Steroid Rosacea?

I wrote in about 3 months ago regarding a rash I had. You suggested it being steroid rosacea. I ended up getting a second opinion from another doctor and she agreed that it was. She put me on mynocycline (sp?) 50 mg twice a day. I was still on the 1% steroid cream, but weaning off.  I started using Elidel also. The rash seemed to improve.  About 2 months ago I was done with the steroid cream and only on antibiotic and Elidel.  6 weeks into I went to see her again. It was better and she said we should try an antibiotic cream, clyndimicine (sp?) and stop the pills. I am allergic to something in that cream. But I was also on a Z-pack from a bronchitis.  For 2 weeks on that things seemed good. Then about 2 weeks ago I started breaking out again really badly. Perhaps the z-pack was out of my system by then.  I started back on the mynocycline and called her. I waited two weeks and that and nothing much is happening. She thinks I need a higher dosage and one that is time released. I also find that my face is inflamed more when I drink a couple glasses of wine, or drink diet coke, or anything with caffine in it. I have looked at pictures of regular rosacea, and I don't look like that. Plus this itches like crazy. I have included a couple of pictures to show what it looks like.  

http://img.photobucket.com/albums/v505/Lissac1967/rash-1.jpg

I am just at a loss. Should I be on a higher dosage? Should I start the Elidel again? The Derm. I am seeing now didn't think the Elidel would do much of anything. It doesn't sound like Rosacea to me since it has come on suddenly in the last 3 or 4 months to this extreme. Any ideas if it really is steroid rosacea or what to do? Thank you!

[Alan Rockoff, MD]

The truth is, I'm not sure.  The photo you have is hard to interpret.  It may indeed be that you have a rebound of the steroid rosacea, and that you ought to be on a higher dose of antibiotic for a while longer.  I think that is at least a reasonable approach.  I think what ever happened after clindamycin sounds more like a rosacea rebound than a reaction to this very innocuous cream.  I'd follow your dermatologist's sensible-sounding advice.  It may take a while and some adjustments, but you'll get there.

Best.

Dr. Rockoff

[lmknip67]

Does it appear to be regular rosacea do you think? I know it is reaching to as this on a picture or discription. Can it take months and months for steroid rosacea to clear up? Should I try the clyndimicine (sp?) cream again? My derm said it was up to me. But I don't go back in for 3 weeks, so any ideas you can give me also would be great. thanks so much!

[Alan Rockoff, MD]

Probably not regular rosacea.  Yes, steroid rosacea take a long time.  Hang in there.

Dr. Rockoff

[max'smom]

When I was 20 year old I gave birth to my first child. It was right afterwards I noticed a red rash on my right cheek. It started as a light red rash, then over the years (now I am 44)it has become very dramatic with deep looking lines. It has crossed over my nose and now is spotty on my other cheek. I have had professionals look at it and they suggest it might be Lupus, rosacea,and one Doctor had no clue. If I try to cover it with makeup I look like I have a mask on.    Any sugguestions?

[shauneymb]

I have been diagnosed with Acne, Rosasea,Steroid Rosacea, and Ocular Rosacea.  I had a team of seven Dermatologists whom have now given up on my case and have referred me to a university.  I am unable to see them until February.  I am having another severe attack, which has lead me to the emergency room many times before.  I don't know what to do.  I was wondering if there was something I could do in the mean time while I await my appointment.  These outbreaks I have are so painful.  They have me taking Yasmin and Bactrin but its not helping at all.  I just don't know what to do.