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What Causes Red And Itchy Patches On Face?
Question: Hi I am 40 year old male, I am having red, itchy patches on my face, what it could be?Is it eczema? Attached are images.
Thanks
Thanks
Brief Answer:
Possibility of either Seborrheic dermatitis Or Allergic Contact dermatitis
Detailed Answer:
Hello. Thank you for writing to us.
I have gone through your query and I have also reviewed the images.
I suggest a possibility of Seborrheic dermatitis Or Allergic contact dermatitis. Both of these skin conditions may present as itchy, scaly, red patches on face.
Facial seborrheic dermatitis typically involves beard and mustache region with itchy, dry/scaly patches. Facial seborrheic dermatitis may also involve nasolabial folds with redness, itching and scaling.
Allergic contact dermatitis to shaving cream Or aftershave can also give rise to similar sort of presentation.
I would like to know the duration since you noticed these patches?
What all priducts do you use on face? Have you been using any cream? Or did you initially notice them after changing to a different cream?
Regards
Possibility of either Seborrheic dermatitis Or Allergic Contact dermatitis
Detailed Answer:
Hello. Thank you for writing to us.
I have gone through your query and I have also reviewed the images.
I suggest a possibility of Seborrheic dermatitis Or Allergic contact dermatitis. Both of these skin conditions may present as itchy, scaly, red patches on face.
Facial seborrheic dermatitis typically involves beard and mustache region with itchy, dry/scaly patches. Facial seborrheic dermatitis may also involve nasolabial folds with redness, itching and scaling.
Allergic contact dermatitis to shaving cream Or aftershave can also give rise to similar sort of presentation.
I would like to know the duration since you noticed these patches?
What all priducts do you use on face? Have you been using any cream? Or did you initially notice them after changing to a different cream?
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello
I use L'Oreal face products on my face both face wash and shaving cream , the problem is more after shaving, it started last year with a very small patch on left side and unti 2 months ago i had grown a beard and use to trim with a trimmer, use to feel itchy but felt could be due to the hair on face and the heat, when i clean shaved last month this problem started , i use vaseline moisturiser twice daily morning and night. I now put olive oil after bathing as that helps in soothing the skin and reliieves me of itching
I use L'Oreal face products on my face both face wash and shaving cream , the problem is more after shaving, it started last year with a very small patch on left side and unti 2 months ago i had grown a beard and use to trim with a trimmer, use to feel itchy but felt could be due to the hair on face and the heat, when i clean shaved last month this problem started , i use vaseline moisturiser twice daily morning and night. I now put olive oil after bathing as that helps in soothing the skin and reliieves me of itching
Brief Answer:
Seborrheic dermatitis; I suggest a moderately potent topical steroid cream
Detailed Answer:
Hi. Thank you.
After going through the details I will keep a primary possibility of Seborrheic dermatitis affecting your face.
Seborrheic dermatitis is a steroid responsive dermatosis. Therefore I suggest you to use a moderately potent topical steroid e.g either fluticasone propionate 0.05% cream Or Triamcinolone acetonide 0.1% cream, twice daily for a few days.
Regards
Seborrheic dermatitis; I suggest a moderately potent topical steroid cream
Detailed Answer:
Hi. Thank you.
After going through the details I will keep a primary possibility of Seborrheic dermatitis affecting your face.
Seborrheic dermatitis is a steroid responsive dermatosis. Therefore I suggest you to use a moderately potent topical steroid e.g either fluticasone propionate 0.05% cream Or Triamcinolone acetonide 0.1% cream, twice daily for a few days.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hello,
Thanks so much doctor, but I heard steroids give temporary relief only and the flares return after discontinuation, will this ever go?
Also steroids have side effects with thinning and darkening of skin.
Thanks so much doctor, but I heard steroids give temporary relief only and the flares return after discontinuation, will this ever go?
Also steroids have side effects with thinning and darkening of skin.
Brief Answer:
Moderately potent topical steroids are safe to use on face for 2-4 weeks
Detailed Answer:
Hi.
You are right. Seborrheic dermatitis may relapse after discontinuing steroids.
However topical steroids are first line treatment of seborrheic dermatitis for initial 2 weeks. Thereafter, once significant improvement as been achieved with topical steroids they can be substituted with a different topical agent e.g pimecrolimus, if required for milder disease or early relapse. Pimecrolimus is an immunomodulator but not a steroid and can be used long term to maintain remission. Moderately potent topical steroids e.g fluticasone propionate 0.05% cream are safe for use on face for the recommended duration of 2-4 weeks. Longer and unsupervised use can cause side effects like thinning.
Regards
Moderately potent topical steroids are safe to use on face for 2-4 weeks
Detailed Answer:
Hi.
You are right. Seborrheic dermatitis may relapse after discontinuing steroids.
