I am a 21-year-old male. Before two months, my face started to become red, irritated and inflamed without reason. The sides of my face, ears, and eyes are red and puffy. They burn and itch badly. When I wake up in the morning, I wake up with a lot of mucus on my eyelids. I suffer from nasal congestion and cannot breathe well. Please help me.
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You have a differential diagnosis of acne rosacea, seborrheic dermatitis, fungal infection, photodermatitis, and irritant contact dermatitis. Please mention whether you have a burning sensation while on exposure to the sun or while drinking hot fluid or tea, any aggravating factor, any stress, a habit of alcohol drinking, and mention whether you use a steroid cream on your face. Please mention whether you had a fungal infection in the past, any aggravation due to winter season, any dandruff issues, any contacts with irritants, any prolonged exposure to the sun, history of photosensitivity, and used any harsh products on your face.
There is diffuse erythema in the picture (attachment removed to protect patient identity) and it suggests rosacea. You can use Tacroz 0.03 (Tacrolimus) ointment in the evening for fifteen days, use Metronidazole one percent gel at night for fifteen days, and use a Photostable sunscreen daily at 9 'o clock in the morning, 12 'o clock in the afternoon, and at 3 pm for two months. Kindly answer these questions to confirm the diagnosis.
Thank you doctor,
I do not have a history of fungal infection. I had a bad sinus infection before few years. I do not use harsh chemicals or face wash on my face as my face gets dry. I am experiencing dry skin for a while now. I do not take hot showers. Recently, my eyelids and the sides of my face became itchy and dry. My eyes produces lot of tears. I wake up with a layer of dry tears over my eyelids. I do not drink alcohol but I smoke Marijuana for a couple of years now. I do not think that is causing the problem. I do not smoke cigarettes. I have a lot of stress. Can I buy the suggested creams over the counter?
Welcome back to icliniq.com.
Use Venusia moisturizer (Glycerin with Dimethicone) or Cetaphil moisturizer for getting hydration of the skin. Liquid paraffin is also a good option for dry skin. It makes the skin soft and smooth. You can use mild soaps like Cetaphil soap for bathing. Avoid using high alkaline soaps and reduce your exposure to irritants. Apply moisturizer once or thrice daily depending on the dryness. Use sunscreen half an hour before going outdoors and indoors as mentioned previously.
Red inflamed skin with dryness, itching, and a scaly appearance suggests a condition of xerosis (dry skin). It can be caused due to bathing too frequently, poor water intake, low humidity, dry winters, prolonged exposure to the sun, and usage of certain drugs. Avoid using Marijuana. Stay hydrated and drink a lot of water.
Moisturize your skin immediately after taking shower. Eat a diet rich in zinc, vitamin E, and Omega 3 fatty acids. Avoid rubbing the skin and gently pat dry using a towel. You can use olive oil, almond oil to soothe the skin. Avoid using perfumes, soaps, detergents containing drying agents, and avoid alcohol. Use a broad-spectrum sunscreen of SPF (sun protection factor) 30 or more. Avoid going out to direct sun. You can use Hydrocortisone cream one percent for a week to reduce redness. Avoid using harsh topicals.
You can also use Metronidazole and Tacroz as mentioned previously. Use lukewarm water for bathing. Avoid taking spicy foods, hot beverages, exposure to the sun, and intake of coffee and alcohol. Reduce your stress and stay relaxed. You can take a tablet Loratadine 10 mg twice daily for seven days.
Please mention whether you have a history of allergies, atopic dermatitis, any history of runny nose, any changes due to climatic conditions, any history of photodermatitis, acne, heat rash, dandruff, airborne contact dermatitis, parthenium dermatitis, any allergy to plants, dust, and pollens, any history of fever, allergic rhinitis, any aggravation due to summer and winter, any dryness in other parts of the body and any history of severe erythroderma.
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