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Rash on face, pustular bumps, flushing - WITH PICTURES!

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  • Rash on face, pustular bumps, flushing - WITH PICTURES!

    Hi!
    5 months ago I took accutane for the purpose of eliminating my oily oily skin (which was only eliminated while on it) for 5 months on a dose of 10mg a day. Around the forth month into treatment I began flushing intensely around once a day. I seized the accutane after a month of this occurring and the flushing gradually reduced for the next 2 months post accutane.

    Around this 2 months post accutane mark - I had an allergic reaction to shrimp which caused rashes on the side of my nose, in and around my nostrils, and below my mouth. I used a prescription glucocorticoid steroid called mometasone furoate which would clear the rash up within hours of application. The rash would be gone for a few days but then reappear full force (bringing back the feelings of flushing episodes that accutane caused) - and I would apply the steroid to clear it up. This continued for a few months until about 2 weeks ago when I read up about steroid dependency.

    Now, I only applied the steroid cream around my nostrils, on both sides of my nose, and under my mouth; BUT I didn't apply the cream to the blotchy red spots on my cheek/on the top of my nose (between eyes). Could the steroid cream use cause an overall rosacea effect the these areas?

    The derms I have been too all say its seborrheic dermatitis, and wont even take the time to listen to me about the steroid cream use/ relation to accutane and just prescribe me MORE STEROID CREAMS!! which I refuse to use.

    MY personal thoughts it that I have steroid induced dermatitis/rosacea. Normally steroids wouldn't cause an overall blotchy redness on cheeks, and rash on face/flushing. BUT because my skin was already thinned out and sensitive from accutane use I think the steroids may have had much more negative consequences then they would otherwise.

    What do you guys think is wrong with me!? Should I just wait it out for a few months? I've attached pictures of my condition.
    Attached Files

  • #2
    Heres a picture from today with better lighting:IMG_2114.jpg

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    • #3
      Anyone? Any input would be great!

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      • #4
        Has anyone mentioned perioral dermatitis to you?

        http://www.dermnetnz.org/acne/perioral-dermatitis.html

        It looks very similar to photos of that condition and remarkably similar to what I had a couple of years ago.

        My adive would be to follow your gut instinct and avoid the steroid cream and infact avoid putting anything much one it. I would agree that the accutane has probaby given you sensitive skin that easily reactes to triggers because it is either overdry, irritated by the flushing or has an impaired barrier. This should back to normal, esepcially as you took a low dose and stopped when you experienced problems but it make take time to get there.

        For now i would follow the advice in the link I gave. Avoid steroid creams and any creams for now. Stop using toothpaste with mint in it as this can make it worse (go to health food shop and get a 'natural' one), wash with just tepid water. I would also consider going back to your doctor and ask for an oral antibiotic if it contiues to get worse.

        You have to be prepared for the rebounds that are bound to occur from stopping steroids and just hang on in there. As you say I think your skin is confused by all the meds and will settle in the end by itself. From my point of view your skin doesnt look bad at all.

        If you want to read more about how people treated steroid rosacea just do a search, there are many threads with people going from bad flairs back to great skin.

        Good luck

        Sarah

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        • #5
          Here is a thread showing my skin a few years ago. As you will see at one point I ended up with a very similar rash around my mouth.
          http://www.rosaceagroup.org/The_Rosa...light=phlika29

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          • #6
            If you have already been diagnosed with seborrhoeic dermatitis. It would be a good idea to treat for this first. You don't need to use a corticosteroid cream to treat SD. Ketoconazole cream (an anti-fungal cream) is frequently used. Then re-evaluate your progress. Doing nothing may make it worse.

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            • #7
              I've seen that face somewhere else...

              Anywayssss, don't you just hate it when people tell you "From my point of view your skin doesnt look bad at all"?

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              • #8
                No Ian, I hate it when people take comments out of context and choose to try to make them something they are not.

