Steroid Induced Rosacea..

[CptMaggs]

I am a 21 year old male. I have been using hydrocortisone 1% fairly regularly, on my face, for almost 2 years. About 3 months ago my face went a little red, and after using some hydrocortisone for a couple of weeks my skin returned to normal. However, three weeks ago my skin started to redden again, and i went to see the doctor. I got given just some metronidazole cream and told to apply this twice a day. A few days later though and my face was more red, dry, very hot and my eyelids had began to swell up. If i apply a little hydrocortisone the swelling and redness goes down for a couple of days then re-occurs. I don't seem to have much in the way of papules and pustules, but the skin does weep a little. It is very distressing. Does this sound like steroid rosacea? And will i my skin recover if i stop using the steroid cream completely and just continue with the metronidazole? Is an oral antibiotic necessary too?

[CptMaggs]

Oh yes, and i have also had a return of eczema on other parts of my body since the face started redenning. I have what looks like eczema on my neck, under my arms, the joints of my legs and my inner thigh..

[CptMaggs]

Could what i have just be eczema/dermatitis? Because it is a little itchy, and i don't think i have any papules.

I visited the doctor this morning and he has taken me off metronidazole. He has given me hydrocortisone 1% to use for one week, plus lots of aqueous cream. Then i must return to the doctor for another evaluation.

[Dr Santos]

Hi,

Periorifacial dermatitis is a common facial skin problem in adult men and women wherein groups of itchy or tender reddish papules appear most often around the mouth, chin, cheeks, around the eyes, or nose. The surrounding skin may be reddish or pink, and the skin surface often becomes dry and flaky.  The exact cause is not understood but the most common frequent cause is topical steroid creams or ointments. The more potent the steroid cream, the more rapid and severe the  dermatitis which may result.

Are there other signs or symptoms present? Discontinue applying all face creams including topical steroids, cosmetics and sunscreens. When a steroid cream is discontinued, the rash gets worse for a few days before it starts to improve.Wash the face with warm water alone and keep the area clean and dry.  If it persists, it would be best to have it evaluated by your doctor or be referred to a dermatologist. A course of oral antibiotics for six to twelve weeks may be prescribed. This condition may recur when the antibiotics are discontinued, or at a later date. However, the same treatment can be used again.

Take care and keep us posted.

[loiloi]

Hi. Hydrocortisone is not indicated for long term use on the face as it causes thinning of the skin. It is not suitable for treating rosacea because, as you have found, the initial redness comes back worse.
Oral oxytetracycline may be necessary as well as topical metronidozole.
La Roche-Posay make a good cleanser called Rosaliac which is good for thin, fragile skin and Rosacea.
Eloise.