Q. I am not sure if I have rosacea. Please help.

Answered by Dr. Kakkar S and medically reviewed by iCliniq medical review team.


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Hello doctor,

I am a 25 year old male. I am 6'1" tall and I weigh 170 pounds. Often, I get red cysts of some sort on my face beneath the skin that take a while to heal. I have oily skin, and get whiteheads as well. I have fluid-filled boil-like lesions on my face. I have been to a few dermatologists and one of them said that I have rosacea.

I do not believe that I am allergic to any food. I take more than enough of my vitamins and minerals. I eat very healthy and do not mess around with any junk food. I do not smoke or drink. I am a writer, and I tend to sit down a lot, for the majority of the day. I do not have triggers that make me flush.

I am beginning to suspect that I do not have rosacea. My skin is not really sensitive. I am not sure if I have the regular acne as other people do. Is it any other skin disorder? Please help.

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Dr. Kakkar S
Dermatology, HIV/AIDS Specialist, Venereology


Welcome to icliniq.com.

Rosacea is a skin disorder that affects people above 30 years. Other than acne-like lesions, people with rosacea have redness of the face and dry skin associated with burning sensation. They also have redness and irritation in the eyes. The redness of the face is aggravated by triggering factors such as weather changes, stress, alcohol consumption, exercise, and spicy food.

Your clinical condition is not rosacea since your history is contradicting with the above-said information. You seem to have acne. The cysts are a part of acne. Acne varies in severity from individual to individual. Some may have mild acne which may come off and on. Others may have an almost incessant eruption of acne, which may leave behind post-acne hyperpigmentation and acne scars.

For acne, you need to be constantly taking care of your skin until the tendency for new acne formation dies down. Topical treatment of acne mainly revolves around topical antibacterials (Clindamycin gel or Nadifloxacin gel), Benzoyl peroxide and topical retinoids. Topical retinoids are comedolytic thereby preventing new acne.

For inflammatory acne (papules and pustules), I suggest starting with one of the oral antibiotics either Azithromycin, Doxycycline or Minocycline. Cystic acne is an indication for starting oral retinoids. They are the most effective drugs for acne and are usually the first choice in severe acne or cystic acne or moderately severe acne or acne not responding adequately to traditional anti-acne medications or acne significantly affecting the quality of life of patients regardless of severity. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent.

You could also take a few peeling sessions like Salicylic acid peels from a dermatologist. Salicylic acid peels are specific for acne. Acne is a recurrent condition and once your acne is brought under good control with oral and topical anti-acne medicines, you should still continue to use a cream/gel (topical retinoid) for maintenance of improvement. Topical retinoids are ideal for maintenance of improvement because they are comedolytic as well as anti-inflammatory, thereby preventing the formation of new acne.

For further follow up consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

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