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1415174 tn?1453243103

dyshydrotic ezcema on face?

Hi, everyone, I asked this question on another forum but thought it would good to ask it here too. I have dyshydrotic eczema on my shins, then it spread to my hands. I have used the Eucerin Plus product for hands and I use it on my legs and it has really kept it at bay. I also use nitrile gloves to prevent extra hand washing so most of that has cleared up. One thing I noticed after a bad breakout on my legs though the eczema didn't return the skin is still red there. It doesn't hurt or itch it is just more pink than the other leg. Does anyone know why. Secondly, now I have some very very itchy tiny red bumps on my face that I haven't yet shown the doctor. I have used the Clobetsol topical cortisone ointment on it and it goes away within about 2-3 days. It comes back about one a week or two. Is it bad to use the cortisone topical so often? Is there anything else I can do to prevent it? I use Eucerin sun screen for sensitive skin (fragrance free) and it still comes back. Suggestions? It looks somewhat more rough on my face than on my legs and hands. I know I need to get to a dermatologist but I have a back problem and it is hard to get around.
thanks,
mkh9
Best Answer
563773 tn?1374246539
MEDICAL PROFESSIONAL

Hello,
Clobetasol 0.05% is not a very high concentration of potent steroid but it should be used with caution on the face because of the above mentioned side effects. also it can cause steroid induced rosacea on the cheeks. Steroid induced rosacea or dermatitis is an adverse effect of using steroids. Some patients develop steroid-induced rosacea within weeks of applying a topical steroid; others may not experience it for years.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.



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563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Antibiotics if used for a long time can predispose to fungal infection and hence use it only till your dermatologist prescribes it. Secondly, if you are allergic to any antibiotics then you should discuss it firstly with your dermatologist and then start with any antibiotics.

I hope it helps. Take care and regards.
Helpful - 0
1415174 tn?1453243103
Dear Dr. Bhupinder Kaur,
I went to the dermatologist several times and he thought that the rash was the steroid induce rosacea. So, I was given a level low to moderate steroid to taper off. I did that and the rash went away. It was peeling badly too. But now it has been two weeks and it seems like it is coming back some but not as itchy yet at last time. The dermatologist physician assistant said I may need to take low dose tetracycline if it came back. He said the subclinical dose tetra is to lower inflammation. My two questions are 1. could a subclinical or low dose antibiotic cause resistance to normal flora organisms . 2. When I was about 10 years old I got a shot of terramycin and walked outside to the car and almost passed out. I was never afraid of the doctors or shots. Should I not take this antibiotic or do you think it was just that my blood pressure dropped? Is there any risk here?
thank you,
Mkh9
Helpful - 0
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,

As I had mentioned earlier, steroid induced rosacea is an adverse effect of using potent steroids on the face. Some patients develop steroid-induced rosacea within weeks of applying a topical steroid; others may not experience it for years.

Using tacrolimus often resolves the itch, redness, and tenderness of steroid-induced rosacea but it should be taken after a dermatologist’s guidance. Avoiding rosacea triggers, such as caffeine, spicy foods, and alcohol, also may help clear the skin. If the symptoms persist then please consult a dermatologist. Also use of antibiotic creams, antihistaminics, sun screens helps but consultation of a dermatologist is required first.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

Helpful - 0
1415174 tn?1453243103
Hi again,
After using metrogel for 5 days my face was peeling really badly and itches so badly I can't sleep. Then It started swelling in the infranasal area on both sides and then to the left side. I went back to the dematologists PA and he said I may have steroid induced rebound as it was about 3 weeks since I had last used it and he said that was about the time you get rebound. He wasn't sure if it was a reaction from the Metrogel. So he is tapering me off of steroid using a lesser level steroid. The peeling skin has almost gone over night and the itching is tolerable. I am to use it 3 times a day until the inflammation goes down and then 2 times a day then once a day. I hope it doesn't come back again. I really wish my GP had told me not to use it on my face and that you can get steroid rebound or steroid induced rosacea like  blemishes but it was a lot worse than that for me. The severe peeling and swelling I think is still due to the Metrogel. I hope this forum helps someone else. Does steroid rebound or going of of it really cause all of this peeling and swelling or am I allergic to the Metrogel too?

