Is this rosacea?

[tru3006]

I don't know which topic to put this under because I have no idea what it is. I want to stress how important this is to resolve, as it's been affecting my life for a few years now. I am very self conscious and i have actually held back from going off to college just because of this. It affects my life tremendously.

When I was about 16 years old I started to notice that my nose was getting oily. I always dabbed it off. It started to spread to my cheeks as time went on. Around this period i also began to get some acne, so i began washing my face frequently. A few weeks later I noticed that my chin had some flaky dry skin (still oily nose/cheeks). From then on, it's only progressed. At 20 years old my face is pretty much 100% oily and dry, everywhere. If I wash my face (i use spectroderm or cetaphil, some times apple cider vinegar) my skin gets dry immediately and the oil starts to show about 1 hour later.


Some symptoms to note that may help you identifiably what exactly this is:

-around 15 I started getting bad dandruff. My scalp would become very greasy and scaly. I still get dandruff and my hair is very oily (just like my face.. oily + dry)
-around this young age I also used to get patches of itchy red skin on my face some times... almost looked like sun burn
-I also used to get flaky yellowish patches of skin on my face
-The inside of my ears and directly behind them are usually dry
-Currently I don't usually get any red patches on my face.. the odd time i just get a white hive looking bump which is really itchy. I just suffer from and oily and dry trunk.
-My grandfather some times gets red patches on his face after shaving. I have seen Rosacea cream in his bathroom before.
-My father will break out with itchy red dry patches around his cheek line about once ever couple months. He applies hydrocortisone cream and it goes away.



Any ideas what I have and what I should do?

Thanks a lot

[tru3006]

Again, thanks a lot for your help. I will try to consult with a dermatologist as soon as possible and I will let you know with updates

[Bhupinder Kaur, MD]

Hello,
Seborrheic dermatitis is usually caused by overgrowth of Malassezia furfur. This skin disease commonly affects adolescents and young adults, especially in warm and humid climates and is aggravated by sweating and humidity. I suggest you to get an examination done from a dermatologist so that diagnosis can be confirmed and then only treatment can be started.

I hope it helps. Take care and regards.

[tru3006]

I genuinely appreciate the response Bhupinder. You are the first person of your stature to actually take the time and try to help me out. As I mentioned, this condition is really dragging my social life down and preventing me from going to college.

I was very intrigued after a search of 1% pimecrolimus creame. The results seem to clear up the majority of patients with Seb derm.

About the doctor, I actually went in TWICE already to explain the conditions and trying to get a referral or whatever it's called to a dermatolgist... both times the doctors didn't even seem to believe what I was explaining. I live in a small town so they aren't used to weird conditions like this I guess.

Is it possible to go straight to a dermatologist without consulting a doctor first? I know a dermatologist in a city 3 hours from me. I have his phone number and address

[Bhupinder Kaur, MD]

Hello,
From the symptoms it looks like seborrheic dermatitis. Seborrheic dermatitis is a common skin condition that causes flaky, dry, white to yellowish scales to form on oily areas esp under the nose or anywhere on face. People with seborrheic dermatitis produce too much sebum (the natural skin oil). Later, pityrosporum yeast grows excessively in the sebum, sometime along with bacteria, making the dermatitis more persistent.
Topical antifungals and mild steroids are the usual treatment and combination of the two can be used to treat stubborn patches. Oral antifungal drugs and immunomodulators such as tacrolimus and pimecrolimus are used in very severe cases. The other possibilities are of eczema, lupus erythematosus or dermatitis. Best would be to consult a dermatologist and get biopsy skin done to confirm the diagnosis.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.