Chronic rash on left cheek of face

[brokenneck]

I am desperate!!  I am 42 years old, and I have had two cervical discectomy's within the last two years, and I feel like my immune system has crashed somewhat, due to the surgeries.  

1 year after my second surgery (April 2008) I tried to stop taking Cymbalta, and was finally off of it for a month, then I had a severe reaction, and could not handle the horrible underlying nerve pain. I also experienced facial swelling, migraine's, and apparently this rash that I still have now.  My pain doctor advised me to start taking Cymbalta again.  At the same time this rash appeared (which first looked like a horrible Cystic pimple) I also had a Levulan treatment done on my face, and the person performing this used a very high setting, which left my face very burned, and peeling for a week.

The rash is extremely painful, and creates linear hard crusty things under my skin, which then become infected.  I do have a little one above my left eyebrow, and you can see a hard white line under my skin. I try to rub them out sometimes, because the pain is horrible, and it's such a relieve when it comes out.  I know that rubbing the area has probably made it worse, but it drives me crazy!  It almost looks like hard white slivers. I have tried everything, and anything on my face. The dermatologist gave me Differin Gel, and topical antibiotic cream called Benzclin, and neither of these helped. The doctor at first thought that it was Cellulitis, and put me on Bacitricin, and then Cephalexin, and neither of those helped.

The hard crusty skin seems to grow underneath my cheek, and it stays there for weeks until I can't stand the pain and itching anymore?  The crusty skin seems to be super glued into my cheek. I'm pretty sure that the hard long white stuff is Keratin, but why won't it go away?  Could it possibly be an allergy to the Titanium plate in my neck?  It's really strange, but anytime I get a pimple now, and I pop it the skin becomes crusty, and hard, which it NEVER used to before.

[loiloi]

Hi. Topical antibiotics and retinoids like Differin (adapalene) are used for severe acne and are too harsh to use on a rash.
Instead use bland cosmetics such as those by La Roche-Posay. The Rosaliac cleanser is good for calming sensitized skin and rashes. Rather than trying "anything and everything" use one simple regime. It is better to perserve with one regime for an adequate trial than constantly switch products before they've had time to work.
It sounds like you've been through a lot. Hope you feel better soon, Eloise.

[Alan Rockoff, MD]

It is hard for me to get a clear understanding of your problem from a distance, but here is one thing I do know: if you don't stop rubbing your face, you will not get better.  Period.  There are no skin diseases I know of that "linear hard crusty things under my skin."  Ditto for "hard white slivers."  This has nothing to do with titanium plates or weakened immune systems.  Apply ice packs if you need to for the pain and other things you feel.  If you leave the face alone--and I mean completely, 100% alone--for one month, I think it is likely that you skin will be all or nearly clear.  If it's not, then please see a skin doctor in person again.

Thanks.

Dr. Rockoff