Rash around nose

[mave]

Hey Dr. Rockoff,

I'm an MRI Technologist and I was browsing around the net and stumbled across this site, pretty cool idea.

Anyways, I thought I'd fire one across your bow about a strange rash I have had for a few months in the alar-facial groove on the outside of my face. More recently a patch has appeared below my bottom lip.

History includes - painful(burning & itching sensation) at times, is highly red and seems to die down occasionally and flare back up. It seems to be bumpy with clear fluid inside the bumps. I have also noticed a few white fluid filled pockets in the rash occasionally.

Originally I had tried an otc antibiotic ointment with no luck, then moved on to a cortizone ointment with no luck.

A doctor friend gave me a sample of betamethazone to try and it seems to be helping slowly over about 5 weeks, but it seems to have stopped progressively getting better. Doesn't seem like its quite enough to make it completely disappear. Any suggestions as to what this is and how to treat it?

Thanks!
mave

[Alan Rockoff, MD]

You may have steroid rosacea.  Steroids, especially fairly strong ones like betamethasone suppress the rash and redness a bit, only to produce a flare as soon as you stop.  My advice therefore is to avoid all cortisone derivatives and to see a doctor about using a topical antibiotic like metronidazole.  I can't say what produced the rash in the first place, but it's not uncommon.

Best.

Dr. Rockoff

[dcdre14]

Hi,

I've been getting the exact same symptoms as you describe over the summer since I was a teenager... I always thought it was just sun damage or dry skin or whatever...

This summer it got so bad - red, inflamed skin on my nose, cheeks, upper lip, lower lip and chin - that I caved and went to a dermatologist.

He gave me a prescription for the metronidazole cream the good doctor mentions here.  My doctor said it would take about a month for the stuff to kick in and produce a noticeable result.

Well within two weeks the redness and inflammation was completely gone! Even the small blackheads on my nose and cheeks have cleared up... I've spent years trying to get rid of those using the strips and special soaps!

I guess I had an unusually fast result, but it's worth a shot... The only downside is that I'm told the metronidazole doesn't actually cure the condition... it just treats the flare-ups... I'm on it for life!

Good luck,
E