Facial Skin Condition/Dermatitis or Rosacea

I have a facial skin condition that has been diagnosed as seborrheic dermatitis and rocacea.  The doctors that have seen my condition have not seen anything similar and so are not positive on the diagnosis.  The condition appears to be onset by extremes in temperature and has the following progression:

A few small white pustules form on my chin and under my nose that rapidly progress to maybe 50 small white heads covering my entire chin and under my nose.  This progression occurs within under 1 day.  I experience a burning sensation in the skin.  This acne rash type condition lasts for approximately 4-5 days and is followed by oily scaly deposits on chin, under nose and around nostrils (I have a picture of this, can I upload it?).  This material is slightly yellow in color and the skin is still very red and burny.  This lasts for approx 3 days, and then my skin returns to normal.  In addition, since my last outbreak I have developed excess skin growth on the tip of my nose and area between nose and upper lip, which have not receded.

I find that the severity and occurance of this problem are both increasing.  Initially the condition was set off by hot weather, but is now occuring in cold weather as well.  In the cold weather I have a less severe, but constant inflamation (inflammation) under the nose which is more like the final stage of the condition, i.e. very oily skin that is very senitive (burning and itching).

[Alan Rockoff, MD]

Pustules are a feature of rosacea, not seborrhea.  I assume that the doctors you've seen are dermatologists.  If so, they will surely have performed bacterial cultures on the pustules, and tried rosacea therapies (oral, topical antibiotics) to gauge the response.  If you haven't seen skin doctors, you should.  Obviously, you have a case that's at least somewhat atypical, so it needs to be diagnosed and treated in person.  I'm confident that testing and treatment will bring whatever it is under control.

Best.

Dr. Rockoff