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  • Flakey Face

    So this has been driving me nuts pretty much my whole life (im 24). Before i had super oily skin with flakes, sounds like seb derm right? However 2 years ago they found a hormone imbalance in my blood test, put me on spiro, and now no more crazy oily skin. You would think that would solve the problem if it was seb derm, no more oil, no more flakes. Well, i'm just as flakey as always. What has me puzzled is that it's not in the typical seb derm areas, but rather my ENTIRE face. Cheeks, nose, chin, forehead... everything! It seems to be more flakey around my nose/cheek folds and my eyebrows. What is the cause of this, is it seb derm? And what can i do for it? Exfoliating is sadly out of the question because of the sensitive rosacea skin. I do my best by just using my fingers and water to rub out some of the flakes. Please help Being able to wear makeup would help but because of this, i can't it just flakes up!

  • #2
    I mean, you describe my EXACT situation. I have been searching for a solution for ages.

    In my case I'm pretty certain it is not seb derm.

    With me, it began after I had had rosacea for a fair while, and slowly set in over about a six month period. I've tried to connect it with the two significant things that occurred during that period - giving up smoking (some kind of stress hormone imbalance?) and staying indoors (lack of vitamin D?).

    Other than that, I'm still fairly in the dark. I've quizzed my derm about it loads and his perspective is that the inflammation from the rosacea disrupts the normal process of skin barrier formation. Hence the flakes, as the skin tries to form properly, but fails. The oil would be some kind of compensation-reaction.

    I'm not totally convinced by this explanation, since as I say, I had rosacea without these flakes. And there doesn't seem any variation in them, no matter how inflamed my skin might be.

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    • #3
      I have the same as you have. I am a male, 25 years old. Rosacea has been slowly building up on me during the last 2 years. For two months it´s been unbearable, so I visited a doctor.
      I am currently taking oral metronidazole for a month... 500 mg x 3 times a day.

      It´s absolutely no seb. derm.
      But rosacea combined with flaky skin.

      Right now as we speak, my rosacea is not in a flare, wich means the flaking is pretty easy to cope with. But as soon as the rosacea flares up, the flaking comes along with it.

      TheMediumDog I might actually support your derm´s theory about rosacea stopping the skin from healing and therefore the flaking. A lot of things point in that direction - at least for me.
      But you might have it different of course.

      EK1: I have the same. It often happens that i rub some water gently on the face, and voila, the flakes are gone! I wonder if it might be as simple as dry skin? But regular moisturizers makes my skin go haywire. I will ask my doctor for something good later this week, and will keep you updated.

      Have a nice day!
      Last edited by siliconmessiah; 10 June 2009, 07:03 PM.

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      • #4
        I dont think its dry skin because i can never get rid of all of the flakes.

        Do you guys also have it that if you put your nail against your skin and lightly move it up, a ton of flakes will come up? Does that make any sense? Cause going down is in the direction of the skin but going up goes against it.

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        • #5
          Exactly the same here it seems.
          My theory is that it is co-related with the inflammation of rosacea. It is not Seb. Derm.
          As I said, right now I am not having a flare, it´s pretty calm. But the flakes are still there.

          Anyway:
          I am currently taking oral metronidazole.
          I have started to excercise almost everyday.
          No alcohol (at least as long I am on oral metro)
          Stopped using tobacco.
          Eating healthier.

          So this summer I´ll win over my rosacea.
          Keep it up!

          Comment


          • #6
            i also have this exact same problem that you describe and it is also driving me mad!

            MediumDog - I don't quite buy your GP's explanation either and others have offered the same one to me. The flakes on my face carry on regardless of how red/inflamed my face is and like you, I had Rosacea without the flakes previously.

            EK1 - I don't think it is as simple as just dry skin either. Seb Derm is the more plausible explanation as moisturiser doesn't do much to get rid of the flakes - def not in my case anyway. I'm pretty sure it's possible for Seb Derm flakes to appear all over the face.

            Interesting that you had a hormone imbalance. This is something I'm trying to look in to at the moment. Can I just ask how you found the Spiro? Did it help with the Rosacea symptoms (other than this flakiness)?

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            • #7
              Spiro does absolutely 0% for the rosacea.
              I got spiro from my derm after a blood test with my family doctor checking my hormone levels. It's only prescribed for too much DHEAS/Testosterone in you as it blocks the androgens. This is why males can't take it.

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              • #8
                Originally posted by sarahjonjon View Post
                EK1 - I don't think it is as simple as just dry skin either. Seb Derm is the more plausible explanation as moisturiser doesn't do much to get rid of the flakes - def not in my case anyway. I'm pretty sure it's possible for Seb Derm flakes to appear all over the face.
                There are moisturizers availible that is made up of propylene glycol, those have also a microbial effect (like seb. derm). It is common for derm´s to prescribe a combo of metro-gel and this special type of moisturizers for rosacea.

