Redness in creases of nose

[sam887]

I am 28-years-old and have been experiencing moderate to severe redness on my face, most pronounced in the nasolabial folds or creases around my nose.  I have very oily skin and have been to a dermatologist, who prescribed retin-a.  However, I don't think he accurately diagnosed the redness around my nose.  He said that he thinks I have seborrheic dermatitis on my scalp, but didn't comment on my nose.  I think the seborrhea is causing the redness.  I also smoke daily (about 5 cigarettes per day) and drink fairly frequently.  I have noticed that both seem to aggravate the condition (I know I need to quit!)  However, I am wondering what I can safely use to treat the condition if it is in fact seborrhea around my nose.  I seem to have a very low tolerance for fungus/skin irritants (I get tinea versicolor on my back if I don't use selenium sulfide in hot weather).  Would selenium sulfide--like that found in Head and Shoulders--work on my face?  Is there something specifically designed to treat facial seborrhea?  

Also, on the retin-a, I've only been using it for about 10 days but it's made my forehead very bumpy (not huge pimples, but lots of little bumps).  Is this part of the process?  Is there anything I can use in combination with the retin-a to get rid of the acne?  (I have very oily skin so flaking is not a big concern).  I have read that benzoyl peroxide counteracts retin-a.  What about Differin?  Or something else?  Sorry for the long post--most concerned with the answer to the seborrhea/nose redness.  Thank You!

[Alan Rockoff, MD]

Seborrhea causes not just redness but scaling, and this is limited to the skin right next to the nose.  From your description, I'm not sure whether you have that.  You may just had skin that's somewhat red and oily.  If so, there isn't much you can do to change it (not counting makeup, of course.)  Lasers might be an option to minimize redness--perhaps you should look into that.  I don't advise self-medication.  All you're likely to do is aggravate the redness.  Ditto for self-medicating your acne.  benzoyl peroxide does not counteract acne, by the way, as long as they are not applied at the same time.  Get another opinion, if you like, but don't try to figure this out and treat it yourself.  Any dermatologist can diagnose seborrhea or acne.  Retin-A takes 8-12 weeks to work, so you might as well at least stick with what you've started for now.

best.

Dr. Rockoff