a condition in which yeasts (not the ones that cause vaginal yeast infections) cause pimples in the facial follicles.  It sounds reasonable and safe to try treating that, since everything else has failed.  Your dermatologist seems to be thoughtful and sensible, and I advise you to follow his advice.



Take care.



Dr. Rockoff
Member Comments (11)

by lmknip67, Feb 27, 2006 12:00AM
Can I ask what is that condition called?

by Alan Rockoff, MD, Feb 28, 2006 12:00AM
Pityrosporum folliculitis.



Dr. Rockoff

by jccsr9261, Mar 19, 2006 12:00AM
To: imp
Hi imp:  well, guess what?  I have the exact same thing!  I had a short run of antibiotics in August of '04 and by 2/05 my face broke out with this rash, started in between my eyebrows and slightly above each one.  I also had a very itchy scalp but like you with no bumps and my rash is exactly like yours.  Same description, then it spread over my forehead and to my cheeks and then attacked my nose and then my chin -- basically my "T-zone." My dermatologist diagnozed it as a "yeast" overgrowth, which it is.  He recommended "Selsun Blue" dandruff shampoo at least 2x a week and wash once, leave one minute, then wash again and leave 3-5 mints.  I also rinse with white distilled vinegar 1/4 c. diluted with warm water in between those days.  That's taken care of the the scalp itch.  Both of those things kill the yeast and return the acid mantle to your scalp so your pH is returned.  Now, for the facial rash, he prescribed 2 creams which I mix 50/50; 1 is Desonide 0.05% and the other is Ketoconazole 2%.  The 1st is a cortizone cream to stop the redness and itch; the second is an anti-fungal. Antibiotics wipe out all bacteria, good and bad in your intestines and that's how yeast takes over.  It proliferates and then when your kidneys and liver can't process it fast enough, your skin is attacked.  Probiotics are essential is ridding this.  Believe me, I've had this for over a year and I'm going to "War" on it because it's getting worse and I've had it.  You will need to restrict, temporarily, sugar from your diet which means no breads, pasta, sugar, honey, wine, beer (any alcohol) soy sauce, fruits (except lemons/limes) and you need to restore your system with probiotics which are the "Good" bacteria that will control the yeast. Yeast can never be destroyed, but you need to "rebuild" your system so you can tolerate the regular amount and not have an overgrowth which is caused by antibiotic use.  If you need sources for probiotics, you can call me.  That cream has worked well to treat the symptoms, but I want to get to the "cause and root" of my problem so it goes away...

by jccsr9261, Mar 19, 2006 12:00AM
To: imk
Hi imk, sorry I typed your name in wrong...I also read that taking medications used for asthma (as well as Prednisone, etc.)also cause a yeast overgrowth.  Yeast is stubborn and the treatment takes about 3 months to 6 months to get rid of it.  So far, my face has cleared up 80% and my scalp is not itchy and my IBS has improved.  I think I'm on the right track.  Treating your scalp is important because yeast likes hair roots.  I've seen pictures of what the M.D. suggested, the follicle infection, but that doesn't look at all like what you and I have. My yeast a feeding on my my T-zone because of the oil as well.  So I keep it dry and don't put moisturizer on my face at all.  I also sit in the sun just 10 minutes in the morning when I can because it kiils yeast as well.

by applejacks01, Mar 26, 2006 12:00AM
hi im 17 yrs old and have the samething and i have no idea what this is...all i know is that i was on biotics for strep and the docs put me on zpacs and it killed everything good and bad! now i have to go around school with my mouth all red and my head ichy...i do have a lot of suger in almost everything that i eat...i just want to know what i can do to get rid of it...i was putting this triple antibiotic ointment that my dad had in a first aid kit he got from work...it helped!in a day or two it would be gone but then it would come beck in about a week...i have a little cuz that is almost three and well she wanted to spend the night with me  but the only way that she will fall asleep is if she can touch my face... if i dont let her then she wont sleep so she did and now it is back and its been on my face for a week and it wont go away...i dont know what to do...if you know anything....please........let me know!!

by VJWTCB, Mar 27, 2006 12:00AM
I just got through taking a hug amount of anibiotics to have a root canal.  About 4 days later a rash started appearing around the bottom of my eyelid, one side went away on its own and the other side got worse.  Just little red dots that itch and when scratched whelp up and spread.  Now they are all over my face.  It seams that I can look at my face i hour and come back in another hour and there will be 2 and up to 4 more in different places.  If it is yeast can it be spread by makeup and/or moisturizers and what kind of cream can you use to make them dissapear and can it be used daily for prevention.  This sounds like the same rash that the others have and the same cirumstances with takin antibiotics.  Please help have a very important function to go to in a week.

by myok, Apr 05, 2006 12:00AM
To: imkmip67
Hi,



I have had the same similar rash. I had it for almost a year.  I went to a Derm Dr, she told me, I had Seb Derm, or facial ezcema and she put me on some ointments that alieviated the redness, but the rash did not go away.  I started applying OTC Cortisone 10 on my face 3 times a day to the effected areas, and the rash has gone away. Now, When ever I see a small red area under the skin