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Dermatology (Expert Forum)
mystery mutant rosacea from outer space
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.
mystery mutant rosacea from outer space
by cbfak, Nov 05, 2002 12:00AM
Okay, so I've had this condition for a few years now that I think is probably some early form of rosacea.
A dermatologist told me it was an allergic reaction.
So, I go to an allergist, who tells me, no that's not an allergic reaction, it's maybe a urticaria, or something... not rosacea either, 'cause rosacea "isn't painful".
The Condition: Starts out with very small (1-2 mm) irregular faint red spots that itch and sting a little. The spots appear mostly on my cheeks, chin, corners of my mouth, and lower forehead. The spots do not appear to be swollen or raised in any way. The skin in these areas becomes very oily. This early condition can last a few hours to a few days. It seems to be mostly a seasonal thing (autumn and winter).
With the right stimulus, the spots can flare up into a continuous "flush" that looks just like a sunburn. Feels and acts like a sunburn, too... I have a distinct, severe 'burning' sensation on my face, and in some instances I actually see skin flaking and peeling after the flush subsides. Again, there is no obvious swelling, bumps, pustules or anything like that... just red, oily, irritated skin. The flush usually lasts less than a day, and disappears completely until next time.
The most common stimuli for the "flush" reaction appear to be:
- Staying too long in the shower;
- Rapid temperature change (e.g., going from cold outdoors to heated indoors).
- Exposure to wind (even a little breeze, if it is cold).
- Letting even a little beard stubble grow out.
- Putting ANYTHING on my face, including hydrocortisone or any other supposedly anti-inflammatory ointments or creams.
I've tried switching to hypoallergenic, alcohol-free shampoos, laundry soap, etc., but that didn't seem to have much effect. The only product I've gotten any relief with is a particular shaving gel containing 'oatmeal'. I've even used this shaving gel as a face cleaner, on occasion.
I do have allergies, but they are almost entirely to plant pollen and outdoor molds... not likely culprits for a mostly-wintertime affliction.
I would appreciate any suggestions you may offer that might provide a new lead or line of diagnosis...
A dermatologist told me it was an allergic reaction.
So, I go to an allergist, who tells me, no that's not an allergic reaction, it's maybe a urticaria, or something... not rosacea either, 'cause rosacea "isn't painful".
The Condition: Starts out with very small (1-2 mm) irregular faint red spots that itch and sting a little. The spots appear mostly on my cheeks, chin, corners of my mouth, and lower forehead. The spots do not appear to be swollen or raised in any way. The skin in these areas becomes very oily. This early condition can last a few hours to a few days. It seems to be mostly a seasonal thing (autumn and winter).
With the right stimulus, the spots can flare up into a continuous "flush" that looks just like a sunburn. Feels and acts like a sunburn, too... I have a distinct, severe 'burning' sensation on my face, and in some instances I actually see skin flaking and peeling after the flush subsides. Again, there is no obvious swelling, bumps, pustules or anything like that... just red, oily, irritated skin. The flush usually lasts less than a day, and disappears completely until next time.
The most common stimuli for the "flush" reaction appear to be:
- Staying too long in the shower;
- Rapid temperature change (e.g., going from cold outdoors to heated indoors).
- Exposure to wind (even a little breeze, if it is cold).
- Letting even a little beard stubble grow out.
- Putting ANYTHING on my face, including hydrocortisone or any other supposedly anti-inflammatory ointments or creams.
I've tried switching to hypoallergenic, alcohol-free shampoos, laundry soap, etc., but that didn't seem to have much effect. The only product I've gotten any relief with is a particular shaving gel containing 'oatmeal'. I've even used this shaving gel as a face cleaner, on occasion.
I do have allergies, but they are almost entirely to plant pollen and outdoor molds... not likely culprits for a mostly-wintertime affliction.
I would appreciate any suggestions you may offer that might provide a new lead or line of diagnosis...
Doctor's Answer
by Alan Rockoff, MD, Nov 07, 2002 12:00AM
, Nov 07, 2002 12:00AM
Several doctors, especially some in Philadelphia, are doing research on "sensitive skin," skin that seems to react to stimuli which don't bother other people. We know little about this phenomenon, and at present can offer little. I have three suggestions:
1. Consider a course of treatments (2-3 months) for rosacea: one of the cycline antibiotics by moth and a cream constaining either metronidazole or sulfacetamide.
2. Try different "sensitive skin" products. Cetaphil is a good place to start, but if you've done that already, just go by trial and error down the long list of available ones.
3. Consult with Dr. Albert Kligman or James Letden, both prominent dermatologists in Philadelphia.
Best.
Dr. Rockoff
1. Consider a course of treatments (2-3 months) for rosacea: one of the cycline antibiotics by moth and a cream constaining either metronidazole or sulfacetamide.
2. Try different "sensitive skin" products. Cetaphil is a good place to start, but if you've done that already, just go by trial and error down the long list of available ones.
3. Consult with Dr. Albert Kligman or James Letden, both prominent dermatologists in Philadelphia.
Best.
Dr. Rockoff
