Your son almost certainly has had his skin thinned and gotten iatrogenic rosaca thanks to this dermatologist. He should try and wean off the topical steroid. If the doctor tells you that low strength hydrocortisone can't cause rosacea, you should look online and in medline... It can.
As for sensitive skin, try non-water washes I would suggest "Tolerin dermo cleanser" (fluid, not foam) for cleaning the skin (wipe off with cotton pads) and "Tolerin light facial fluid" as a moisturiser, finish off with Linda Sy Zinco to protect the skin. Stay away from ANYTHING with alcohols in, including cetyl, benzyl and cetereal alcohols, they will make him burn and sting and flake.
I've been where your sun is, there is a way back.
Hello Dr. and Shmo,
my son has exactly the same symptoms and face issues as mentioned in the posting, "Flushed, tight, flaky skin after washing: just sensitive?" He has been struggling with the same problems and was amazed that someone wrote about the exact same facial/skin problems that he has been dealing with. He would like to talk with Shmo if at all possible via email. He is 21, in college, and has been under the care of a dermatologist for several years. Really...nothing has been very effective. The facial burning, itching, and redness are extremely problematic. He talks about a couple areas on his face that never stop itching. In addition to this, he feels like he'll never be able to stop using topicals with hydrocortosone....and even though his dermatologist says to use these creams....we are worried about the side effects of using these for a long period of time. He gets very agitated with the facial redness and having to deal with the emotional side of this. What works? He has been diagnosed with acute dermititis. We are hoping for some sort of breakthrough in dermatology for this facial issue. thank you! Please respond to my email and I'll pass it along to him.
I think you have eczema, which does all the things you describe. Eczema is hereditary, although you may not know anyone in the family who has it, because they may have a mild case they just ignore as dry skin. In any case, you don't need to change your soap and other facial products. I suggest you try 1% hydrocortisone (over-the-counter) twice a day for a week. Then call the dermatologist you saw, tell him or her what response you had, and get a prescription for what the doctor thinks would be best. Eczema does come and go, more in the winter, but does not get progressively worse over the years.
Take care.
Dr. Rockoff