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Facial Skin Concern
March 2001

Q. I'm 29 and in the last 3 years I've developed dry, blotchy, itchy skin around my cheek area. I've gone to the dermatologist and he keeps prescribing things that just don't seem to work. I've tried Metro Cream, Minocycline, Tetracycline and Clindamycin. He believes it may be rosacea and I know you can't get rid of it but I would like to at least control it.

Prior to this I never had problem skin. I feel I'm being misdiagnosed. The only cream I thought was working were the hydrocortisone creams but the doctor says it's not meant to be used regularly. I feel that my salvation is something topical not all the medication I've been ingesting.

Do you recommend anything that I can use on a regular basis? I've bought expensive brands and not so expensive brands and none seem to soak into my skin the way I feel it should. Can you please recommend something?

Note: All this medication has been taken throughout the 3 years giving it the intended period time to work.

A. Dermatology questions are especially difficult to answer over the Web because so much is gathered by a physical exam (which is not possible to do over the Web). Certainly your doctor has been treating you as though you have rosacea, but you are not responding the way most patients who have relatively mild (as you would seem to have) rosacea.

The fact that your rash gets a bit better with hydrocortisone cream and is dry, blotchy, and a little itchy could mean that this is a type of eczema. Certain hydrocortisone creams, especially those that are more potent, are not meant to be used chronically. However, the more mild hydrocortisone creams, such as those available over the counter, can be used for long periods of time without difficulty.

I am confused as to why your dermatologist would think that your problem is rosacea if it indeed is eczema (the two are quite different). For this reason, I doubt that this is eczema, which then leads us back to the question 'what is this and how can you be treated?' Given that your current doctor is unable to find a successful treatment, it makes sense to me that you seek a second opinion.

You can learn more about rosacea at: http://www.rosacea.org/

Please note that this particular site has links to some other excellent Web sites as well as a link to a pamphlet on coping with rosacea, which lists tips on lifestyle management for people who have this disorder.

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