However topical steroids are first line treatment of seborrheic dermatitis for initial 2 weeks. Thereafter, once significant improvement as been achieved with topical steroids they can be substituted with a different topical agent e.g pimecrolimus, if required for milder disease or early relapse. Pimecrolimus is an immunomodulator but not a steroid and can be used long term to maintain remission. Moderately potent topical steroids e.g fluticasone propionate 0.05% cream are safe for use on face for the recommended duration of 2-4 weeks. Longer and unsupervised use can cause side effects like thinning.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
I went to a dermatologist and she said this is due to allergy and recommended elocon cream on face once at night for 10 days and after that use it every alternate day for 10 days and then stop, I have also had mild eczema on my eyelids for years and she asked to use Desowen for 10days at night and stop, in addition i am using epilsoft face cleaner which is soap free and Epitheliale moisturiser and to take Allegra 180 for one month.Feeling much better after using the above for 5 days.
I was reading on internet about steroid withdrawal symptoms and the images are horrific and too scared, extremely worried about this... Please help will I get same symptoms if I stop using cream, too scared doctor.
I went to a dermatologist and she said this is due to allergy and recommended elocon cream on face once at night for 10 days and after that use it every alternate day for 10 days and then stop, I have also had mild eczema on my eyelids for years and she asked to use Desowen for 10days at night and stop, in addition i am using epilsoft face cleaner which is soap free and Epitheliale moisturiser and to take Allegra 180 for one month.Feeling much better after using the above for 5 days.
I was reading on internet about steroid withdrawal symptoms and the images are horrific and too scared, extremely worried about this... Please help will I get same symptoms if I stop using cream, too scared doctor.
Brief Answer:
Only unsupervised use of topical steroids for long durations can cause S/E
Detailed Answer:
Hi.
Ok.
Elocon is mometasone furoate 0.1% and Desowen is Desonide 0.05%.
Using steroids for the prescribed duration is not going to have any side effects therefore mometasone for 2 -3 weeks is safe and desonide for 2-3 weeks is safe. Mometasone should not be used longer than 2-3 weeks on face. Only if these steroids are used for longer durations i.e for months or years can they cause side effects like skin thinning, photosensitvity, acne, telangiectasia.
Therefore, you have nothing to worry if you stick to the prescribed duration of use of these steroids as this is not going to cause any side effects.
Though I slightly disagree with the diagnosis.
I would have kept seborrheic dermatitis as my first diagnosis and allergic contact dermatitis as the next one as discussed in my previous replies as well.
Anyways, initial treatment for both these conditions is more or less the same i.e topical steroids creams.
Regards
Only unsupervised use of topical steroids for long durations can cause S/E
Detailed Answer:
Hi.
Ok.
Elocon is mometasone furoate 0.1% and Desowen is Desonide 0.05%.
Using steroids for the prescribed duration is not going to have any side effects therefore mometasone for 2 -3 weeks is safe and desonide for 2-3 weeks is safe. Mometasone should not be used longer than 2-3 weeks on face. Only if these steroids are used for longer durations i.e for months or years can they cause side effects like skin thinning, photosensitvity, acne, telangiectasia.
Therefore, you have nothing to worry if you stick to the prescribed duration of use of these steroids as this is not going to cause any side effects.
Though I slightly disagree with the diagnosis.
I would have kept seborrheic dermatitis as my first diagnosis and allergic contact dermatitis as the next one as discussed in my previous replies as well.
Anyways, initial treatment for both these conditions is more or less the same i.e topical steroids creams.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thanks so much for your reply, just one more question, after completing the treatment as recommended by the doctor and finishing the course of steroids and allegra. What do you think are the chances it may flare up again and what precautions should i take in preventing it.
Thanks in advance.
Thanks so much for your reply, just one more question, after completing the treatment as recommended by the doctor and finishing the course of steroids and allegra. What do you think are the chances it may flare up again and what precautions should i take in preventing it.
Thanks in advance.
Brief Answer:
Whether the condition recurs or not remains to be seen.
Detailed Answer:
Hi.
Seborrheic dermatitis may return sometime later specially in cold weather conditions in winters. If it does flare you may need a non-steroidal immunomodulator e. g pimecrolimus or tacrolimus, for minor involvement/ recurrences and for keeping the disease at bay.
However if it is due to allergic Or irritant contact dermatitis, removal of the possible allergenic product would prevent it from recurring again. Try changing your shaving cream to a different one, the one which mentions hypoallergenic and non-irritating.
Use a gentle cleaner for face wash e.g cetaphilc cleansing lotions. Avoid soaps, face washes etc.
Regards
Whether the condition recurs or not remains to be seen.
Detailed Answer:
Hi.
Seborrheic dermatitis may return sometime later specially in cold weather conditions in winters. If it does flare you may need a non-steroidal immunomodulator e. g pimecrolimus or tacrolimus, for minor involvement/ recurrences and for keeping the disease at bay.
