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Forum Name: Dermatology Topics

Question: Persistent facial dermatitis

 Bounceback - Sat Jan 06, 2007 3:38 am

User avatar Age: 21

Over the past six months I have suffered from what appears to be seborrheic dermatitis. Initially it was infrequent and was concentrated under and between my eyebrows. However, this has since subsided and I now suffer from more frequent yet similar red patches around the edges of my nose and on my cheek ([img]please see the picture below[/img]).

During flare ups these patches are very visible and embarrassing. I try to control the flare ups with over the counter corticosteroid (clobetasol propionate 0.05% w/w). However, this has failed to rid me of the problem and every two weeks another flare up occurs. I am conscious of the side effects of corticosteroids (i.e. skin thinning) and have discontinued its use and am desperate to seek another form of treatment. What would you recommend as the best course of action?

Thanks in advance for your kind assistance.
 Dr. Chan Lowe - Tue Feb 20, 2007 4:51 pm

User avatar Your initial symptoms seem to be quite consistent with Seb. derm. The new rash that you are having along your nasal folds may still be seb. derm. or may be a different condition, such as eczema. Typically, seb. derm is quite sensitive to corticosteroids. Clobetazole is quite a potent steroid and should have done the trick.

In general, I recommend against using any steroid other than a mild steroid (such as hydrocortisone) on the face due to the side effects you point out. Seb. derm. is also typically responsive to dandruff type shampoos (dandruff is basically seb. dermatitis of the scalp). You can use your preferred brand and wash your face with the shampoo daily as well. This may help.

I would recommend that you be evaluated by your doctor for this. There are a few other conditions that can cause irritated skin along the cheeks, such as rosacia and even steroid overuse that should be checked for. If your primary doctor is unable to diagnose you, a dermatologist is your next step.

Hope this helps, and sorry for the delay in answering.

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