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                • #9
                  I may have the same thing and have been to many derms who are not sure what it is......it is all over my beard, cheeks and temples....it is like fine white sand coming out of my pores...it does have a waxy appearance like SebDerm but all Sebderm meds haven't made a dent....I can remove the flakes by exfoliating but then I get nasty flare and more flakes follow....does anyone relate to this?

                  One derm said the exact same thing about scales following inflammation.

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                  • #10
                    One problem, as I see it, is knowing whether we are all talking about the same thing.

                    I too have it that flakes will really appear if you run a nail along. There is basically a layer of flakes, instead of a proper barrier. Does anyone have it that if they leave the skin a few days without washing it, these flakes will kind of build up? (If you wash your skin every day with a fair amount of thoroughness, this won't be apparent).

                    I can literally only wipe my skin very lightly with a wet tissue (any harder and it aggravates the rosacea) so I am prone to this kind of build-up. It is as though the skin is desperately trying to form a barrier, but something is stopping it from doing so properly.

                    I don't find that my face feels particularly 'tight' as a rule (someone else mentioned this) although it definitely used to for several hours after I used a cleanser, even a very mild one. It can, though, feel a bit 'raw'. Like, if I scrunch up my forehead it can feel kinda like its sunburned.

                    It is very sandpapery to the touch. This is the flakes - I find that if I wipe it quite a bit, it returns to a normal soft texture, although, again, I can't do this because it aggravates the rosacea.

                    It does have a dry look (you can see that kind of dry lines if you stretch it), and I'm sure it is dry, without a decent barrier. Moisturizers just clog everything though, and I've tried every one.

                    I would be interested in people describing things in detail, including especially what they think it might be connected to. Maybe we might see some common features.

                    In this spirit - how is everyone's sun exposure? I've recently discovered that vitamin D is central to proper skin formation. Those with deficiency apparently don't tend to have skin problems, but, you know...not everything is known.

                    The hormonal connection is interesting.
                    Last edited by TheMediumDog; 11 June 2009, 10:40 AM.

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                    • #11
                      EK1,

                      I will also be very interested to find out if clonidine helps your face via lessening the amount of inflammation that is going on.

                      My derm thinks that flushing and inflammation are rather separate (you get flushers who do not have sensitive, inflamed, p&p-prone skin; and you get the latter who don't flush), and told me he thought therefore clonidine wouldn't help me with the flakes (which, as I mentioned, he thinks are due to inflammation interfering with the normal processes of skin formation).

                      Again, not sure how much I really buy his view.

                      Comment


                      • #12
                        I was getting sunshine on a daily basis....I was tan with pink cheeks but it made no difference on the scales...I recently stopped getting much sun as the weather has turned very hot.

                        I have tried to moisturize but I also breakout...not matter how gentle or oil free the moisturizer is.

                        I have found Elidel to be very soothing but after a month of every other day use, I have come to the conclusion that it hasn't done anything for the scales.

                        I do have regular discomfort in the form of itching and slight burning and I get a tightness dry feeling.

                        Any manipulation to remove the scales results in irritation and any type of exfoliating products containing Urea or SalAcid results in redness and pimples.

                        If I don't shave for a few days the scales seem to get more dense....so shaving does exfoliate to some degree and I always get some pimples or red bumps the following morning. But my cheeks and temples have much more visible scales.

                        So nothing works and doctors are not sure what it is or how to treat it.

                        I have had extensive blood work done and all normal.... and it seems my only option is a biopsy....which I think I may do very soon.

                        Last point, I had normal skin up until I used steroids 4+ years ago and got Steroid Rosacea.....guess the scales were an added bonus.

                        I am posting some pics for a few days for you all to see and we can all compare.



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                        • #13
                          Originally posted by TheMediumDog View Post
                          One problem, as I see it, is knowing whether we are all talking about the same thing.

                          I too have it that flakes will really appear if you run a nail along. There is basically a layer of flakes, instead of a proper barrier. Does anyone have it that if they leave the skin a few days without washing it, these flakes will kind of build up? (If you wash your skin every day with a fair amount of thoroughness, this won't be apparent).

                          I can literally only wipe my skin very lightly with a wet tissue (any harder and it aggravates the rosacea) so I am prone to this kind of build-up. It is as though the skin is desperately trying to form a barrier, but something is stopping it from doing so properly.

                          I don't find that my face feels particularly 'tight' as a rule (someone else mentioned this) although it definitely used to for several hours after I used a cleanser, even a very mild one. It can, though, feel a bit 'raw'. Like, if I scrunch up my forehead it can feel kinda like its sunburned.

                          It is very sandpapery to the touch. This is the flakes - I find that if I wipe it quite a bit, it returns to a normal soft texture, although, again, I can't do this because it aggravates the rosacea.

                          It does have a dry look (you can see that kind of dry lines if you stretch it), and I'm sure it is dry, without a decent barrier. Moisturizers just clog everything though, and I've tried every one.
                          MediumDog, I relate to all of these points and experience the same. My skin does feel tight though and this sensation comes and goes. Sometimes the tightness lasts for days at a time, It feel like my face will crack (and it will!) if I smile.

