Persistent Facial Redness: Seeking Solutions for Unresolved Skin Issues

Q: Persistent Facial Redness: Seeking Solutions for Unresolved Skin Issues

Hello： Based solely on the textual description, it is not possible to accurately diagnose a skin condition. <br>Generally, simple eczema does not last that long. <br>It may be necessary to rule out allergic predisposition, rosacea, or autoimmune issues, among others. <br>If the s

Facial erythema?

From approximately January 2021 to June 2021, the nasolabial folds extended upwards to the sides of the nasal bridge (without affecting the nostrils) and downwards around the lips, ultimately reaching the chin, forming a triangular shape without touching the lips or nose, only surrounding these areas.
The affected regions were in a state of erythema, without itching or small rashes.
I consulted two well-known dermatologists, both of whom diagnosed it as eczema.
The first dermatologist had me return for two follow-up visits with no improvement, and the second dermatologist had me return nine times, prescribing oral medications and topical ointments, but there was still no improvement.
Eventually, I sought treatment from a traditional Chinese medicine practitioner, who stated that the term "eczema" is not used in traditional Chinese medicine, but still prescribed oral medications, which also proved ineffective.
The erythema has not improved over the past six months, and in fact, due to the medications and ointments, I developed a number of acne lesions on my cheeks (which I had never experienced before).
I would like to know if this condition will eventually improve.
Thank you!

w, 10~19 year old female. Ask Date: 2021/06/25

Dr. Li Yufen reply Dermatology

Hello: Based solely on the textual description, it is not possible to accurately diagnose a skin condition.
Generally, simple eczema does not last that long.
It may be necessary to rule out allergic predisposition, rosacea, or autoimmune issues, among others.
If the skin condition does not improve or worsens, it is advisable to consult a nearby dermatologist for diagnosis and to assess whether further examination and treatment are needed.
Thank you!

Reply Date: 2021/06/25

More Info

Persistent facial redness can be a frustrating and distressing condition, especially when it has not responded to various treatments. Based on your description, it seems that you have been dealing with this issue for an extended period, and despite consulting multiple dermatologists and even a traditional Chinese medicine practitioner, you have not seen significant improvement.
Facial redness can be attributed to several underlying conditions, including rosacea, seborrheic dermatitis, contact dermatitis, or even allergic reactions. Given that you mentioned the redness does not itch and is not associated with small bumps, it could suggest a non-allergic inflammatory condition like rosacea or a form of eczema.

Treatment Options
1. Topical Treatments: Since you have already tried various topical medications without success, it may be worth considering a different class of topical treatments. For example, topical agents like metronidazole or azelaic acid are often effective for rosacea. If your condition is more akin to seborrheic dermatitis, antifungal creams containing ketoconazole may be beneficial.

2. Oral Medications: If topical treatments have not worked, oral medications may be necessary. Antibiotics such as doxycycline or minocycline can help reduce inflammation associated with rosacea. However, it is crucial to discuss the potential side effects and the duration of treatment with your dermatologist.

3. Lifestyle Modifications: Identifying and avoiding triggers can significantly help manage facial redness. Common triggers include spicy foods, alcohol, extreme temperatures, and certain skincare products. Keeping a diary of your diet and activities may help you pinpoint what exacerbates your condition.

4. Skincare Routine: A gentle skincare routine is essential. Use a mild, fragrance-free cleanser and avoid products with alcohol or harsh exfoliants. Incorporating a good moisturizer can help maintain the skin barrier, which is crucial for sensitive skin. Look for products containing ceramides or hyaluronic acid, which can help hydrate and protect the skin.

5. Professional Treatments: If over-the-counter and prescription treatments are ineffective, consider professional treatments. Laser therapy, such as pulsed dye laser or intense pulsed light (IPL), can effectively reduce redness and improve skin texture. These treatments target the blood vessels that cause redness and can provide long-lasting results.

6. Diet and Hydration: Maintaining a balanced diet rich in antioxidants and staying hydrated can support skin health. Foods high in omega-3 fatty acids, such as fish and flaxseeds, may help reduce inflammation.

Psychological Impact
It’s also important to acknowledge the psychological impact of persistent skin issues. Many individuals experience anxiety, low self-esteem, or depression due to their skin condition. Seeking support from mental health professionals or support groups can be beneficial in managing these feelings.

Conclusion
In summary, persistent facial redness can be challenging to treat, and it often requires a multifaceted approach. If you have not seen improvement with your current treatment plan, it may be worthwhile to seek a second opinion from a dermatologist who specializes in inflammatory skin conditions. They may offer new insights or treatment options that could lead to better management of your symptoms. Remember, patience and persistence are key, as finding the right treatment can take time.

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