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Ask Dr.Sumanth Your Own Question
Dr.Sumanth, Doctor (MD)
Category: Dermatology
Satisfied Customers: 20058
Experience:  Consultant Pediatrician at Kanchi Kamakoti CHILDS Trust Hospital
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I have had what I thought was really bad eczema on my face

Customer Question

I have had what I thought was really bad eczema on my face that’s making my skins peel off and becoming really painful
JA: How long have you been dealing with this issue? Any other skin concerns?
Customer: eczema around 20 years but worsening on my face since April/may
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: no
Submitted: 4 days ago.
Category: Dermatology
Expert:  Dr.Sumanth replied 4 days ago.
Hi...Welcome to Just Answer. I am Dr. Sumanth Amperayani. I have 17 years of experience in the field of Medicine at a tertiary care referral hospital. I am currently reviewing your question.

Kind regards ***** ***** Sumanth Amperayani

Expert:  Dr.Sumanth replied 4 days ago.

Skin conditions are always best diagnosed and treated after seeing them directly. May I request you to upload some images please.

Customer: replied 4 days ago.
File attached (752ZZ4V)
Customer: replied 4 days ago.
I also have dry skin in other areas but this is the worst area that has been ongoing
Customer: replied 4 days ago.
Are you there?
Expert:  Dr.Sumanth replied 4 days ago.

I am very much here the photos just got downloaded please hold on I am typing some questions

Expert:  Dr.Sumanth replied 4 days ago.

I am sorry for your symptoms. I need some more information.

1. May I know your age please?

2. Are you having any burning or gritty feeling in the eyes?

3. Did this start after any facial application?

4. Have you observed any aggravating factors like hot and spicy food, hot drinks, alcohol, very hot or cold ambient temperature, exposure to sunlight or any stress or emotional issues?

5. Are there any skin bumps which are not pus filled?

6. An personal or family history of rosacea?

7. Are you having any burning sensation or itching?

8. Is your nose red/ swollen and rounded during the flare?

Customer: replied 4 days ago.
I’m 39, no eye burning, no to no 3,4,5,6, it’s burning and itchy, no to number 8
Expert:  Dr.Sumanth replied 4 days ago.
Please hold
Expert:  Dr.Sumanth replied 4 days ago.

Hi..thank you for the information and upload the images for my better understanding. I feel this is Rosacea. The other close differential diagnosis is Cholinergic Urticaria.

Rosacea is a skin condition that causes redness and raised, red bumps on the cheeks, nose, chin, forehead, or eyelids.

Rosacea is a long-term condition that can get worse over time. Rosacea happens most often in adults ages 30 to 60.

Rosacea affects the cheeks, nose, chin, forehead, or eyelids.

Symptoms include:

- Redness

- Blushing easily

- Raised, red bumps with or without pus in them – Bumps from rosacea can sometimes look like acne, but they aren't acne.

- Tiny, swollen blood vessels on the skin (called "telangiectasias")

- A burning or gritty feeling in the eyes

- A red, swollen, and rounded nose

Sometimes, people's symptoms are under control. Other times, symptoms worsen and flare up. There are some things that might make redness on the face worse.

- Eating hot or spicy foods, or drinking hot drinks

- Drinking alcohol

- Being too hot or cold

- Sunlight

- Stress and other strong emotions

Treatment for rosacea has 2 parts. The treatments do not cure rosacea, but they help control symptoms and prevent flare-ups.

●Medicines – The medicines can come as gels, creams, or lotions that go on your skin, or as pills that you swallow. You will likely need to take or use medicines for a long time.

●Lifestyle changes –

•Avoid the common triggers listed above and any other triggers that you know worsen your symptoms

•Use mild, unscented face cleansers to wash your face

•Wear sunscreen every day

•Avoid using products on your face with alcohol, acid, or other ingredients that could bother your skin

Prescription drugs for rosacea include:

- Topical drugs that reduce redness. For mild to moderate rosacea, your doctor may prescribe a cream or gel that you apply to the affected skin. Brimonidine (Mirvaso) and oxymetazoline (Rhofade) reduce redness by constricting blood vessels. You may see results within 12 hours after use. The effect on the blood vessels is temporary, so the medication needs to be applied regularly to maintain improvements.

Other topical products have less effect on the redness but help control the pimples of mild rosacea. These drugs include azelaic acid (Azelex, Finacea), metronidazole (Metrogel, Noritate, others) and ivermectin (Soolantra). With azelaic acid and metronidazole, noticeable improvements generally don't appear for two to six weeks. Ivermectin may take even longer to improve skin, but it results in a longer remission than does metronidazole.

- Oral antibiotics. Your doctor may prescribe an oral antibiotic such as doxycycline (Oracea, others) for moderate to severe rosacea with bumps and pimples.

- Oral acne drug. If you have severe rosacea that doesn't respond to other therapies, your doctor may suggest isotretinoin (Amnesteem, Claravis, others). It's a powerful oral acne drug that also helps clear up acnelike lesions of rosacea. Don't use this drug during pregnancy as it can cause serious birth defects.

I sincerely ***** ***** I have helped you today!

Is there anything else where I can be of assistance to you in this regard please. We can continue here until you are satisfied, simply use the reply box and let me know.

Kind regards ***** ***** Sumanth Amperayani

Customer: replied 4 days ago.
Sunlight can make it worse if I don’t have on spf
Expert:  Dr.Sumanth replied 4 days ago.

Please read my response above and get back.

Customer: replied 4 days ago.
I have been treated for rosacea n had no effect the treatment made my skin feel more dry x
Expert:  Dr.Sumanth replied 4 days ago.

In that case the other possibility which remaining to consider is autoimmune disease or autoimmune vascular it is or it could also be a simple bacterial infection requiring clindamycin which is the best antibiotic with excellent tissue penetration.