Rash on my face

Hello,
I am 24 year old male, and I get this rash above the bridge of my nose on my forehead, my nose and on the right cheek that is red and slightly raised and extremly itchy and it burns (but not scaly) and it refuses to go away. I deveolped a rash similar about 5 mo ago and I found a steroid cream in the medicine cabinet (Clobetasol Propionate) which I tried a very small amount on the affected area and it cleared up withing a few hours, and it stayed away for 2-4 days at a time. I have had to keep using it since then whenever it comes back. I heard from someone out that steriod creams thins the skin out, so I worried a bit and did some researh on this Clobetasol Propionate, and found out it is a super strong steriod cream (mind you I use tiny amounts), but I was still worried. So I tried to stop this treatment and I lasted about 5 days without the cream, but my face itches and burns and screams for the steriod cream. The rash is not very noticeable on the face it looks like my skin is just iritated, but the itching and burning consumes me and it gets worse the longer I go without it. I recently went to urgent care for another minor problem and let the doctor look at the rash while I was ther. She said it looked like baby acne (or diaper rash). I forgot to mention to her that I was using the cream. She prescribed doxcycline and a Hydrocortisone cream. I have started the doxcycline, but have not used the cream.

Questions:

Could my skin be "addicted" to the steriod cream, because I think it is, (is there such a thing)?

If so, how do I get off of it?

Will me using that Clobetasol Propionate damage my skin permanently, or anything else for that matter (when I use it my skin looks and feels pretty much normal)?

I see a primary care doctor in a couple of weeks, should I ask for a dermatolgy referal?

Should I change to the Hydrocortisone cream and slowly try to ween myself off of the topical steriods or just stop cold turkey?

Should I continue with the Doxcycline?

Thanks
Brett

[Alan Rockoff, MD]

Good diagnosis!  You have steroidm rosacea, sometimes referred to as the "steroid addiction syndrome."  Clobetasol is way too strong to use on the face--it can NOT, however, cause permanent damage.

The doxycycline is just the thing.  You may need to use it for a month or two.  At first your skin may worsen, because it "wants" the steroid.  Don't listen!  Your doctor probably intended to wean you to the weaker hydrocortisone beofre stopping steroids altogether, but I think you're better off just using the doxycycline and perhaps adding a topical antibiotic (clindamycin, metronidazole).

Once you're clear, you should be all set indefinitely.  It sounds like your doctor has the situation properly sized up and well in hand.  Good job.

Take care.

Dr. Rockoff

[jannov]

Dear,
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