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Burning Face. Will Eczema Skin Come Back When I Stop Using Locoid? Can A Swollen Nose Hurt?
Question: Attention Dr. XXXXXXX Bhatti:
Below is a summary of your last response to me:
Dear XXXXXXX
Thank you for following up.
1. It is normal for skin, especially delicate facial skin to feel tight, dry and itchy as cold weather has a desiccating (drying) effect. Without moisturizers, it is almost impossible to keep skin supple. Added to this is your skin 'atopy' which makes your skin feel uncomfortable.
2. Beta blockers have been used safely for many decades by individual patients. Remember that they do have side effects. A mild anxiolytic may also help instead. However, all the medications should be taken under the supervision of your physician. I would recommend only short term use, in any.
Have you scheduled your dermatologist's visit?
Hope, this answers your query.
Wish you good health.
I had an appointment with my dermatologist 2 days ago. He said that I have "eczema skin" and that is what is going on with my tight/burning face. He said that I have sensitive skin and some dermatitis on my face. He prescribed locoid cream for me to use twice daily.
He was very busy so did not take much time for me. He said that I can use the locoid cream for 2 weeks. I have already began using it and I find that it is helping with the burning and heat. My cheeks feel cooler to the touch.
He said that I can use the locoid cream for 2 weeks-- when I stop using it, will the symptoms come back?
I have another question regarding my nose. It has been bothering me again. I have all of this pressure in it-- and some pressure in my sinuses. My nose really HURTS though. It seems to worsen when I change environments (go from hot to cold), drink warm drinks, lie down or switch positions or sometimes it will feel like it is swelling up for no reason.
When I went to my allergist, he said that my nose looked "moderately swollen." Can a swollen nose hurt??
I believe that this is vasomotor rhinitis, correct? Can a nose swell up for no reason? I have bad allergies, as I have mentioned before. When my nose swells, I don't really have any other symptoms except for some sinus pressure.
Thank you, XXXXXXX
Below is a summary of your last response to me:
Dear XXXXXXX
Thank you for following up.
1. It is normal for skin, especially delicate facial skin to feel tight, dry and itchy as cold weather has a desiccating (drying) effect. Without moisturizers, it is almost impossible to keep skin supple. Added to this is your skin 'atopy' which makes your skin feel uncomfortable.
2. Beta blockers have been used safely for many decades by individual patients. Remember that they do have side effects. A mild anxiolytic may also help instead. However, all the medications should be taken under the supervision of your physician. I would recommend only short term use, in any.
Have you scheduled your dermatologist's visit?
Hope, this answers your query.
Wish you good health.
I had an appointment with my dermatologist 2 days ago. He said that I have "eczema skin" and that is what is going on with my tight/burning face. He said that I have sensitive skin and some dermatitis on my face. He prescribed locoid cream for me to use twice daily.
He was very busy so did not take much time for me. He said that I can use the locoid cream for 2 weeks. I have already began using it and I find that it is helping with the burning and heat. My cheeks feel cooler to the touch.
He said that I can use the locoid cream for 2 weeks-- when I stop using it, will the symptoms come back?
I have another question regarding my nose. It has been bothering me again. I have all of this pressure in it-- and some pressure in my sinuses. My nose really HURTS though. It seems to worsen when I change environments (go from hot to cold), drink warm drinks, lie down or switch positions or sometimes it will feel like it is swelling up for no reason.
When I went to my allergist, he said that my nose looked "moderately swollen." Can a swollen nose hurt??
I believe that this is vasomotor rhinitis, correct? Can a nose swell up for no reason? I have bad allergies, as I have mentioned before. When my nose swells, I don't really have any other symptoms except for some sinus pressure.
Thank you, XXXXXXX
Dear XXXXXXX
Thank you for your update.
1. 'Eczema' is chronic 'atopic dermatitis' which has all the symptoms: various rashes, redness, dryness, itching and many worse conditions. However, in your case itching is not a major symptom.
2. Locoid ceam is a steroid ointment and you will have to discontinue its use. Steroids are powerful disease modifying agents and your condition will improve even after stopping it's use.
