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Having some strange spots on face with stinging and tingling sensation. Is this keratosis?

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Practicing since : 2005
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looking for a dermatologist. I have had a problem especially on my face for 2 years now. I am thinking its a form of keratosis but i dont know. I first noticed it during benzo withdrawal 2 years ago. a small spot on my left cheek that tingled. then i would get a stinging sensation on my upper lip where hair groes that would bring tears to my eyes and the hair in that spot would be gone, and that also happens on my bearded area. I also have stinging and tingling on my nose cheeks and one eyelid. sometimes on the top of my head. It never goes away, sometimes it just gets easier to deal with. I have pictures. it is hard to see anything though. I can see a skin colored waxy lines and circles on my cheeks in right sunlight but other than that you really wouldnt notice it unless your me. I know its there. it drives me crazy and I have to know what is going on. I believe it effecting my scalp too, i shaved my head and there are what appear to be lines of less hair like corn rows but thats not even that noticeable. It almost seems like my darker hair on my beard area are being plucked out and I can feel it, especially when it happens on my upper lip. I have pics
you will notice slightly off colored skin in my side face pictures and patch hair loss. my cheeks are what tingle and feel as though something foreign is on them all the time. i tried fungal cream etc. nothing worked. youll see my upper lip where hair went missing from stinging pain. please ask me any questions you may need to help me
the right side of my face shows lots of off colored circles and spots in the light i took this is. my family dosnt seem to see anything but i do and this picture shows it well
almost like a waxy look but flush with the skin. some are raised so slightly its hard to tell that they are. just giving you all info I can
also, where i lose hair from this stinging sensation, it groes back only to happen in a different spot
i meant grows back. it also feels as though my skin on my arms has changed too, my veins used to stick out and now it seems to have a layer of skin preventing that from happening. this may be something else but i find it strange. my face head and neck are what bug me the most. feels like i have bugs on me but thats not the case
could this be a form of hives that do not go away? I am so desperate for answers. I do not have insurance so going to the doctor has not been a real option yet. i am in school full time, working on my recovery, and this issue is a threat to my sobriety it drives me that crazy. Also is there something you could suggest to use at home to help this go away? Ive tried washing my face with dandruff shampoo, fungal creams, vaseline etc.
also, i know you cannot diagnose without seeing me in person, but could you give me your best educated guess as to what it may be, i need options to look into because the internet is not helping after a year of looking this up... thanks in advance. Also, could this be some sort of life threatening thing?could this be some sort of parasite? nobody else in my family have gotten this from me, but i wonder about some sort of worms etc. ive thought of everything

Posted Fri, 24 May 2013 in Skin Hair and Nails
Answered by Dr. Johny Chacko 25 hours later

Welcome to XXXXXXX

Thanks for the detailed history and photographs. Few of the pictures were clear enough for me to observe the faint redness and swelling over your cheeks and the dilated blood vessels. I could appreciate the patchy hair loss too. In my opinion, these could be two different conditions. The red rash with dilated blood vessels (telangiectasia) and tingling sensation could be due to a sensitive skin condition called Rosacea.

In Rosacea skin is very sensitive to a whole lot of things most important being sunlight. Skin might be sensitive to spicy foods, hot beverages, alcohol, after shaves, hot fumes, smoke, cosmetics etc. and even embarrassing social situations might make it red. A contact allergy or irritation to the multiple creams you use is a differential diagnosis.

In addition, a condition called seborrhoeic dermatitis needs to be ruled out. As you rightly said yourselves, a face-to-face consultation with dermatologist will be required for that accurate diagnosis.
Patchy well defined hair loss over your face and scalp could be an autoimmune condition where your own body mounts allergy against your hair and removes them, called Alopecia areata.

Stinging sensation is rare but possible prior to the hairfall. There are differential diagnoses for that also and confirmed diagnosis can be made if you do a skin biopsy from the patch, which should again be done by a dermatologist.

The condition of the skin over your arm does not seem to be related and I would appreciate if you could send pictures. You have a feature to upload the images by yourself on the right side of this query page. You may want to utilize it.

This is not because of parasite and you would not transmit it to others. It does not look like hives.

Treatment should be started once the diagnosis is made. Avoiding sunlight and using a sunscreen during the day will help and as much as possible stay away from the triggers of Rosacea which I mentioned earlier.

Hope I have answered your query. If you have any further questions, I will be happy to help. Take care.
Above answer was peer-reviewed by
Follow-up: Having some strange spots on face with stinging and tingling sensation. Is this keratosis? 13 hours later
Thank You, the red patch on my face was only that one time. the tingling is 24/7 on my nose, cheeks, and sides of my face. the hair grows back after it falls out with the sting prior to it having defined circles and lines of baldness. then it happens in a different area on my face, i am also sure it happens on my scalp too. the pictures that show the sides of my face show the hard to see waxy patches all over from my neck to my cheeks. easier to see where the hair is because where they are where hair grows it goes bald in that spot, or atleast just "plucks" out the darker hairs> I am at school right now, but when i get home tonight, i will upload more pictures. thank you so much for your time on this. it is very frustrating.
Answered by Dr. Johny Chacko 7 hours later

The tingling sensation that you are having throughout the day could be due to the condition called Rosacea. The sites mentioned by you are actually the classical sites of Rosacea, centro-facial area including nose, cheeks, even forehead and chin. Even though redness and flare up of rash might be in episodes, a trained eye can make out the faint rash at all times. Another thing is that Rosacea if it persists for long duration can cause phymatous changes, which might explain the hard to see waxy patches.

Alopecia areata can have such a course where the patch will grow hair and a new patch will develop elsewhere.
A dermatologist's consultation is required in your case and you will get improvement with right treatment.

If you have any further questions, I will be happy to help.

Take care.
Above answer was peer-reviewed by
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