Facial rash/infection? The dermatologist has diagnosed rosacea and dermatitis. (Photos)

Question

I have had this issue for over a year I have been controlling it wit clovate (steroid cream) anti- inflammatory it takes this away completely but it comes back if I don’t apply every night. I have been swabbed and came back negative for bacteria and HSV-1 tried various antibiotics Co-amoxiclav, flucloxacillin, erythromycin, topical clindamycin, dermol wash (antibacterial) the dermatologist has diagnosed rosacea & dermatitis. I feel like this is completely wrong, different diagnosis??

Amy Miller, MD · Answer

From the pictures it look like you are suffering from Perioral dermatitis.  Unfortunately this is made worse by long term use of steroid creams.  The treatment of choice is doxycycline but you may need a longer course of treatment than usual because of the steroid use.  Pimecrolimus cream is helpful, especially for steroid induced perioral dermatitis, and may help resolve the clinical symptoms (giving the doxy some time to work).
It doesn't look classic for rosacea, but you never know with the human body!
Hope this is helpful information.  Best Regards,
Dr. Amy

Davin Lim, MBBS, FACD - Account Suspended · Answer

This is perioral dermatitis or steroid induced rosacea. See a dermatologist to simplify your skin care. Take Doxycycline for 6 weeks, reduce your make up use, and this rash will improve. Stop your steroid creams (this is also known as steroid induced rosacea)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.

Facial rash/infection? The dermatologist has diagnosed rosacea and dermatitis. (Photos)

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Facial rash/infection? The dermatologist has diagnosed rosacea and dermatitis. (Photos)

Answers (2)

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Everything you need to know about Laser Resurfacing

Our mission is to create a world where every investment in modern beauty is Worth It.