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Dermatology (Expert Forum)
rosacea? acne? what else could it be?
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
rosacea? acne? what else could it be?
by MUC, Jun 22, 2005 12:00AM
I'm a 26 year-old fair skined (Scandinavian descent) white male. My face/skin is relatively sensative, and over the years I've always used moisturizer daily after showers. In high school I had acne but my skin has generally been perfect for the past 10 years, a pimple every now and then, but basically *Extremely* clear (I wouldn't be writing/paying if these weren't "out of the ordinary" symptoms). Over the past 8 months I've had the following symptoms:
Small red, slightly raised (although often flush against the skin) spots on my cheek. From a distance one would think they are pimples (they are about the same size as a pimple), but I've had pimples before and these are very different. The red dots seem to come and go in intensity, number, and location on the cheeks but *Never* disappear completely. They are particularly worse after swimming laps in the pool, exercising, or showering. They can't be pimples because of their perminant nature -- I've had acne before and know how it behaves. The dots are not "puss-filled", they don't crust over or dry out. Recently I've tried using an astringent to clean my face more thoroughly, and I can't tell if it's helping or perpetuating the problem, I go in waves of using and not-using-it and symptoms don't dramtically improve or worsen.
Every now and then I get a sharp stinging/pricking sensation on my cheeks/forehead in the location that a new red "spot" will ultimately appear. The ***** is very precise and quick and does not last more than a couple seconds, it almost feels like someone literally touched a pin to my face. It does not itch at all.
I've been reading about Rosacea and wonder if this is it. The red "spots" can tend to blend together and from a distance might look like rosey cheeks, but it's very subtle, and when you look closely you can see the red hue is really composed of a couple (5 to 6) red spots scattered on my cheeks, which individually are slighly red causing the apperance of red cheeks from a distance.
My diet and exercising schedules are unchanged. I do exercise "excessively", however I've done so my entire life, and in the past never experienced such an effect. Pictures of rosacea online tend to be much more severe than what I'm experiencing. Just randomly googling for pictures online this URL is similar to what I'm experiencing (http://www.nlm.nih.gov/medlineplus/spanish/ency/images/ency/fullsize/2469.jpg), but even that is worse than what I have. There is definitely no appearance of broken blood capsules/vessels on the face. Oh, also, I have NO allergies, don't wear glasses, etc, etc, been perfectly healthy my entire life, barely a broken bone.
What's most conerning is the perminant nature of it, I would've written it off as acne otherwise -- clearly something is different in my body.
Thx!
PS -- Sorry for my excessive description, just want to make sure you have enough info. to make the best diagnosis that can be made short of seeing the doctor myself
Small red, slightly raised (although often flush against the skin) spots on my cheek. From a distance one would think they are pimples (they are about the same size as a pimple), but I've had pimples before and these are very different. The red dots seem to come and go in intensity, number, and location on the cheeks but *Never* disappear completely. They are particularly worse after swimming laps in the pool, exercising, or showering. They can't be pimples because of their perminant nature -- I've had acne before and know how it behaves. The dots are not "puss-filled", they don't crust over or dry out. Recently I've tried using an astringent to clean my face more thoroughly, and I can't tell if it's helping or perpetuating the problem, I go in waves of using and not-using-it and symptoms don't dramtically improve or worsen.
Every now and then I get a sharp stinging/pricking sensation on my cheeks/forehead in the location that a new red "spot" will ultimately appear. The ***** is very precise and quick and does not last more than a couple seconds, it almost feels like someone literally touched a pin to my face. It does not itch at all.
I've been reading about Rosacea and wonder if this is it. The red "spots" can tend to blend together and from a distance might look like rosey cheeks, but it's very subtle, and when you look closely you can see the red hue is really composed of a couple (5 to 6) red spots scattered on my cheeks, which individually are slighly red causing the apperance of red cheeks from a distance.
My diet and exercising schedules are unchanged. I do exercise "excessively", however I've done so my entire life, and in the past never experienced such an effect. Pictures of rosacea online tend to be much more severe than what I'm experiencing. Just randomly googling for pictures online this URL is similar to what I'm experiencing (http://www.nlm.nih.gov/medlineplus/spanish/ency/images/ency/fullsize/2469.jpg), but even that is worse than what I have. There is definitely no appearance of broken blood capsules/vessels on the face. Oh, also, I have NO allergies, don't wear glasses, etc, etc, been perfectly healthy my entire life, barely a broken bone.
What's most conerning is the perminant nature of it, I would've written it off as acne otherwise -- clearly something is different in my body.
Thx!
PS -- Sorry for my excessive description, just want to make sure you have enough info. to make the best diagnosis that can be made short of seeing the doctor myself
Doctor's Answer
by Alan Rockoff, MD, Jun 24, 2005 12:00AM
, Jun 24, 2005 12:00AM
The picture you reference is rosacea. Your description does not math that, as you realize yourself. I am frankly not sure what you have. I am not sure you have anything. You are paying very intense attention to minor variations in skin appearance and sensation, more perhaps than is useful. I would dispute your assumption that these changes imply that, "clearly something is different in my body." Most skin changes imply nothing of the sort. It may be just that skin changes a bit in the mid-20's and looks somewhat less even in tone and color than it did before.
To get further information, you will need to see a doctor in person. You need to be prepared, however, to hear that there is nothing in particular wrong with you. If the doctor feels this is early rosacea, treatment may be indicated.
Best.
Dr. Rockoff
To get further information, you will need to see a doctor in person. You need to be prepared, however, to hear that there is nothing in particular wrong with you. If the doctor feels this is early rosacea, treatment may be indicated.
Best.
Dr. Rockoff
I guess the single most "concerning" element was the perminant nature of this condition. It would wax and wane over 8 months but has not disappeared not normal acne.
Best.
/chc7
can you spread molluscum to others if the pimples dont have the white core in the middle?
thanks doc
My cheeks can be especially dry and at times tend to flake a bit. Could this be symptomatic of Seb Derm? How can I differentiate Seb Derm from other disorders?
Thx.