Skin peeling/rash/breakouts

Hi,
I'm going to start from the beginning.  I first noticed signs of a problem when I saw a discoloration on my forehead after being in the sun.  I then developed a skin irritaion on my chin after washing with a washcloth which spread to my cheeks and my nose.  So much skin seemed to be just scaling/peeling off and it was red and irritated.  I had been using duac and metrogel on my face and thought that had something to do with it.  The dermatologist also thought so at first and put me on hydrocortizone, which I was unhappy with, so he then put me on dermatop for a week and a half.  In the midst of this, my internist took me off my birth control pills (Ortho-tricyclon) and found me with a hyperthyroid condition.  While using the dermatop, my chin started breaking out quite a bit around my chin, so the derm put me on ceplexan and had me use lorax (which made me all blotchy so I stopped it) and I used warm compresses twice a day.  The pimples came to a head, but I still kept peeling more when washing (including the skin around my lips.  Everything seemd to irritate it.  Some hot water got on my face when the water fluctuated in the shower and that irritated it.  I was afraid to wash too much because I was stinging and that seemed to make me break out more.  I also think putting neosporin cream on the irritated areas caused more breakouts.  The derm had me use Pandel, but I stopped that after about 4 days.  I tried Cetiphil and that didn't help at all.

I have been reading up on this quite a bit and have found that a hyperthyroid can cause thinning of the skin and other skin conditions.  I went to a thyroid specialist and he said I most likely have Grave's disease according to all of my other symtoms (symptoms) as well (tremors, insomnia, weight loss (14 pounds in a month - 103 to 89).  I probably will be put on radioactive iodine.  I also went to the gynocologist and she is putting me on Ortho-tricyclen Lo (in case the other dosage was too high before on the regular Ortho-tricyclen).  My derm now also thinks that the  thyroid is partly to blame for the original irritation/peeling/scaling problem because a duac reaction would have cleared up already.  However, he wants to treat me for the breakouts using Doryx, and he gave me a cream to use for a week called Cloderm.  My face is breaking out all over now and is all irritated again.  It seemed to get more irritated when I used some cold water on it (I thought that would help).  It now is stinging again in certain areas.  I'm so worried.

Anyway, I just wanted to know if you think this is stemming from a thyroid condition.  Do you think Cloderm will help...or will it make me break out more?  I'm also concerned that the areas where skin originally peeled off, especially around my chin, my nose and forehead, will never grow back properly.  I can't wear makeup now because I'm afraid it will irritate my skin more.  I'm so depressed and I don't know what to do.  Any advise would be greatly appreciated!

[Alan Rockoff, MD]

I don't think the thyroid is related here.  You needn't be concerned that the peeled skin will not grow back properly because superficial peeling always does regrow.  I'm not sure what you mean by "breaking out," but if you're referring to acne-like pimples, you're probably better off not using a cortisone product, even a mild one like Pandel or Dermatop.

I advise you to consult your dermatologist about possible therapy for pimples and about a non-steroid like Protopic or Elidel for the scaling.

Don't be depressed.  After successful treatment, you should be fine and have normal skin.

Take care.

Dr. Rockoff

[GinieL]

I do refer to acne when speaking of 'breaking out'.  What do you think may have been the cause if you don't think the thyroid has anything to do with it?  The thyroid specialist had mentioned that it could have contributed to it.  Why would my eyelids and the area around my lips scale as well? Do the medications you mentioned help stinging as well?

[GinieL]

I found out my Cortisol levels are very high.  Could that have caused the original peeling/scaling?