true diagnosis?

[rudolph]

I got eczema patches on my body for the first time about a year ago - which I thought coincided with contact with builders'dust having moved into and cleaned a new house without gloves,and lived there without carpets for a while. [It also coincided with shortly after going on the contraceptive pill and I notice eczema is a side effect]. The patches have gone but my face became allergic to my usual moisturiser [I always had dry skin] and then dried out and got flakey on my nose chin and forehead and painfully tight and would only stabilise with the use of emollients. I only got to a doctor a couple of weeks after using the emollients, who then said I looked ok and should just continue to use emollients forever more. This was 4 months ago. My skin was still mildly tight so I tried a heavier emollient - at the same time I found my face overheating in the gym to the point eventually it wouldn't cool down and stayed red. I found even if emollient was applied to the hands before exercise these didn't sweat properly. This was a few weeks ago - I am now a different colour. For the first time I can remember I flush all the time. A doctor told me I have rosacea and gave me rozex - only using this product I seem to be getting pimples, or blocked pores? There is some scary stuff on the net. Is it wise to give up cv exercise in the gym to stop the face heating up? Is it ok to use rozex for 6 weeks if it is a wrong diagnosis? How serious is the warning to avoid bright sunlight? [it is summer!] I was told vaseline is as good a moisturiser as is available - this I don't believe. I am told to use a good moisturiser but am left totally confused as to what this might be. The only emollient I found that worked well is going off the market! And also coincided with this excessive red colour and broken capillaries. I no longer use it. [It was not a herbal preparation]. The commercial world is trying to sell me stuff that the doc said is 'only cosmetic' and a load of nonsence. And the rosacea sites tell me I have a lifelong incurable skin disease! According to what I read in one of your replies I don't seem to fit the rosacea diagnosis??

[Alan Rockoff, MD]

Correct.  Even if you have mild rosacea, the rosacea websites are censorious and alarmist.  I steer my patients away from them.  Avoiding heat, cold, wind, dryness, caffeine, spices, and wine is both impossible and unnecessary.

I don't know what "rozex" is a brand-name of.  if it contains metronidazole, I would try it for 4-6 weeks.  No harm.  Emollients are nice but unimportant--just keep experimenting with inexpensive ones till you find one you like.  Ignore fluctuations in redness and tightness-these are not "allergies" to the last product you used.  They most likely represent rosacea or perhaps facial eczema.  If topical antibiotic creams (presumably Rozex) don't help, your doctor might want to try a weak hydrocortisone, or one of the newer anti-eczema creams tacrolimus or pimercrolimus.

The key is not to think too much about what might be causing or triggering it, just to find something that helps.

Best.

Dr. Rockoff

[lifesmom]

I was diagnosed with rosacea about a year ago. Mostly affects my cheeks. About 2 weeks ago I started the Atkins diet. Yesterday I noticed redness all around the edges of my hair line, and today a rash on my mostly on my forehead and some all over my face. I never connected the rash with Atkins diet. I decided to look up facial rash on the web, and the first thing that came up was a question about the Atkins diet causing it. Coincidence? Hmmm. I have a feeling there is something to this. Also, this rash around the hairline is very itchy and dry.

Before beginning the Atkins diet I started having a lot of dry scalp and itchiness. But this facial rash is completely new. It doesn't look anything like the rosacea.

Any ideas? This is getting harder and harder to cover with makeup. Also, it seems worse at night when I first wash my makeup off. Do you think the makeup might be making it worse?

Thanks for your help. Lifesmom

[rudolph]

Does anyone know why it is advised to stay out of bright/ uv light while using metronidazole?

[Alan Rockoff, MD]

I don't.  I didn't know it is advised.  It's OK.

Dr. Rockoff