Expert: Michael S. Fisher, <B>Ph.D., M.D.</B> - 5/30/2007

Question
Background:  I have always had perfectly clear skin.  About 9 weeks ago, bumps appeared on my forehead, literally overnight.  My forehead was also red.  They never came to a head.  Acne medicines and soaps did not work.  After a few weeks, I saw a dermatologist and she said that I had rosacea.  She put me on Metrogel 1%.  She told me to put it on my cheeks, forehead, and nose.  This gel made my skin bright red and just made it worse.  The bumps then moved down my face.  They appeared on my nose and upper, inner cheek area.  They appeared on my both sides of my chin and most oddly, on the underside of my chin in high numbers.  I went back to the dermatologist and she still says that it is rosacea and she prescribed Rosac Cream.  I haven't started that treatment yet as another symptom has appeared.  I now have circular patches on both sides of my chin and eyebrows.  They are dry, cirlcular, scaly patches.  Also, this entire time my scalp and face has been itchy.  The patches remind me of the pityriosis rosea that I have had in mild amounts on my trunk before.  The bumps are still present on my forehead, nose, and chin area but the redness has subsided.  I just cannot believe that rosacea would start literally overnight.  What do you think?  Thank you!

Answer
I believe that you have two skin conditions.  One is dry skin from the topical medications that you have used.  The other rash can be Rosacea or Acne.  I would recommend that you visit the web site www.rosacea.org and look up the tripwires.  If any of the tripwires make your face flush or blush then you have Rosacea.  With the skin condition that you describe you may have to take oral medication like Oracea or Solodyn to help clear your facial skin.