Dr. Ashwini. V. Swamy
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am 28 years old. I have acne-prone sensitive facial skin. In winter it is dry, and in summer it is oily. I am unable to select my skincare products, and due to this, my skin is getting worse. I cannot try various home remedies as some of them make my face red and irritated. Mostly, my face becomes red and irritated after I wash my face. And mostly my face becomes red when I wash my face only with water in the morning. I also have large pores on my face and pimples are a significant problem. Due to these problems, I do not use moisturizers. My skin is losing elasticity too. So please suggest some chemical-free or herbal products for my skin in winter and summer. How should I take care of my face?
Hi,
Welcome to icliniq.com.
Use aloe vera cream twice daily. It will help to moisturize your skin. Do you get flushing or redness on your face when eating spicy food? Hot coffee or tea? Stress? Do you get more red pimples during your menstrual cycle? Have you used steroid creams on your face like Betnovate, Panderm?
Patient's Query
Thank you doctor,
Currently, I am using a grapefruit face wash. For moisturizing, I am using aloe vera gel. I am not using any other product. There are small red bumps that appear and go frequently on the face. On the cheeks, there are red medium-sized bumps with large open pores. The skin on the cheeks seems to be more oily and weird because of the constant red bumps. When I wash my face with face wash or just with water, red marks, itchiness, and a little warmness appear on the face. The picture that I have sent is the one just after the face was washed. My cheeks get red when I am out in sunlight though I wear a scarf and it becomes normal after some time when I am indoors. When I eat spicy food the next day, a pimple pops out on my face. The pimples or small red bumps start to pop out before a week of my period date. I am not using any steroid cream for the last eight years. But before ten years, I had taken treatment for pimples in allopathy, and homeopathy, and applied some ayurvedic face packs also. Now I am not taking any medication. I have had an asthma problem since the age of three years, and sometimes I face acidity problems. I cannot use any home remedies also as they make my skin red and itchy.
Hi,
Welcome back to icliniq.com.
Your condition is more consistent with rosacea. You need to avoid triggering factors like sunlight and eating very spicy food. For now, hold off on your face wash and all other face products. Your treatment regimen will be Cetaphil gentle cleansing lotion (Methylparaben with Cetyl alcohol). It is a face wash that does not produce lather or foam, but it is perfect for sensitive skin. Wash your face with this face wash in the morning and evening.
Apply clear gel Clindamycin 1 % gel. It is a topical antibiotic. It is helpful in acne as well as rosacea. After washing the face, apply it over the pimples in the morning. Allow it to absorb well. On the top of the Clindamycin gel once it is dry, apply Photobloc sunscreen (Zinc oxide and Titanium dioxide), 30 minutes before going out in sunlight. Use sunscreen every day even if it is cloudy because UV rays are always present during morning hours. The most important thing is, sunscreen has to be reapplied every four hours when you go out in sunlight for a longer duration.
Use Topmetro gel (Metronidazole) 0.75 % at night. After washing the face with Cetaphil gentle cleansing lotion, apply Topmetro gel, a thin layer on the red areas of the face. If you feel any irritation or burning, wash it off after one hour, otherwise, leave it overnight.
Patient's Query
Thank you doctor,
Are you sure that it is rosacea? As redness and itchiness usually come sometimes only. It is not permanent. I am attaching some of my face images of this morning. Today my face is clear with no redness. Kindly view and suggest that it is only the pimple problem with sensitivity or rosacea problem.
Hi,
Wlcome back to icliniq.com.
Rosacea is an inflammatory condition with pimples in an episode of flare-ups and resolution. There can be a combination or overlapping of acne (pimples) and rosacea too which is difficult to rule out. In this case, it is acne rosacea or adult acne. I have mentioned rosacea, based on the picture that you have attached and your history. I have prescribed Clindamycin gel in the morning which works for pimples mainly. It also helps with rosacea. I have not suggested you any strong medicine like Benzoyl peroxide, Adapalene, and Tretinoin as you have sensitive skin. After looking at the other pictures that you have attached, your condition seems very mild. I strongly feel it is rosacea with overlapping pimples because redness and sensitivity are the striking features of rosacea. Cetaphil face wash is very helpful for sensitive skin. Use Clindamycin gel for the red bumps in the morning and Metronidazole for the red areas of the face at night. Regular use of sunscreen is essential.
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