Burning skin

[Nickname321]

Ever since moving from Perth to Melbourne a couple of years ago, I have had problems with my skin. I never really had to do much to keep my skin happy before, I had a regular routine with cleanser and moisturiser with occasional exfoliation and that's about it. For the last two years since moving here though, my skin has become unbearably sensitive and I am completely at a loss at how to fix it. Whenever I wash my face, even with just water and no products, my face feels like its on fire or like I'm badly sunburn and gets really red, even if I haven't been outdoors and I usually wear sunscreen anyway. I've written the details below because I'm really hoping someone might be able to help... sorry for the lengthy post but I'm getting pretty desperate :(

At an attempt to fix my skin a few months back, I went to a beautician and had a microdermabrasion, followed by weekly weak lactic peels (the beautician seemed to know what she was talking about at the time) and I bought the skin care products she recommended:

- Aspect Gentle Clean Facial Cleanser
- Aspect Cell-ablation (small-grained exfoliant)
- Apect Phytostat9 (moisturiser)
- ASAP daily moisturiser plus sunsreen (which I used over th moisturiser)

I stopped the lactic peels after about 3 of them because I decided I wasn't sure if I trusted the beauticians opinion enough to keep forking out the money (I can;t remember why, I think she contradicted herself on skin-care advice or something) but I continued to use the products. My skin was a bit better with these products, and by that I mean the burning was bearable and didn't last as long. Actually, the one thing that seemed to sooth my skin the most was the sunscreen for some reason. I did drop the cleanser because my skin started stinging when I used it even though it was very mild, and I limited myself to washing my face by quickly splashing cool water on it and moisturising straight away which seemed to cause less pain.

Eventually I decided I shouldn't have to live with "just bearable" pain day in day out, so I went to my GP and got a referral to a dermatologist. I booked an appointment a month and a half in advance which ended up being last week. I told her my problem and she asked a couple of questions (like clarifiying if my skin was itchy, which it wasn't, and what kind of stinging it was) and then she said it seems like eczma. Bad eczma runs in my family so this seems to fit. She told me to buy some cetaphil cleanser and gave me a sample, and then she prescribed me differin which she said was for my "acne". I found this strange since I only had one pimple on my chin, and that's about as bad as it ever gets (and I wasn't bothered by having a pimple). I clarified that my problem was that my skin was sensitive, sore and feels like its burning after washing, and asked if differin would dry out my skin. She said that while it helped my "acne" it would also help with my eczma and that I should leave it on overnight. She said I should try to stop using my moisturiser too and just use the sunscreen, as this with the differin would be enough. I put my fears aside and trusted her and followed her advice.

The cetaphil was fine, but the differin stung my face a bit at first. The doctor said it would take a while to get used to so I kept using it. Each day it got worse until today, when it was excruciating. My face was red and burning, it felt and looked like I had terrible sunburn all over my cheeks and in patches of my forehead. I washed my face and slathered it with the sunscreen that is usually soothing, but it stung this time. I decided to google differin, and on their website it clearly said that differin should not be used on skin with eczma. Then I googled eczma, where it said that it is important to moisturise skin with eczma... So this contradicted the dermatologist telling me to not use my moisturiser and prescribing me differin.

I went and spoke to a chemist (who was appalled I'd been prescribed differin for eczma) and bought cetaphil DailyAdvance Ultra hydrating lotion and Hamilton skin therapy oil for skin with eczema. I went home and put them on my face, and then tonight I washed my face and put the lotion and oil back on again and its still really really painful and is really red. Even above my cheek bone in the soft area under my eye its red and burning, which Ive never had before. My skin is currently more painful than ever before. (As a side note, I saw on google a lot of people were complaining about how the initial result of their acne being treated with differin was that their acne would become worse than ever. My experience is not similar to that at all, the little pimple on my chin is now gone.) I'm scared that these products might be bad for my skin too, but I don't want to make another dermatology appointment after my last experience.

Does anyone have any good advice for how I can stop my face from feeling like this? Does it even sound like eczema? Has anyone heard of Cetaphil or Hamilton skin therepy? I find myself just daydreaming about getting a really cold cream being slathered over my face and feeling a soothing sensation instead of feeling like I've been lying face up in the desert for a week, while every few hours someone comes and rubs hot sand on my face, washes it off with battery acid and then dries my face with sandpaper...

Please specifiy if you're responding and don't have any medical experience.

Thanks for your time, I appreciate any responses.

[Bhupinder Kaur, MD]

Hello,
From the symptoms it looks like irritant contact dermatitis that you are having now after using the topical treatment. The condition of the skin sounds like eczema. Irritant dermatitis, the most common type of contact dermatitis, involves inflammation resulting from contact with acids, alkaline materials such as soaps and detergents, cosmetics, or other chemicals.
Avoid using any lotions and creams over the face for the meantime. Wash your face with a mild cleanser with moisturizing properties like Cetaphil. Pat your face dry. Then apply a good hypoallergenic moisturizer over the area. At home, you could try calamine lotions and cool colloidal oatmeal baths to help relieve itching.  If the rash doesn’t improve, or is spreading you need to contact a dermatologist. A corticosteroid medication similar to hydrocortisone may be prescribed to combat inflammation. Pill or injection is prescribed if this also does not help. Prescription anti histamines would be prescribed to relieve any itching.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Nickname321]

Sorry, I thought this was one of those websites where anyone can answer and thought I may end up with a response from an unqualified person, but I've had a look around and saw that only doctors reply so please ignore my "medical expience" request! :)