rosacea? acne? what else could it be?

[MUC]

I'm a 26 year-old fair skined (Scandinavian descent) white male. My face/skin is relatively sensative, and over the years I've always used moisturizer daily after showers. In high school I had acne but my skin has generally been perfect for the past 10 years, a pimple every now and then, but basically *Extremely* clear (I wouldn't be writing/paying if these weren't "out of the ordinary" symptoms). Over the past 8 months I've had the following symptoms:
    
Small red, slightly raised (although often flush against the skin) spots on my cheek. From a distance one would think they are pimples (they are about the same size as a pimple), but I've had pimples before and these are very different. The red dots seem to come and go in intensity, number, and location on the cheeks but *Never* disappear completely. They are particularly worse after swimming laps in the pool, exercising, or showering. They can't be pimples because of their perminant nature -- I've had acne before and know how it behaves. The dots are not "puss-filled", they don't crust over or dry out. Recently I've tried using an astringent to clean my face more thoroughly, and I can't tell if it's helping or perpetuating the problem, I go in waves of using and not-using-it and symptoms don't dramtically improve or worsen.

Every now and then I get a sharp stinging/pricking sensation on my cheeks/forehead in the location that a new red "spot" will ultimately appear. The ***** is very precise and quick and does not last more than a couple seconds, it almost feels like someone literally touched a pin to my face. It does not itch at all.

I've been reading about Rosacea and wonder if this is it. The red "spots" can tend to blend together and from a distance might look like rosey cheeks, but it's very subtle, and when you look closely you can see the red hue is really composed of a couple (5 to 6) red spots scattered on my cheeks, which individually are slighly red causing the apperance of red cheeks from a distance.

My diet and exercising schedules are unchanged. I do exercise "excessively", however I've done so my entire life, and in the past never experienced such an effect. Pictures of rosacea online tend to be much more severe than what I'm experiencing. Just randomly googling for pictures online this URL is similar to what I'm experiencing (http://www.nlm.nih.gov/medlineplus/spanish/ency/images/ency/fullsize/2469.jpg), but even that is worse than what I have. There is definitely no appearance of broken blood capsules/vessels on the face. Oh, also, I have NO allergies, don't wear glasses, etc, etc, been perfectly healthy my entire life, barely a broken bone.

What's most conerning is the perminant nature of it, I would've written it off as acne otherwise -- clearly something is different in my body.

Thx!

PS -- Sorry for my excessive description, just want to make sure you have enough info. to make the best diagnosis that can be made short of seeing the doctor myself

[KristenP]

Hi my name is Kristen and I have a question about skin treatment. I have had a small, red dot on my face for about 2 years and I don't know what it could be. It is about the size of a pimple but it is not puss-filled and it doesn't itch or dry out. It is just a small red dot about the size of a pimple, and I was hoping you could find a way for me to treat it so it will go away. It does not hurt or anything and it does not spread, I have only had one and I have never seen anything like it before. It doesn't have any feeling but it is bright red and in just one spot. I was hoping for a way to get rid of it. I also would like to know if it is something serious of if I could just go buy something from a drug store to treat it. Also if I could treat it with something from a store or catalog, etc. Please tell a product name. Please respond, Thank you so very much for your time, Kristen.

[kniskern]

Ok.  so this isnt on my face, but I have several small red blister like bumps that appear on my hands and knuckles each summer, and they stay for months at a time...  they are extremely ithcy, and are not allergy related.  I can break the blisters which are puss filled, but usually I scratch them so hard that they scab over.  the itching is relentless.  dont have the problem during fall or winter.  Any help?

[jonathon882001]

CAN people get molluscum on their arms? i have little small red pimple like on both of my arms? i do have molluscum in my groin area? is it possible if you use a sponge with soap to clean your groin area and then use the same sponge to wash the rest of your body, can the molluscum spread to other parts this way, please help!

can you spread molluscum to others if the pimples dont have the white core in the middle?

thanks doc

[MUC]

Uh, not sure how that's related but I had a follow up question for the Doctor as well.

My cheeks can be especially dry and at times tend to flake a bit. Could this be symptomatic of Seb Derm? How can I differentiate Seb Derm from other disorders?

Thx.

[MUC]

Thx for your response, I may go see a dermie but I fear you're right no diagnosis will be made.

I guess the single most "concerning" element was the perminant nature of this condition. It would wax and wane over 8 months but has not disappeared not normal acne.

Best.
/chc7

[Alan Rockoff, MD]

The picture you reference is rosacea.  Your description does not math that, as you realize yourself.  I am frankly not sure what you have.  I am not sure you have anything.  You are paying very intense attention to minor variations in skin appearance and sensation, more perhaps than is useful.  I would dispute your assumption that these changes imply that, "clearly something is different in my body."  Most skin changes imply nothing of the sort.  It may be just that skin  changes a bit in the mid-20's and looks somewhat less even in tone and color than it did before.

To get further information, you will need to see a doctor in person.  You need to be prepared, however, to hear that there is nothing in particular wrong with you.  If the doctor feels this is early rosacea, treatment may be indicated.

Best.

Dr. Rockoff