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Dermatology  (Expert Forum)
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Red Mark on face Very Stubborn
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.

Red Mark on face Very Stubborn

by popcornsean, Oct 21, 2003 12:00AM
Hello,

Not to sure how this is meant to go so I'll put a little about my history and then current issue. Please forgive the spelling mistakes that follow

Oct 2001 Diagnosed with Palmo Platar Pustular Posriasis
Nov 2002 Diagnosed With Seb Derm
April 2003 Red patch appeared, oval shape 5-10mm  corner of eye / bridge of nose (not visible face on) ~ for advice on this I'm Writing  
Background

With the onset of PPPP I had a bout of serious Seb Derm that went off its own accord within a couple of months.
Throughout 2002 I embarked on a trial and error approach to ease the PPPP, the most effective cream being Dyprasylic Acid
Nov 2002 started taking Nutrapack multi vitamins that seemed to ease the PPPP dramatically but this waned after a period off about 6 months.

Now the current issue. I have learned to live / cope with PPPP however the Seb Derm really does cause emotional discomfort. Though That is the diagnosis I do not suffer from itching or excessive redness / scaling which is what I believe are Seb Derms Characteristics and since treatment various lotions / creams and herbal remedies I believe it to be more pronounced if anything. All in all I can tolerate the dry skin but there is on area which varies between 5 - 10mm just to the right of the bridge of my nose which is always at least a pale red and at worst deep red which is slightly flaky but again not sore or itchy. There appears to be two spots which are slightly redder than the rest of the patch which at VERY close inspection are slightly raised which always re-appear in Exactly the same place. This condition is not symmetrical.  Only once has the condition completely cleared when I used hydrocortisone 1% 4 times a day for 2 weeks but whilst still using this the condition flared up again.

Other points:
When taking anti biotics both the eye condition and the PPPP flared up within 3 days of taking the medication
I sometimes show a slight fluctuation upwards in my cortisone level (urine samples)

Now the Question:
I've accepted the PPPP and the dry skin but find the red patch intolerable and depressing, its all I can see when I look in the mirror! Have you heard of this before? Is it  Seb Derm? Why wont the red patch just go away! (please, Mr red patch if your reading this just go on a long vacation!!!!)

Any advice/ tips would be greatly appreciated..

At present:

I smoke
Eat a balanced diet
Do not drink Alcohol
MSM 3000g a day
Grapeseed extract 4 * 180g a day
Nutrapack Multi vitamin
On and off Borage oil / Primrose oil (finds it makes other parts of my face too oily with prolonged use)
Milkthistle
Additional probiotics
After washing (non-alcoholic soap free) I splash a 50:50 organic cider vinegar, colloidal silver on my face.
As a moisturiser I use a calendula based cream and or Aloe vera straight from the plant

Creams I have used and can remember the names off

Skin Cap
Double Base
Nizoral cream and shampoo
Hyrocortisone 1%
Diprobase

Sean

by Alan Rockoff, MD, Oct 21, 2003 12:00AM
It seems odd to me that you're satisfied with the control of your palm and sole psoriasis, which is hard to control, and unhappy with facial sevorrhea, which should be quite easy to control.

Any number of mild topical steroids should be able to suppress facial involvement to the point of invisibility.  Non-steroidal creams like tacrolimus or pimecrolimus (not sure of trade names in UK) may well do likewise.  Nothing cures the condition, of course, but you should be able to walk around without anyone knowing you have it.

I advise you to ask your dermatology consultant about this.

Best.

Dr. Rockoff
Member Comments (3)

by popcornsean, Oct 21, 2003 12:00AM
other creams: Cutiax, tea tree cream biocare, MSM lotion, E45, Savlon,etc... Currently waiting for delivery of biolayn cartilage cream

by popcornsean, Oct 21, 2003 12:00AM
sorry once last point which I'm sure will be off value to many. I see you advise the use of 1% hydrocortisone for facial seb derm yet on the tubes they advise against this. I guess this is becasue the skin is thinner on the face and atrophy is more probable. How long should this be used on face and how long between courses to avoid such a thing? Great site by the way!
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