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Dermatology (Expert Forum)
Acne Rosecea?
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.
Acne Rosecea?
by justystarz, Feb 10, 2004 12:00AM
Help, please. I am very frustrated and becoming very depressed. About 6 months ago went to the dr for a small itchy flakey rush rash under my nose. Dr. said it was fungus and gave me lotrisone, said that it would probably come back a few times and to continue using until rash no longer came back.
Never fully went away, a few months later went to see dr #2 because rash was starting to spread to the sides of my mouth, itchy and flakey. He had no idea what it was, gave me desoximetasone. Used for a month and rash continued to spread, now onto my checks.
Went to see dr #3, once again had no idea what it was, first had me try an over the counter combo for yeast and fungus, no luck. Then gave me Metrogel. Used Metrogel for 2 months, rash as always starts to clear and comes back worse each time.
Went to see a dermatologist, said reaction was due to skin being addicted to steroid. Gave me Klaron and continued Metro also said to use the steriod when rash begins to flare (no more than 2 times per week). I researched on the internet and all the cases I found similiar to mine were steroid rosecea and the advice was NO MORE STERIODS. So 3 weeks ago I stopped the steriod and have been using the Klaron and Metrogel.
I called my dermatologist today because the rash is worse then ever and now appearing in between my eyebrows, she said it's because of lack of steriod and to keep using the steroid twice a week until the rash goes away. But I am afraid to do that because everything I read says that this will only start the cycle again. I expressed my concern and her reply was to buy a weaker over the counter steroid cream and continue the Metrogel and Klaron. I can't go to see another derm right now either because my primary dr is giving me a hard time for a referral and I had to pay $85 out of pocket the first time. The rash is now around my nose on the sides of my mouth and all over my chin, it's flakey and itchey red blotches and my nose has also been running for this entire 6 months. Help, please!
Never fully went away, a few months later went to see dr #2 because rash was starting to spread to the sides of my mouth, itchy and flakey. He had no idea what it was, gave me desoximetasone. Used for a month and rash continued to spread, now onto my checks.
Went to see dr #3, once again had no idea what it was, first had me try an over the counter combo for yeast and fungus, no luck. Then gave me Metrogel. Used Metrogel for 2 months, rash as always starts to clear and comes back worse each time.
Went to see a dermatologist, said reaction was due to skin being addicted to steroid. Gave me Klaron and continued Metro also said to use the steriod when rash begins to flare (no more than 2 times per week). I researched on the internet and all the cases I found similiar to mine were steroid rosecea and the advice was NO MORE STERIODS. So 3 weeks ago I stopped the steriod and have been using the Klaron and Metrogel.
I called my dermatologist today because the rash is worse then ever and now appearing in between my eyebrows, she said it's because of lack of steriod and to keep using the steroid twice a week until the rash goes away. But I am afraid to do that because everything I read says that this will only start the cycle again. I expressed my concern and her reply was to buy a weaker over the counter steroid cream and continue the Metrogel and Klaron. I can't go to see another derm right now either because my primary dr is giving me a hard time for a referral and I had to pay $85 out of pocket the first time. The rash is now around my nose on the sides of my mouth and all over my chin, it's flakey and itchey red blotches and my nose has also been running for this entire 6 months. Help, please!
Doctor's Answer
by Alan Rockoff, MD, Feb 10, 2004 12:00AM
, Feb 10, 2004 12:00AM
OK, I'll try:
1. You are correct--no more steroids.
2. Continue the topical treatment.
3. Get a prescription for oral doxycycline, 100 milligrams, twice a day for 30-60 days. If your primary physician doesn't feel comfortable recommending this, or referring you a dermatologist for the purpose, get another primary physician and/or scream bloody murder--by what justification should a doctor refuse to get a specialty opinion if his or her patient has a faceful of rash?
Properly cared for, your rash (technical name: perioral dermatitis) will indeed go away and leave no scarring.
Take care.
Dr. Rockoff
1. You are correct--no more steroids.
2. Continue the topical treatment.
3. Get a prescription for oral doxycycline, 100 milligrams, twice a day for 30-60 days. If your primary physician doesn't feel comfortable recommending this, or referring you a dermatologist for the purpose, get another primary physician and/or scream bloody murder--by what justification should a doctor refuse to get a specialty opinion if his or her patient has a faceful of rash?
Properly cared for, your rash (technical name: perioral dermatitis) will indeed go away and leave no scarring.
Take care.
Dr. Rockoff
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I am sorry that you have been having such a hard time with this.
When I was reading your post it sounded just like what my wife had.
I did some research on the net and found the following image:
http://www.dermnetnz.org/images/pd1.jpg
When I started looking for images I found this one, and it looked exactly like what she had.
She was also using a steriod cream that her OB/GYN prescribed to her. She would use the steriod and then it would get better. Stop using the steriod and it would come back.
She made an appointment with a derm, and I went with her, and I told him that I had self diagnosed her with perioral dermatitis.
He told me that I had it right! He prescribed the same thing that Dr. Rockoff told you about.
It has made a world of difference.
I hope that you can get your Dr. to work with you.
Good luck!
I agree with you concerning the fact that four doctors blew you off and Dr. Rockoff diagnosed you sight unseen and got it right.
Dr. Rockoff is a great man. He has helped literally thousands of people all with keystrokes!!!!!!!
I hope that you continue to do well.
After reading about Perioral Dermatitis at this forum, i'm positive about my condition.
I've been using Quadriderm for the last 3 years to "calm it down" but it hasn't healed it (this cream was prescribed by a dermatologist) and i'm worried about using this substance on my skin for so long. I'm sure it's not good and i also believe that after all this time it has lost it's effect on me.
Anyway, i made some research here in my country and the Doxycicline cream does not exist ( Mexico). I found "Vibramicina 100mg" but it's capsules not cream...
Are Doxycicline capsules as effective for Perioral dermatitis as it is the cream? Can i ask this prescription from a Dermatologist?
I in advance thank for you assistance and wise advise.
Regards,
Carolina Gómez
Mexico City.