                          Detail;

                          -Flakes across forehead, cheeks, chin and nose with particular build-up at the sides of the nose. The only areas of my face to be UNAFFECTED by this are close to the jaw and ears and the eyebrows (strangely, as it's a typical area for seb derm).

                          - The flakes, like MediumDog's, seem to sit on top of the red Rosacea skin, almost like another layer of skin. They have a yellowy appearance when they 'build-up', similar in appearance to bad crusty make-up applied over damaged skin.

                          - The flakiness seems to be independent of the redness and inflammation in my skin. It's always there regardless of the behaviour of the rest of my face. Incidentally, on a hormonal note, the redness really calms down in my skin just before my period and the P&Ps completely disappear. The flakes however, remain vigilant!

                          - Moisturiser does not appease this. A tiny amount of Serum does seem to break them down a bit but I'm as yet unsure if this is a good idea as my skin seems to get redder. Or is it just the redness that is always there underneath the flakes?? Coconut Oil does the same.

                          - I don't know if this is Seb Derm or part of Rosacea. I posted recently under the heading 'Extreme Dryness Overnight' asking this very question. I have not had it properly confirmed by a Derm though I was prescribed Nizoral cream by my GP (this didn't work).

                          - This sandpaper skin developed over a day or two for me. Prior to that my face was oily/combination (with Rosacea for a good while). At the time I was coming to the end of a 3-month course of Oxytetracycline. Did this occur for anyone else while they were on antibiotics? (i realise the inferences to be drawn are a bit loose as so much rosacea so many antibiotics everywhere).

                          - The reason I felt it could be Seb Derm is due to the fact that I have suffered that condition on my scalp my whole life. Strange that it should suddenly spread ALL OVER my face but it did worsen on my scalp at the same time.

                          - When the flaking began I had recently switched from using my old moisturiser that contained alcohol and fragrance (but never caused me any problems!!) to one without but that did contain several oils. Around the same time I experienced very bad flushing one evening and tried Aloe Vera Gel on my face which really dried it up. I wondered for a while if I had just dried my face out from using that but of course, it's been way too long now.

                          - I have noticed that the flakes get worse when I stay in one environment for too long. Fresh air seems to help. Going for a gentle run helps.

                          - The flakes are least visible first thing in the morning. After 20 mins or so awake they start to creep back. Any contact with water brings them on full-force.

                          As for sun-exposure, I haven't had any since this dryness began as I have been too scared to put my Rosacea face in the heat. I guess therefore this is the longest I have ever been without sun - I have always loved it. I do know that the only time in my life that the Seb Derm cleared up on my head was when I spent a year in SE Asia. Again, I have no idea if these flakes are SD or not. Grrr.

                          Uh, you wanted detail...

                          Oh and Monte, the flakes on my face are a lot denser and more scaly looking than yours kind of as if the skin is cracking. How loose do the flakes feel? Could you wipe them off easily or would you have to 'pick' at them? Gross question I know...

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                          • #14
                            Alright here are my details!

                            +My face is always flakey, no matter what

                            +I could rub till the cows come home, there are always flakes. I just rub to get the apperance of most of them gone, but they get "flattened" and you can't see them as much.

                            +Putting on my metrocream (or any other for that matter) always results in some of the flakes sticking to the cream and getting rubbed out.

                            +There are kinda different types of flakes if you will, ones that are like sticking out that you can to pull/scrape at to remove and others are more flat like a layer of skin. No matter what, whenever i run my fingers down my skin, some flakes will come off. Hence why i never scratch or touch my skin during the day.

                            +The only thing that ever removed them was the first time i used hydrocortisone (it was mixed with clindamycin but that caused me clogged pores problems). However i used hydrocortizone again 4 months after with ketaconazole and it didn't do anything to help the flaking really. It did get rid of the tight layer i got (it hurt i couldnt move my face, my skin felt like a layer was stuck to it... this happened in the fall of 2007. I have since never got that tight layer ever.) I was also given Loprox (antifungal cream) but that didn't change anything either.

                            +I am currently using a sulfacetamide/sulfur foam (clarifoam) every 2nd night. It seems to be smoothing out my skin. I tried using it every night but it made me too dry and tight. It is supposed to help skin turn over (the sulfur) so perhaps this will provide some relief. It is meant for rosacea and seb derm. It's been 2 weeks or so on it, but i don't think that's enough time to tell especially since i can't use it every night. When i feel i'm getting too dry, i take an extra day or so without the foam so i'm not over doing it.

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                            • #15
                              Also, I think it would be beneficial to disclose derms diagnosis. I have almost received a different diagnosis per each derm..... I have been told the following: SebDerm, Atopic Dermatitis, Rosacea, Sun Damage, Polymorphic Light Eruption, allergic dermatitis and recently a derm told me I may have some unique acquired Icthyosis variant.

                              Subsequently, I have tried a multitude of topicals which have only irritated at best and at worst turned my face bright red with pimples.....one thing that has remained a constant are the scales.

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