ichy, whitehead RASH on chest

[ginascissorhands]

I am a 25 year old female who suffers from adult acne.  About a year ago, I developed a RASH on my chest that is similar looking to acne in that it has red spots with tiny, very superficial white heads. Since this was the first rash breakout I mistook it for acne and used an acne spot treatment (benzyl peroxide 2.5%)  The next morning my skin was itchy and extremely irritated, and I realized it was a rash and not pimples and the benzyl peroxide irritated it a lot.  I then used calamine and benedryl topical lotion with little results. Hydrocoritsone 1% DID clear my rash within a week, with milder breakouts until finally gone.  This rash has come back 2 or 3 times in the past year, always slowly improving with hydrocortisone 1%.  I haven't changed any soaps, lotions or perfumes yet this rash comes up every few months on me.  I no longer can be in the sun (even with spf 70) without my chest getting at least a little irritated and anthing on it for too long (i.e. necklaces, all made of different metals which makes me assume it's the actual friction that irritates my chest skin) irritate the skin.  This is the fourth or fith time this rash has attacked me and now it seems like hydrocortisone only helps, not clear it completely. It has spread to my shoulders neck before but the chest is the main area. I plan on using CeraVe lotion after the rash clears up as my regular lotion since I have heard dermatologists reccoment it for sensetive skin that needs to rebuild/maintain it's barrier. I realize that hydrocortisone is a steriod that is not meant for daily use but this espisode of the rash is clearing up and then re-flaring up.  What could be causing this rash?  I can be fine and then suddenly wake up broken out, itchy and irritated by the slightest touch.  I plan on seeing a dermatologist but I'm terrified they'll want me to treat it like acne when I know it's not from experience.  Is there any quick fix if this happens on an important day (i.e. my wedding day in a year)  like persciption strength hydrocortisone cream?

Thank you for your time,
Gina

Also- I wash the affected area with baby shampoo and lukewarm water in the morning and evening before applying hydrocortisone 1%.  Today was reapplying hydrocortisone cream during the day due to itching and slight burning.  

[Clairelindsay]

Also, just a side note: I was prescribed Apprilon (a doxycycline modified release capsule) last month, as I have had marginal success with antibiotics over the years (twice, to be exact). When I googled this medication I found it is usually used to treat acne only associated with rosacea, and does not help in areas of bacterial infection, but inflammation.. I'm thinking my doc screwed up.  Any chance Apprilon caused this whitehead rash? I've had acne on my chest and back (hence the prescription) but this whitehead rash is brand new. I usually have cystic acne..

[Clairelindsay]

I am having this exact problem! Same history also, although I am 32 with a history of acne (cleared up when I was on the BC pill) and acne has continued into adulthood.  just recently experienced this whitehead rash (exactly as (Gina described it) which I also thought was acne and have been treating as such. (I live on a small island with no dermatologist). Any recommendations on how to treat it? i have been using acne products on it, which sounds like the wrong thing to do! Also I find the sun can be helpful for my acne, so was planning a marathon sunbathe (I know not great for me, but the acne is horrible)...sounds like that will only make it worse...How do I find the culprit? Sweat dermatitis? Reaction to drugs? I've got a recommendation in the works to a derm but no appointment date set.  
Thank so much!,,

[oly9]

i have same problem, and the culprit is some of the chemicals added to food or that are processing the food plus otc vitamins and a few other things,
unfort the derm. doesnt give a **** she treats them like pimples, what an idiot!
so much school for nothing
:(

[Bhupinder Kaur, MD]

Hello,
It can be due to irritated hair follicles, heat rash or sweat dermatitis. Avoid using any lotions and creams for the meantime. Use a mild cleanser with moisturizing properties like Cetaphil. Also use cotton clothes and change the clothes twice if there is any increased sweating. Try keeping the skin free of sweat as far as possible. If the symptoms still persist then you can apply mild steroid like dermacort. For the itching antihistaminics like Benadryl or Claritin can be taken.

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.

[ginascissorhands]

Just to clairify - I don't normally use hydrocortisone daily, only during rash espisodes.