Painful, dry, burning cheeks: Eczema or steroid withdrawal or Rosacea? (Photos)

Question

Nummular eczema over body since birth. Intermittent use of topical steroids through life. Beginning around 2011 for a couple of years mild to potent creams (elidel, protopic) used for dry red spots on cheeks. Quitting made it worse. It's been several years since , still have painful, burning cheeks, red spots, sometimes bumps. Comes + goes. Face lotion is temporary. Cannot wear makeup as it looks worse. Could it be a developed food allergy? Chemistry changes post pregnancy? Severely depressing.

Sameer Bashey, MD · Answer

The problem today is that most doctors will simply put on you topical steroid after topical steroid again and again and steroid sparing creams like elidel without addressing the underlying cause of the skin irritation which is poor barrier function. When skin is healthy and strong it is able to protect itself from such sensitivity. You should see a dermatologist who can both patch test you and address the barrier funciton of the skin.

Vicki J. Levine, MD · Answer

You may want to have patch testing done  to see if there is anything you are allergic to  period you would go to a dermatologist for  that,not an allergist . In the interim you might want to try a cream that has absolutely no preservatives in it.. It is called Vanicream. Good luck

Davin Lim, MBBS, FACD - Account Suspended · Answer

More information given to a medical dermatologist can help. This could be irritant or contact dermatitis - testing is needed. Photodermatosis ( unlikely) or rosacea- steroid induced rosacea, acne- rosacea. A medical dermatologist can take a comprehensive history, perform some tests and come up with a diagnosis. Rosacea is very complex and a tailored treatment program give the best results. This is because there are many types of rosacea (telengtctatic or capillaries, flushing and redness, acne like rosacea, ocular rosacea and even rhinophyma rosacea.)
  
To add to the complexity, everyone has different flare factors- Sunlight, stress, foods, chemical irritants, creams, changes in temperature, alcohol. The list goes on. 
  
A detailed history, together with a treatment tailored according to YOUR type of rosacea will give the best results. As a guide, I use a combination of -
  
1. Lasers ( to treat redness, broken capillaries, rhinophyma, flushing)- best laser is the V BEAM. IPL can be used, but usually not as effective. Laser toning using the long pulse Nd Yag at 1064 can help with background redness. 
  
2. Creams - anti inflammatory
  
3. Tablets -anti - inflammatory and sometimes low dose Vitamin A. 
  
4. For females- Mineral make up is recommend, over make up that contains parabens. 
  
For the best results, consult a dermatologist for both medical and laser treatment options. 
  
Kind regards.
  
Dr Davin S. Lim.
  
Laser Dermatologist.
  
Brisbane, Australia.

Painful, dry, burning cheeks: Eczema or steroid withdrawal or Rosacea? (Photos)

Answers (3)

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