Skin rash - Is it an allergy? Rosacea? (photo)

Question

I’m 40 year old female in July of 2024 I developed this “rash” on my cheeks I went to 6 dermatologist since then And it felt like everyone was guessing the cause.. from rosacea to Keratosis pilaris, dermatitis, food allergy/ make up allergy. I’m on antibiotics for inflammation, I was on azelaic cream please help me

Anna Chacon, MD, FAAD · Answer

Hello, and thank you for sharing your concerns. It sounds frustrating to experience a persistent rash and receive differing diagnoses from multiple dermatologists. Here are some considerations that might help guide further evaluation and treatment:

Possible Causes:

Rosacea: This condition often presents with redness, visible blood vessels, and sometimes acne-like bumps on the face. Triggers can include sun exposure, stress, hot drinks, and spicy foods.

Keratosis Pilaris: Typically characterized by small, rough bumps, often on the arms and thighs, but it can appear on the cheeks. It’s usually linked to dry skin and may improve with moisturizers and exfoliants.

Dermatitis: This covers a range of skin inflammations, including allergic contact dermatitis (reaction to a product) and atopic dermatitis (eczema), which can cause redness, itching, and dryness.

Allergies: Both food and cosmetic allergies can manifest as skin rashes. Keeping a diary of foods and products used can help identify potential triggers.

Current Treatments:

Antibiotics: These can help reduce inflammation and treat any underlying bacterial infections that may be contributing to the rash.

Azelaic Acid Cream: This is often used for rosacea and acne due to its anti-inflammatory and skin-renewing properties.

Next Steps:

Patch Testing: Consider asking your dermatologist about patch testing to identify specific allergens that might be causing the rash.

Comprehensive Evaluation: A thorough review of your medical history, lifestyle, and environmental factors might reveal clues. Sometimes, systemic conditions or hormonal changes can also manifest as skin issues.

Consultation with Specialists:

If you haven’t already, consider seeking a consultation with a dermatologist who specializes in complex cases or a dermatologist with expertise in allergy testing.
I hope this provides some guidance. It’s important to continue working closely with a healthcare provider to find a tailored approach to your condition. Best of luck, and I hope you find relief soon.

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