3. A swollen nose will hurt because of the inflammation. That is why you have to take a trial of the medication that I have recommended to reduce the inflammation.
4. The nose has as many nerves supplying it as it has blood vessels. Hence in response to stress, vasomotor ot 'intrinsic' rhinitis commonly develops. Fortunately , the treatment remains the same.
5. Swelling in the nose blocks the sinuses and creates sinus pressure and discomfort. You must go ahead with the medication. Since you have a long standing condition, be patient and you will improve with this treatment.
Kindly let me know the progress of your treatment.
Regards.
Thank you for your update.
1. 'Eczema' is chronic 'atopic dermatitis' which has all the symptoms: various rashes, redness, dryness, itching and many worse conditions. However, in your case itching is not a major symptom.
2. Locoid ceam is a steroid ointment and you will have to discontinue its use. Steroids are powerful disease modifying agents and your condition will improve even after stopping it's use.
3. A swollen nose will hurt because of the inflammation. That is why you have to take a trial of the medication that I have recommended to reduce the inflammation.
4. The nose has as many nerves supplying it as it has blood vessels. Hence in response to stress, vasomotor ot 'intrinsic' rhinitis commonly develops. Fortunately , the treatment remains the same.
5. Swelling in the nose blocks the sinuses and creates sinus pressure and discomfort. You must go ahead with the medication. Since you have a long standing condition, be patient and you will improve with this treatment.
Kindly let me know the progress of your treatment.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Dr. Bhatti,
Thank you for your response. You think that I should discontinue the Locoid cream now? I have been using it since Tuesday and it seems to be really helping me.. I use it twice a day. I am experiencing some itching but it is mostly a tight/burning/warmness that my doctor says is inflammation. The cream seems to be helping but will the problen recur when I discontinue its use? He said that I have very "sensitive skin." He said to use the steroid for 2 weeks but I think I should stop after a week or maybe wean off?
I seem to be ok until I go out into cold and windy weather. My dermatologist told me to stay out of the wind as much as possible...but I have to live my life, ya know? Tonight I covered up with a scarf and was ok except for a little tightness and dryness that crept in so I immediately applied cerave moisturizing cream and was a little better. Do you know why this continues to happen? My skin cannot seem to handle the cold and windy weather. It was about 40 degrees tonight when I was out. I am hoping that my skin will improve in time? How can I speed this process along?
In regards to my nose troubles....it seems to feel very swollen randomly and is very painful. You said that there are a lot blood vessels and nerves in my nose... this can cause a painful swollen nose that comes and goes? It seems to be worse with temperature fluctuations.
Do you think my skin issues are related to my nose troubles?
I sincerely apologize for the monotony of my questions. I am just so frustrated and want, my life back.
Thank you, XXXXXXX
Thank you for your response. You think that I should discontinue the Locoid cream now? I have been using it since Tuesday and it seems to be really helping me.. I use it twice a day. I am experiencing some itching but it is mostly a tight/burning/warmness that my doctor says is inflammation. The cream seems to be helping but will the problen recur when I discontinue its use? He said that I have very "sensitive skin." He said to use the steroid for 2 weeks but I think I should stop after a week or maybe wean off?
I seem to be ok until I go out into cold and windy weather. My dermatologist told me to stay out of the wind as much as possible...but I have to live my life, ya know? Tonight I covered up with a scarf and was ok except for a little tightness and dryness that crept in so I immediately applied cerave moisturizing cream and was a little better. Do you know why this continues to happen? My skin cannot seem to handle the cold and windy weather. It was about 40 degrees tonight when I was out. I am hoping that my skin will improve in time? How can I speed this process along?
In regards to my nose troubles....it seems to feel very swollen randomly and is very painful. You said that there are a lot blood vessels and nerves in my nose... this can cause a painful swollen nose that comes and goes? It seems to be worse with temperature fluctuations.
Do you think my skin issues are related to my nose troubles?
I sincerely apologize for the monotony of my questions. I am just so frustrated and want, my life back.
Thank you, XXXXXXX
Dear XXXXXXX
Thank you for following up.
