Red, flushed, itchy flakey face

Hello,
I have had skin problems ever since I was a child.  I was diagnosed with mild psorasis on my scalp and small spots on my body that would show up every once in while.  I have had that for 20+ years.  My mother said I had ezcema (eczema) as a child.  I have had rosy cheeks forever and in the past 5 years it has gotten worse.  My face burns, itches in varying degrees all the time.  I flush very easily and sometimes while not doing anything.  It really hurts!  Sometimes the only thing that will help is ibuprophen or a cool wash rag. Most of the time it is really flakey and scaley.  Though at times it can be oily, usually before it turns scaley. It is very embarrassing and nothing seems to help.  I have been on many medications, both topical and oral, and nothing works.  

My new derm. (whom I have seen twice), this second time prescribed locoid for 2 weeks and eletone.  My problem is that the lipocream worked!  It worked SO good, my skin felt the best it has in over a decade!  No swelling, burning, itching, and minimal flakeyness and redness.  I used it twice a day for 2 days, then once a day, then every other day for a couple days.  All while using the eletone emoillent.  Felt and looked great.   Then after about 4 days of stopping the Locoid, it all came crashing back!  I thought I had it beat. I am devistated!  I know that steroids are only for the short term, but this is the ONLY thing that has worked for me!

My diagnosis was initially rosacea, but I have no papules or pimples, except the  ocassional one.  This last visit, I asked her if it was ezcema (eczema), and she didn't really say one way or the other.  She said well it definately isn't a sunburn, because you avoid the sun. Which I do, it hurts my skin, and I feel sick usually after being in it.  Does anyone have any thoughts or advice.  I am miserable.  I go back to see her in a couple of weeks.  Thanks.

[luvdogz]

No thoughts?  Anyone?

[Bhupinder Kaur, MD]

Hello,
From the symptoms that you have described,it indeed sounds like rosacea and eczema(chances are more).The cream that your dermatologist has prescribed i.e. locoid(steroid) and Eletone emollient is the standard treatment of eczema.I would suggest that you get a biopsy of the skin scrapings done to confirm the diagnosis. Till then,wash the areas several times with fresh water. Do not use any cosmetic products at the sites. You can apply some calamine lotion at the rash as it will help in soothing the skin. You can take some OTC oral antihistamine medications like Benadryl or Claritin and see if it helps.Also keep it well mositurised by the emollient cream.

Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any additional queries.Warm regards.