DERMATOLOGY COMMUNITY
rosacea? keratosis pilaris rubra? red, dry irritation 1month

rosacea? keratosis pilaris rubra? red, dry irritation 1month

For nearly a month I've had a left facial cheek that looks like it's been slapped, and to a lesser extent on the right cheek. I've also been flushing in response to heat and after washing my face and applying products. A dermatologist diagnosed me with rosacea. My PCP said he had no clue what it was, but it wasn't parvovirus b19 (aka fifth disease/ 'slapped cheek'). I asked him if it could be keratosis pilaris rubra, he said maybe, but I would need to see a specialist again. I do not have health insurance and cannot afford to visit another medic until I save the money.

The redness appeared over the course of about 2 weeks. It began as a general, fainy erythema on my cheeks, but did not feel dry or irritated in any way. I then got a break out of zits (the dermatologist said they were a mixture of rosacea papules and pustules and acne vulgaris). I wasn't aware of rosacea then. Stupidly, I spent the next week using turmeric with my moisturiser (turmeric is a vasodilator, i.e. encourages flushing), and applying perhaps a bit too much retin-a, zineryt, and alcohol cleanser (which was meant for hands). Then I woke up with a bright red, inflamed face. I blamed the over-use of topicals, especially the alcohol. My PCP agreed, and said the irritation would subside within a week. It didn't.

So then I thought the retin-a was going to produce some peeling, as if I'd had a chemical peel, but that never happened either. I did and still am getting patches that are peeling very slightly, but not to the extent that they did when I previously peeled from retin-a. I've been using it on and off for 10 years, peeled majorly twice in the first year of using it but was fine afterwards. It has rarely irritated me since, except for the occasional dry patch which heals itself in a few days.

Over the last 8 months I've been having skin problems in general on my face and upper right arm, but never as bad as this. I had seborrheic dermatitis in June last year, patches of eczema on my face and right arm in October (the eczema on my arm is still there depsite having tried a plethora of creams prescribed by my PCP), general flushing in response to heat, washing and applying products, and now this.

The redness subsided about 50% in the first week after the flare up, but has not changed since then. It shows up bright red again when washed or touched in any way, and subsides from as little as a minute to as much as several hours.

My mother has rosacea, which came on in her early 20's after starting on birth control. I am 27, mixed race, never taken birth control. I do not smoke, drink, eat red meat or spicy foods. I've completely overhauled my diet and facial care regime, yet the irritation is not budging. I am getting concerned that it may be permanent.

Any idea what it is that I've got, and how to treat it?
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