Rosacea or Eczema or Sun Damage?

[Mellia]

I'm a 21 yeard old white female. I started having skin problems about 6 months ago when I bought over the counter acne lotions for my face. ( I had a couple of pimples, and got nervous because my face never had any breakouts before.) I used several lotions and my face after a couple of days was red and irritated.  The irritation would come out more when I came out of the shower. However, I never experienced any kind of itching. I went to the derm and was diagnosed with eczema, I was prescribed protopic and locoid lipocream(steriod). The steriod medication irriated my face more and I was extremely itchy when it was put on.  From then on my face was always hot, blotchy and irritated.

A couple months later,I went to Cancun for spring break and got sun poisoning on my face, mostly on cheeks. My eyelids were also very swollen. The derm prescribed the steriod medication dermatop and prednisone. My face was so swollen and red that I didn't notice any irriation from the cream. The medication helped the swelling.  Finally after a couple of weeks, the swelling was down completely.  However, after stopping the steriod on my face, I would break out with itchy red raised blotches (almost looking like red pimples).  These blotches were extremely itchy on my face. I went back to the derm and said that i'm probably having an allergic reaction to some shampoo or fragrance I'm using. She advised me to put the steriod medication on for the itching.  The itching would stop when I used the steriod, however when I stopped the red itchy patches would come back.  Sometimes they would trigger under any circumstances.

After this I was getting extremely frustrated and upset with my skin condition, I went to derm #3 and said that I probably have rosacea. I was prescribed with metrocream. I have been diagnoised with many different things and I'm not sure which route to follow.  I've been trying to read up on all these skin conditions because I really want help.

A couple of  final comments/questions:

- There is facial redness, so rosacea would make sense but the flareups are extremely itchy. Is rosacea symptoms usually associated with itchiness?

-Could it be a reaction to all the medications, esp the steriod medications? I've never had these problems until I started using all these medications. I know dermatop is a pretty strong steriod.

-Also, since I have learned my lesson with my sun posioning incident, Im always using SPF 15 or higher, i put 30 on my cheeks. However, I've noticed that when Im in the sun all day, my face still gets a pimply rash that itches.  Is this from the sun poisoning incident, has my skin never fully healed? oR is it extremely sensitive because of the medication?

    I'm sorry there are so many questions, I'm just so concerned about my skin condition it has really left me very stressful. I'm hoping that you can offer me great advice because I've been reading all your forums and it seems to be helpful.

Thanks

[Alan Rockoff, MD]

It's hard for me to tease out all the details and ups and downs of your condition.  Bottom line: I think dermatologist # 3 is right--what you have, now at least, sounds like steroid-induced rosacea.  This is completely curable.  I would ask derm # 3 to consider adding one of the cycline antibiotics to the Metrocream.  Shouldn't take more than a month to clear things up.  Then if you do get some eczema on the face, you can use one of the nonsteroid creams like Protopic or Elidel.  



As to the "sun poisoning<" i advise you to clear up the other matter first--that may take care of the sun sensitivity, and if it doesn't, the matter will be clearer and easier to dissect.



Best.



Dr. Rockoff