However if it is due to allergic Or irritant contact dermatitis, removal of the possible allergenic product would prevent it from recurring again. Try changing your shaving cream to a different one, the one which mentions hypoallergenic and non-irritating.
Use a gentle cleaner for face wash e.g cetaphilc cleansing lotions. Avoid soaps, face washes etc.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thanks for your message, I have read Seborrheic dermatitis is basically a fungal problem which needs to be eliminated from the body and once steroids are stopped since we are surpressing the symptoms temporarily the flares come back more with a vengeance due to toxic build up.
Also is it ok to use home remedies like Neem leaves and Apple Cider Vinegar (diluted 1:1 ratio with water) on areas affected with SD as lot of people claim to find a cure using these.
Right now I am feeling perfect but worried about future flare ups after stopping the treatment.
Thanks for your message, I have read Seborrheic dermatitis is basically a fungal problem which needs to be eliminated from the body and once steroids are stopped since we are surpressing the symptoms temporarily the flares come back more with a vengeance due to toxic build up.
Also is it ok to use home remedies like Neem leaves and Apple Cider Vinegar (diluted 1:1 ratio with water) on areas affected with SD as lot of people claim to find a cure using these.
Right now I am feeling perfect but worried about future flare ups after stopping the treatment.
Brief Answer:
I am not in favor of home remedies
Detailed Answer:
Hi.
You are right to an extent.
Though seborrheic dermatitis might return any time after seemingly complete cure with topical steroids but that might not always happen soon after treatment is stopped.
Relapse may be delayed for weeks or months Or it may happen only in certain weather conditions like dry and cold weather in winters.
Seborrheic dermatitis is an interplay between two factors i.e
1. Inflammation and
2. a fungus namely Malassezia furfur.
What exactly is the role of fungus is not yet completely known yet but Malassezia furfur is definitely implicated as one of the factor in seborrheic dermatitis. One postulated view is that this fungus feeds on sebum/ oil and the breakdown products induce inflammation.
In those who relapse repeatedly are certainly candidates for steroid sparing agents like immunomodulators Or topical antifungals. Topical Immunomodulators like pimecrolimus Or tacrolimus can be used long term without side effects. Topical antifungals like ketoconazole cream/ lotion etc can also be used as maintenance treatment or for treatment of minor relapses.
Even Oral antifungals like Itraconazole can be used for treatment of seborrheic dermatitis.
I am not in favor of any home remedies like neem or vinegar as they are not approved treatments and can have side effects like irritation and burning.
Regards
I am not in favor of home remedies
Detailed Answer:
Hi.
You are right to an extent.
Though seborrheic dermatitis might return any time after seemingly complete cure with topical steroids but that might not always happen soon after treatment is stopped.
Relapse may be delayed for weeks or months Or it may happen only in certain weather conditions like dry and cold weather in winters.
Seborrheic dermatitis is an interplay between two factors i.e
1. Inflammation and
2. a fungus namely Malassezia furfur.
What exactly is the role of fungus is not yet completely known yet but Malassezia furfur is definitely implicated as one of the factor in seborrheic dermatitis. One postulated view is that this fungus feeds on sebum/ oil and the breakdown products induce inflammation.
In those who relapse repeatedly are certainly candidates for steroid sparing agents like immunomodulators Or topical antifungals. Topical Immunomodulators like pimecrolimus Or tacrolimus can be used long term without side effects. Topical antifungals like ketoconazole cream/ lotion etc can also be used as maintenance treatment or for treatment of minor relapses.
Even Oral antifungals like Itraconazole can be used for treatment of seborrheic dermatitis.
I am not in favor of any home remedies like neem or vinegar as they are not approved treatments and can have side effects like irritation and burning.
Regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hello Doctor
Thanks so much for your reply. Last question, i have finished using 10 day Elocon cream and desowen around my eyelids once daily at night, and from XXXXXXX will apply eleocon every alternate day for 10 days and desowen asked to stop from toda . I am also taking allegra 180 daily at night, after i finish all medication as recommended by doctor, can i apply aloe vera gel, as i heard its good for people who have eczema.
Thanksy
Thanks so much for your reply. Last question, i have finished using 10 day Elocon cream and desowen around my eyelids once daily at night, and from XXXXXXX will apply eleocon every alternate day for 10 days and desowen asked to stop from toda . I am also taking allegra 180 daily at night, after i finish all medication as recommended by doctor, can i apply aloe vera gel, as i heard its good for people who have eczema.
Thanksy
Brief Answer:
May apply aloe vera
Detailed Answer:
Hi.
Yes. You can apply. Make sure you don't apply fresh aloe vera directly taken from plant leaves. You can apply the formulated one available in market.
Regards
May apply aloe vera
Detailed Answer:
Hi.
Yes. You can apply. Make sure you don't apply fresh aloe vera directly taken from plant leaves. You can apply the formulated one available in market.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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