1. Use the Locoid cream for at least two weeks and then taper it to get maximum benefit from it's use.
2. As discussed earlier, avoidance of triggers is of utmost importance. So is the use of barrier and moisturizing creams such as CeraVe.
3. Yes, your nasal swelling and inflammation will come and go and respond to sudden temperature fluctuations. It is an exaggeration of a normal response. It is related to your skin condition.
Have you reviewed all the medication? This will help control your condition.
Regards.
Thank you for following up.
1. Use the Locoid cream for at least two weeks and then taper it to get maximum benefit from it's use.
2. As discussed earlier, avoidance of triggers is of utmost importance. So is the use of barrier and moisturizing creams such as CeraVe.
3. Yes, your nasal swelling and inflammation will come and go and respond to sudden temperature fluctuations. It is an exaggeration of a normal response. It is related to your skin condition.
Have you reviewed all the medication? This will help control your condition.
Regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr. Bhatti,
Thank you for your response; you are most definitely helpful.
The medication that I am taking now prescribed from my allergist are: zyrtec and zantac twice a day and singulair once a day. I am also taking propanlol 20 mgs twice a day to help with anxiety induced blushing. In addition, I get allergy shots every 10-14 days to help keep get my allergies under control.
In regards to "triggers", I am learning that the wind and cold affects my face and causes irritation and burning for about a day or so. So now, whenever I am out in any kind of windy or cold weather, I make sure to protect my face.
Is it usual for someone who has sensitized skin to get so irritated from wind and cold for a day or so? That makes me nervous as I can't stop living my life but on the other hand, when my face flares up, I have to temporarily stop living my life. I am hoping that this will all get better once my skin heals but a small part of me is nervous that I will have to live like this :( Is it possible that this is just a phase? I do avoid the wind as much as possible but it is quite annoying and frustrating to do so.
Is there anything else that you can recommend for my nose? It can get quite painful at times... maybe I should try a neti pot?
In regards to the locoid cream... it is definitely helping and plan to use it a little longer. How do you think I should taper off of it?
Could you please elaborate on how my skin reactiveness when in wind and cold is related to my swollen nose?
Thank you so much, XXXXXXX
Thank you for your response; you are most definitely helpful.
The medication that I am taking now prescribed from my allergist are: zyrtec and zantac twice a day and singulair once a day. I am also taking propanlol 20 mgs twice a day to help with anxiety induced blushing. In addition, I get allergy shots every 10-14 days to help keep get my allergies under control.
In regards to "triggers", I am learning that the wind and cold affects my face and causes irritation and burning for about a day or so. So now, whenever I am out in any kind of windy or cold weather, I make sure to protect my face.
Is it usual for someone who has sensitized skin to get so irritated from wind and cold for a day or so? That makes me nervous as I can't stop living my life but on the other hand, when my face flares up, I have to temporarily stop living my life. I am hoping that this will all get better once my skin heals but a small part of me is nervous that I will have to live like this :( Is it possible that this is just a phase? I do avoid the wind as much as possible but it is quite annoying and frustrating to do so.
Is there anything else that you can recommend for my nose? It can get quite painful at times... maybe I should try a neti pot?
In regards to the locoid cream... it is definitely helping and plan to use it a little longer. How do you think I should taper off of it?
Could you please elaborate on how my skin reactiveness when in wind and cold is related to my swollen nose?
Thank you so much, XXXXXXX
Dear XXXXXXX
Thank you for following up.
1. Your current medication and response is satisfactory.
2. You are now taking as much protection from triggers as humanly possible. Any more precautions and you will have to use a Hincherton hayfever helmet.
3. You can continue your current medication (except the steroids) for many months without any major long term side effects.
4. I will also suggest that you undergo a set of food intolerance tests such as the Food Detective Kit or the FoodPrint Test or similar tests if available.
5. Use normal saline for nasal irrigation.
6. You should taper the use of the Locoid cream by reducing application to once a day for two weeks, then alternate days for two weeks before you discontinue it.
7. Chronic allergy may also involve a Type IV Delayed Hypersensitivity or cell mediated immune memory response which is antibody-independent. This is in addition to cholinergic or stress induced symptoms. Urticaria, Contact dermatitis or Eczema are similar terms. Skin reactiveness to temperature change causes release of inflammatory mediators into the blood stream and causes reflex nasal congestion in an flight or flight response to the immediate and anticipated stress.
