Persistent Redness and Peeling Near the Nose: Skin Condition Insights - Dermatology

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There is a red, swollen area about the size of a 50 NT dollar coin near the cheek close to the nose, accompanied by peeling skin?


Hello Dr.
Huang,
I have been troubled by a skin issue for several years.
My skin was generally good until my sophomore year (about 4.5 years ago) when I started using skincare products and tea tree oil facial cleanser.
Since then, the area near my nose has become red, swollen, and flaky, feeling very dry and rough.
It has not improved since then.
I have consulted several doctors and received various diagnoses.
Some said I have rosacea, but the medication prescribed did not seem to help much.
Others suggested atopic dermatitis or seborrheic dermatitis, indicating that symptoms improve with steroid creams, but they flare up again if I stop using them.
I have noticed that my condition worsens during the fall and winter or in humid weather, and it is often accompanied by issues on my scalp or neck.
Initially, it was only on my cheeks, but now it has spread to my forehead as well.
Could you please advise me on what type of skin condition this might be? How should I care for my skin? Thank you for your response!

Aileen, 20~29 year old female. Ask Date: 2008/05/27

Dr. Huang Ruiyun reply Dermatology


Hello: I apologize, but online diagnosis is not permissible.
Based on your clues: 1.
Rosacea and seborrheic dermatitis can sometimes be difficult to differentiate; 2.
If it occurs only on the face (head and neck) in adults, it should not be diagnosed as atopic dermatitis.
I still recommend that you see a doctor in person.
Thank you.

Reply Date: 2008/05/27

More Info


Persistent redness and peeling around the nose can be indicative of several skin conditions, and it sounds like you have been experiencing a complex issue that may involve multiple factors. Based on your description, it could potentially be a form of dermatitis, such as seborrheic dermatitis or atopic dermatitis, or even rosacea, especially considering the symptoms you mentioned and the seasonal exacerbation.


Understanding the Conditions
1. Seborrheic Dermatitis: This is a common skin condition that causes red, flaky, greasy patches of skin. It often appears on the scalp, face, and other oily areas of the body. The condition can be aggravated by stress, hormonal changes, and weather conditions, particularly in the fall and winter months when humidity levels drop.

2. Atopic Dermatitis (Eczema): This is a chronic condition characterized by dry, itchy skin. It can be triggered by various factors, including irritants, allergens, and changes in temperature or humidity. The fact that you mentioned the condition worsens in certain weather conditions aligns with this diagnosis.

3. Rosacea: This is a chronic inflammatory skin condition that typically affects the face, leading to redness, visible blood vessels, and sometimes acne-like bumps. It can be triggered by various factors, including certain skincare products, temperature changes, and even dietary factors.


Treatment and Management
Given the complexity of your symptoms and the various diagnoses you've received, it is crucial to adopt a comprehensive approach to treatment:
1. Consult a Dermatologist: Since you have seen multiple doctors and received different diagnoses, it may be beneficial to consult a dermatologist who specializes in inflammatory skin conditions. They can provide a thorough examination and possibly perform patch testing to identify any allergens or irritants.

2. Topical Treatments: Depending on the diagnosis, your doctor may recommend topical corticosteroids for inflammation, antifungal creams for seborrheic dermatitis, or other medicated creams that can help reduce redness and peeling. Be cautious with the use of steroids, as long-term use can lead to skin thinning and other side effects.

3. Gentle Skincare Routine: Use a gentle, fragrance-free cleanser and avoid harsh scrubs or exfoliants that can irritate the skin further. Look for moisturizers that contain ceramides or hyaluronic acid to help restore the skin barrier.

4. Avoid Triggers: Identify and avoid any known triggers that worsen your condition. This may include certain skincare products, environmental factors, or dietary items.

5. Sun Protection: Use a broad-spectrum sunscreen daily, as sun exposure can exacerbate redness and irritation. Look for sunscreens that are formulated for sensitive skin.

6. Lifestyle Modifications: Stress management techniques, a balanced diet rich in antioxidants, and adequate hydration can also support skin health.


Prognosis and Prevention
While some skin conditions can be chronic, many can be effectively managed with the right treatment plan. Regular follow-ups with your dermatologist can help monitor your condition and adjust treatments as necessary. Additionally, maintaining a consistent skincare routine and being mindful of your skin's needs can help prevent flare-ups.

In conclusion, persistent redness and peeling around the nose can stem from various skin conditions, and a tailored approach to treatment is essential. Consulting a dermatologist for a definitive diagnosis and treatment plan is the best course of action. With the right care, you can achieve healthier skin and reduce the impact of these symptoms on your daily life.

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