Persistent Hard Skin on Forehead (and shins)

[nawailohi]

Hi there,

For most of my adult life I have had persistently hard (but not flaky) skin on my forehead. It feels like an exoskeleton and looks thick and dull. So far, it has been completely unresponsive to moisturizers. (Even when my forehead looks like an oil slick the skin is still hard.) The condition seems temporarily ameliorated by exfoliation but really only for a day and my skin is too sensitive to exfoliate very often. The redness and inflammation brought on by even gentle exfoliation lasts longer than the return to semi-normal texture. Mousturizers with AHAs or strong retinols make my skin flaky and break out in little, red, ulcer-like pimples.

I was diagnosed with rosacea a year or so ago and given a prescription for Metrogel. Frankly, I haven't noticed a big change since starting this product (2x/day). I still get small, white-ish 'underground' pustules (I am 36) and my skin is still ridiculously sensitive. My derm sees 115 patients a day though (or so her assistants tell me) and she doesn't seem to have the time for anything other than skin cancer (which I am glad she looks for) OR the named skin disorder given when making the appointment. (You only get five minutes and one shot with these things...dang hmo.) My diagnosis of Rosacea and treatment plan, for example was made in 5 minutes after making an appointment to talk specifically about Rosacea, pointing out my perpetual flushing, thickened skin around my nose and cheeks, and telling her that both my parents and grandfathers had Rosacea.

Basically, I'm afraid my 'hard skin' issue will seem to obtuse or vague and wanted to solicit some professional advice before making my appointment.

If it helps, I seem to have a similar issue on my shins. On my shins, however, the skin looks scale-like. I have tried every moisturizer known to man (Vasaline, Am-Lactin, Lac-Hydrin, Carmol-20, etc.all right after tepid showers) and nothing seems to make a dent. I have drank water to the point where I am going to the bathroom constantly and my legs feel like they will burst. I don't know what else to do.

Do you have any ideas that might help me either treat this or at least have a focused discussion with my derm?

Thank you,
NaWaiLohi

[PINKY82]

Could psoriasis be the cause of my asthma ? or maybe the opposite?I have breathing problems and i did have bronchitis, i also have eczema but i'm not sure if all that trigered my breathing problems.Please advice me.

[Bhupinder Kaur, MD]

Hello,
Three possibilities are coming to my mind. First possibility is of eczema, second is of rosacea face, third is of psoriasis. Psoriasis is a chronic, autoimmune disease and causes red, scaly patches to appear on the skin. Eczema is a form of chronic dermatitis (rash).Allergic reaction is one of the important causes of eczema.
My sincere advice is to consult a dermatologist and get a biopsy skin done to confirm the diagnosis.
I hope it helps. Take care and regards.