thanks,
mkh9
Helpful - 0
1415174 tn?1453243103
Hello Dr.Bhupinder Kaur,
I forgot to add that the physician assistant said he thought I had perioral dermatitis but I read that perioral dermatitis doesn't usually itch. My rash is extremely itchy. I have dyshidrotic eczema on my legs and hands. Couldn't this be the same thing? It looks similar to me. Does Rosacea itch?
thanks,
mkh9
Helpful - 0
1415174 tn?1453243103
I have seen the dermatologist's PA, and he said I have peri-oral dermatitis. The cause isn't yet known as to whether or not it was caused by steroid use or allergy. I am using Metrogel and he wanted me to use Oracea pills as well but I may be allergy to Tetracycline so I'm just using the Metrogel 1% topical. It is too soon to know if it is working but it seems to be. Does Rosacea cause itching usually? Is the peri-oral dermatitis a broad term that can include rosacea?  I wanted to thank you for urging me to see a dermatologist. I think it is good that I did. I have a follow up visit in two weeks but you asked me to let you know how the visit went. If I stop using the steroid on my face will the Rosacea stop eventually?
Mkh9
Helpful - 0
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Clobetasol can be used on hands and soles under a dermatologist’s guidance and it is very effective for dyshidrotic eczema.

Regarding the steroid injections of the back, they are a very good treatment option for relieving back pain and are usually considered before going in for any surgical procedure. You can discuss this option with your orthopedician and discuss the pros and cons before going in for steroid injections.
I hope it helps. Take care and regards.



Helpful - 0
1415174 tn?1453243103
I have another question regarding the use of steroids.
1. Should not use it on my hands or legs for outbreaks there too.
2. Should I not get a steroid injection for my back pain if I need it? I was thinking of getting a cortisone injection into my lower pack for pain relief. It worked in the past but if I have steroid toxicity or if it will cause more problems maybe I shouldn't get one? I understand an injection will go throughout the body if it is just intra mucular but I was just wondering if I should stop all steroid use. I do think it probalby is making my face break out. I had thought of this because my friend, who has Lupus can't use her cortisone for her face anymore because she has developed Rosacea. So, I am concerned.
Thanks again,
mkh9
Helpful - 0
1415174 tn?1453243103
Thank you so much for your kind and informative answers to my questions. I have stopped the steroid and will see a dermatologist as soon as possible.
mkh9
Helpful - 0
1415174 tn?1453243103
Thanks for your response. I use 0.05% Clobetasol for about 2-3 days at most, but then it comes back in about 7days to 2 weeks. Is 0.05% Clobetasol still a high potency because of the type of cortisone or is that concentration not too bad?  I am trying to use Eucerin fragrance free face cream with sunscreen on it often to keep it hydrated. Will the bumps go away on their own if I don't use the cortisone? It seems like they get worse if you don't use anything.  My GP said to use the 0.05%Clobetasol on my hands for the dyshydrotic eczema there. I do want to go to a dermatologist, it has been hard for me to get around due to a back injury. The GP hasn't seen the facial "eczema" yet.
thank you,
mkh9
Helpful - 0
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Clobetasol is a high potency steroid which should be used cautiously. You can start with a mild steroid cream like 1% hydrocortisone but don’t’ use it for a long period of time because topical use of steroids is often associated with side effects like telangiectasia, thinning of skin, skin atrophy or redness. Use high potency steroids only after consulting a dermatologist.

You can apply some calamine lotion at the rash as it will help in soothing the skin. For the itching take some antihistaminic like Benadryl. If the symptoms persist then get an evaluation done from a dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

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