                I was trying to reassure Oilking that whilst I can see he has a skin problem he still looks good. If I failed to make that clear I apologise but if you read it within the context of my post I think you will see I was trying to be helpful.

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                • #9
                  wow phlika29 perioral dermatitis does look alot like what I have! and it says it is apparent in people with oily skin, and I have VERY oily skin. Im going to just give my skin a break from everything and just use water for a few months!
                  p.s I think it was very nice of you to say it doesn't look too bad

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                  • #10
                    But we get that from everybody every day, from parents, family, friends. Skin stilll looks good to them but not to me, you know because it's not "normal" anymore like it used to be before rosacea. Here I expected people especially mods to be more sensible?

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                    • #11
                      Originally posted by oilking View Post
                      p.s i think it was very nice of you to say it doesn't look too bad
                      lol

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                      • #12
                        Hi,

                        just my thoughts: I think you do have seb derm. I have completely similar rashes when I have a seb derm flare: red with scaly bits here and there and the skin seems dry there and the structure of the skin is a bit raised or raw looking and reddish. If you scratch over it with your nail, do small scales of skin come off? Then it is very likely seb derm, although the scales are not always present. Also, your rash is on the exact seb derm area's: around the nose, on the nostrils of the nose and around the mouth and the chin. It can also manifest itself in your eyebrows and on the bridge in between the eyebrows.

                        I think you are wise to stop with the stroid cream. Ketoconazolcream is indeed the cream to try now I think. If it is seb derm, it will lighten up within a week or so often. Be careful with yeast (bread etc) and sugar, it will worsen it most likely.

                        You can actually get rosacea from steroid use, even from very short term steroid cream... I got full blown rosacea from 3 days of use, and my rosacea specialist has some patients with similar experiences. However, most people who are not predisposed to it (and don't have the sensitive and fair skin), usually need long term use of steroid cream on the facial skin to get steroid induced rosacea.

                        How often do you flush? Do you flush all over your face, or on your cheeks or just your nose?
                        I would defo try the ketoconazol first, IF you have rosacea, which is not sure imo, it won't worsen it at least. Then look if the flushing calms down as well..

                        Best wishes Natalja
                        My rosacea related blog: http://scarletnat.blogspot.com/2012/...edication.html

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                        • #13
                          Originally posted by IanW View Post
                          But we get that from everybody every day, from parents, family, friends. Skin stilll looks good to them but not to me, you know because it's not "normal" anymore like it used to be before rosacea. Here I expected people especially mods to be more sensible?
                          I think you need to stop picking on people and start trying to help. I have no idea what you are going on about. Did I say that he didnt have a problem? Did I say that he didnt need to treat it?

                          Stop trying to make something out of nothing.

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                          • #14
                            Originally posted by phlika29 View Post
                            I think you need to stop picking on people and start trying to help. I have no idea what you are going on about. Did I say that he didnt have a problem? Did I say that he didnt need to treat it?

                            Stop trying to make something out of nothing.
                            Hey, I'm not making stuff out of nothing and I never said that you implied that he didn't need to treat it. I'm just tired of people telling other people their face doesn't look bad when there's obviously a problem with there skin. It happened to me all the time and I absolutely hated it. OK? That's all I'm saying.

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                            • #15
                              The flushing has definitely decreased over the past weeks since stopping the steroid ointment. I'm hoping the rashes will follow over the next few months. I'm hoping its period dermatitis, or steroid induced dermatitis, rather than seb derm - as Ive heard seb derm is a life long condition. Only time will tell. I've been using apple cider vinegar for the past week and there's been an 80% improvement in the rashes, so at least I have something to keep them at bay while I wait for my skin to readjust to being steroid-less. I have a derm appointment soon and am hoping to get a prescription for finacea, as I hear this is helpful for what I'm going through.

                              Thanks for the input though, guys.
                              Ill keep you all posted over the next few months with pictures if things improve/return to normal.

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