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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified MD
Category: Dermatology
Satisfied Customers: 63757
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Ive had a rash type patch appear on the right side of my forehead.

Customer Question

I've had a rash type patch appear on the right side of my forehead. Its been there for about 5 months since moving in to a new house. I've also recently developed dermatitus around the eyes and sides of the mouth. The house we've moved into is quite old and I wonder if it's an allergic reaction to something like mould or dust mites, or cause by stress of the move and the birth of our first baby. I'd really like to get my skin healthy and back to normal but not sure what cream or medication to use/ I've already tried finacea, ibuprofen gel, hydrocortisone and daktarin creams, the daktarin is the only cream that doesn't make it worse.
Submitted: 3 years ago.
Category: Dermatology
Expert:  Dr. Bob replied 3 years ago.
How large is the patch on your forehead? Is it enlarging? Does it itch? Does it have a sharp border or is it ill-defined?
Expert:  Doctor Natasha replied 3 years ago.
Hi
I was following your question.
It sounds like you have ringworm- because the only cream which does not seem to worsen it is daktarin- which is an antifungal.
You can try any one of these creams:

They are applied twice daily.

Now if you do not see an improvement after 3 weeks of application, you need to see a dermatologist- sometimes the patches on the face and head need oral antifungals which are available only by prescription.

 

Hope this helps :-)

 

Customer: replied 3 years ago.

It itches occassionally at night time and can often gets worse when I'm stressed. It doesn't seem to be getting much bigger but I wonder if it's linked to any sinus infection as I have sinus problems on and off and the patch appears approx 1 inch above my right eye with smaller marks coming down towards the center of my forehead. I've been applying the Daktarin for over 3 weeks with only a very minor improvement if anything. To get to see a Dermatologist I need a GP referal which can take a while, can I get these recommended creams and orals from the GP?

Expert:  Doctor Natasha replied 3 years ago.
No, this is not related to the sinuses
You can get these recommended creams over the counter and the orals from the GP.
Ask your GP to do a scraping of the skin too- they can do that as well.

Thanks!

If this helped, positive feedback is greatly appreciated :-)
Expert:  Dr. Bob replied 3 years ago.
Can you upload a picture of your rash? As they say, "a picture speaks a thousand words". Otherwise we are just groping in the dark here.
Expert:  Dr. Bob replied 3 years ago.
Also, do you have any chronic medical conditions? Are you on any medications other than skin stuff?
Customer: replied 3 years ago.

I have rosacea on other parts of my face so wondered if this could be linked? and I'm not on any other medications

Expert:  Doctor Natasha replied 3 years ago.
Well, that is certainly a possibility and rosacea is treated with medications such as antifungal and steroid preparations that reduce inflammation and the build-up of scaling on the skin.

You can try washing your hair with medicated shampoo like selenium blue and make sure you address this area. Follow by antifungal cream mixed with 1% hydrocortisone twice a day. If this does not help after a few weeks, make an appointment to see your doctor.

Good luck!
Customer: replied 3 years ago.

I've tried the medicated shampoo approach but that didn't work and although I use an anti fungal now I'm reluctant to use a hydrocortisone cream as the one I tried previously made it worse.

Customer: replied 3 years ago.

I've added a photo to the link below, unfortunately it doesn't show it well in the light here but gives you an idea the size and area


 


http://www.alistairwhiteley.co.uk/images/photo.jpg

Expert:  Dr. Bob replied 3 years ago.
Well done on the photo! I agree that the rash is a bit faint in this image, but it does not look classically fungal. Perhaps this is because you have been using an antifungal and it has been partially treated. If you think it has improved, you will likely need to continue this agent for another 4-6 weeks as fungal infections can take a long time to resolve. Another consideration at this time, particularly if the rash does not clear is to have it biopsied. It is on a sun-exposed region and your skin is fair, so this increases the chances of skin cancer. As you probably know, some types are not very aggressive and can be easily removed. Others are more serious and need prompt attention. The only way to reliably distinguish between the two, however, is to do a small punch biopsy and have it analyzed by a pathologist.
Customer: replied 3 years ago.
if it is cancerous would there be any other symptoms?
Expert:  Dr. Bob replied 3 years ago.
Usually not. It is typically silent, though smaller lesions can bleed or itch. While cancer is less likely in this case, the possibility should not be ignored, especially since none of the treatments you have tried (for more common things) have worked. For example, early phases of a type of skin cancer called mycosis fungoides can be difficult to diagnose because it can resemble eczema or psoriasis. A simple skin biopsy will usually clear up the mystery.
Customer: replied 3 years ago.
it's never bled but will often feel like its twitching and/or itching several times each day, itching more noticeable at night and rash seems worse during hot or humid conditions like after a shower, does that sound more like anything familiar?
Expert:  Dr. Bob replied 3 years ago.
Lesions that itch or redden with heat are often either allergic in nature or vascular. If allergic, it would be expected to respond well to antihistamines and a steroid cream, usually within a few weeks. If you have not tried this already it would be worth a shot. You can get an antihistamine over-the-counter (e.g. diphenhidramine) and your doctor can prescribe a steroid cream stronger than hydrocortisone (e.g. fluocinonide ointment works well, but should not be used on the face for more than a few weeks).
...
If vascular in origin, it would not respond to topical agents and would need to be biopsied to identify.
Expert:  Dr. Bob replied 3 years ago.
Hello, Alistair. Did you have any follow up questions about your rash? Please let me know if you do and I would be happy to assist you further.
If you have no more questions, a positive rating would be much appreciated as this is how we get compensated for our time and expertise. Best wishes.
...
Doctor-Bob
Expert:  Dr. Bob replied 3 years ago.
Hi Alistair. Do you offer free consultations in your business?
http://www.alistairwhiteley.co.uk/
Customer: replied 3 years ago.

I've now been to see my gp and another dermatologist who say that it's neither cancerous or fungal. They say a combination of both exzema and rosacea. My next question is what's the best cream I can use which won't irritate the skin and will reduce redness. I am also considering having it lasered so your opinion on that as well please.

Expert:  Dr. Thomas, MD replied 3 years ago.
Hello from JA
The other expert has opted out.
I am a little confused here.
You saw a dermatologist that gave you a diagnosis.
What cream did they give you?

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