Rosacea....?

[anonymous24]

I am a 23 year old male. Around this past December/January my skin on my face (especially the cheeks) began getting very dry and eventually became red and irritated. I attributed the dryness to the dry winter air and the fact that I was shaving every day because of a new job. I began trying various moisturizers to help and found that putting a little bit of vitamin E oil on both my cheeks helped keep my face moist all day. However, then I started to get these little red bumps - they look kinda like pimples but they really itch, and when I scratch them (which I try not to do) clear ooze comes out. I stopped using the vitamin E oil, and I started to apply hydrocortisone cream (Hydrocortisone Valerate Cream USP, 0.2%) at night for about 12 days. The hydrocortisone cream almost immediately cleared up my skin, but about a week after I stopped using it the itchy red bumps started to come back. I then decided to go to my family doctor to see what he thought. He looked briefly at me, said I had rosacea, and prescribed me an oral antibiotic (I believe it was doxycyline or something like that). I took that for 10 days which seemed to help (not as much as the hydrocortisone cream) and went to the doctor for a follow-up yesterday. This time he prescribed me Metrogel.
I have a few questions:  First of all, do you think that I do in fact have rosacea? I am only 23 (I've read that it most commonly affects people in their 30s and 40s). I'm not incredibly fair-skinned (I have brown hair and tan pretty well). I have no family history of rosacea (that I know of). I do commonly get "rosey" cheeks when I drink alcohol, and I do sometimes blush, but it never was a chronic condition previously.
Secondly - Is it possible that something in my shave gel is causing this condition? The condition started when I began shaving regularly (I would only shave once or twice a week in college). Also, this condition is only affecting the area of my cheeks down to my jawline (where I shave) and not at all on my nose or forehead. I currently use Gillette Series gel for "sensitive skin" - ingredients include palmitic acid, triethanolamine, isopentane, glyceryl oleate, stearic acid, fragrance, isobutane, sorbitol, hydroxyethycellulose, peg-90m, propylene glycol and some others. Could one or more of these ingredients be causing some form of dermatitis?
I'm thinking that I might hold off on using the Metrogel and try switching my shave gel first to see if that helps. What kind of shave gel would you recommend?
Please let me know how you would diagnose my condition - if it is in fact rosacea, I want to start treating it as soon as possible.. If not, I don't want to waste my time and money when there's a simpler cure.
Some additional info - I had bad acne as a teenager (I was put on Accutane my soph. yr. of high school). My skin has been good for about the past 6 years until now. Sorry if I'm giving you too much info, I just want to be thorough. Your help is MUCH appreciated.

[Alan Rockoff, MD]

I think you have eczema, not rosacea.  Your shaving gel may be aggravating the problem, but isn't at all likely to be causing it.  I suggest you use over-the-counter hydrocortisone as needed, avoid scratching or popping the bumps, and consult a dermatologist.  One visit should suffice to get you a secure diagnosis and a recommended treatment you can use off and on as needed on your own.

Best.

Dr. Rockoff

[thisperson]

Dr. Rockoff,

If you have a spare moment, could you please take a look at my follow up question from the post 'chronic dermatitis'? I would really appreciate it. Sorry for the post to this thread.

Take care.

[dcdre14]

About rosacea:

I'm a 28-year old white male.  Your symptoms sound exactly like mine... I developed rosacea last year (never had any previous problems of any kind with my skin)... my chin and nose became very red/scaly/shiny/irritated looking.

My dermatologist put me on metrogel, which cleared it up promptly within a month.

I've been on the metrogel ever since (for a year now)... I stopped using it for a few weeks when my prescription ran out and the redness/irritation promptly returned, then when I went back on the metrogel it subsided again... so I'm guessing the metrogel works (for me anyway).

Good luck.

[anonymous24]

Thank you for the input.  I'm not sure if what you're describing is the same though... First of all, my condition hasn't affected my nose or chin at all, although i know rosacea can be different for different people.  Secondly, did you develop little red bumps (look kinda like zits or bug bites) that itch like crazy?  That is what I'm currently dealing with.. It almost looks and feels like I have a little bit of poison ivy sprinkled low on my cheeks.  Is rosacea supposed to look/feel like that?  I guess I'll just wait for what Dr. Rockoff has to say about it all.  Of course I'm always open for any insight that you or others can give.  Thanks again.

[dcdre14]

My rosacea didn't really look like bug bites - it wasn't individual dots or bumps, more like one big lesion of redness/irritation/scaliness spread across my chin, nose, and cheeks (I neglected to mention my cheeks in my first post, but it was there too)...

It was also symmetrical across my face (the shape and size of the lesion on the left side of my face matched the shape and size on the right side) and it didn't spread... it just kinda showed up and stayed until I caved and went to a dermatologist.

It itched like crazy, although I think I exacerbated this by applying various (and ultimately ineffective) over-the-counter topical medications at once (benzoyl peroxide, moisturizers, special soaps, etc.)

When my dermatologist first put me on the metrogel, he cautioned that it would take a few weeks to kick in, and that I should be careful not to put anything else on my face during those first few weeks... Well, as hard as it was NOT to try anything else, I did what he said and it cleared up completely within a month...

I'm not a doctor, so please don't take my input as anything other than an account of my own experience!!!

Good luck.

[Alan Rockoff, MD]

Comments like these are well-meaning but more likely to confuse than to enlighten.  You need to see a skin doctor in person.  Thanks.

Dr. Rockoff

[anonymous24]

Thank you for the response - I will call a dermatologist tomorrow and use hydrocortisone cream in the meantime.  Do you have any idea what could be causing the eczema?  Is it likely to be a chronic condition or something that I can treat for awhile and be "cured" from?  Also, if it is rosacea and not eczema, will hydrocortisone cream make it worse?  Thanks again for all your help.

[Alan Rockoff, MD]

Eczema is usually genetic rather than environmental.   It comes and goes but is not always present.  It's usually easy to treat.  First, though, you need to find out for sure if that's what it is.

Dr. Rockoff

[jerseyman]

Rosacea is a flare up condition where your face gets very red, itchy bumps. Some triggers to avoid are hot exercise, eating spicy foods, drinking hot beverages, drinking alcohol, and eating chocolate. See a dermatologist for rosacea, because there are number of treatment options out there from topical creams to pills. There is no cure for rosacea, but it can be controlled.

Free Dermatology info here:
http://beauty.expertvillage.com/interviews/dermatology-skin-care-2.htm