I suggest that you read up on the new terms that I have introduced you to. If you have any further queries, I will be available to answer them.
Regards.
Thank you for following up.
1. Your current medication and response is satisfactory.
2. You are now taking as much protection from triggers as humanly possible. Any more precautions and you will have to use a Hincherton hayfever helmet.
3. You can continue your current medication (except the steroids) for many months without any major long term side effects.
4. I will also suggest that you undergo a set of food intolerance tests such as the Food Detective Kit or the FoodPrint Test or similar tests if available.
5. Use normal saline for nasal irrigation.
6. You should taper the use of the Locoid cream by reducing application to once a day for two weeks, then alternate days for two weeks before you discontinue it.
7. Chronic allergy may also involve a Type IV Delayed Hypersensitivity or cell mediated immune memory response which is antibody-independent. This is in addition to cholinergic or stress induced symptoms. Urticaria, Contact dermatitis or Eczema are similar terms. Skin reactiveness to temperature change causes release of inflammatory mediators into the blood stream and causes reflex nasal congestion in an flight or flight response to the immediate and anticipated stress.
I suggest that you read up on the new terms that I have introduced you to. If you have any further queries, I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr. Bhatti,
Thank you for your response. I will research the new terms that you have introduced to me.
How long after avoiding my triggers will my skin be back to normal? Do you think that I have to avoid the wind and cold for a long time or should things go back to normal?
In addition to my other ailments, I have been experiencing a burning sensation on the skin on my nose. Is this all part of the allergy/sinus connection? What causes the burning skin feeling ON my nose?
Thanks, XXXXXXX
Thank you for your response. I will research the new terms that you have introduced to me.
How long after avoiding my triggers will my skin be back to normal? Do you think that I have to avoid the wind and cold for a long time or should things go back to normal?
In addition to my other ailments, I have been experiencing a burning sensation on the skin on my nose. Is this all part of the allergy/sinus connection? What causes the burning skin feeling ON my nose?
Thanks, XXXXXXX
Dear XXXXXXX
Thanks again for following up.
1. Your condition will come under control with the current medication. You will have to avoid exposure to wind and cold on a long term basis, even if you start feeling normal. This will be a precaution to avoid provoking the response in future, especially when you taper your medication.
2. The burning sensation is due to dryness, chemical mediators and edema of small unnamed cutaneous nerves.
You may use local moisturizing and barrier creams continuously as long as they do not interfere with perspiration (sweating).
Hope this answers your query.
Regards
Thanks again for following up.
1. Your condition will come under control with the current medication. You will have to avoid exposure to wind and cold on a long term basis, even if you start feeling normal. This will be a precaution to avoid provoking the response in future, especially when you taper your medication.
2. The burning sensation is due to dryness, chemical mediators and edema of small unnamed cutaneous nerves.
You may use local moisturizing and barrier creams continuously as long as they do not interfere with perspiration (sweating).
Hope this answers your query.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr. Bhatti,
Thanks again for your reply.
You said that: "the burning sensation is due to dryness, chemical mediators and edema of small unnamed cutaneous nerves." Could you please explain that in layman's terms? It's too technical for me to understand. That is the cause of the stinging skin ON my nose? I have not been using the locoid cream on my nose because I have been afraid that it will cause visible blood vessels. I guess I should put it on my nose?
My dermatologist seems to think that once my face is healed, I will be able to go out in the wind. I guess it would be best to protect my face indefinitely.
Thank you very much, XXXXXXX
Thanks again for your reply.
You said that: "the burning sensation is due to dryness, chemical mediators and edema of small unnamed cutaneous nerves." Could you please explain that in layman's terms? It's too technical for me to understand. That is the cause of the stinging skin ON my nose? I have not been using the locoid cream on my nose because I have been afraid that it will cause visible blood vessels. I guess I should put it on my nose?
My dermatologist seems to think that once my face is healed, I will be able to go out in the wind. I guess it would be best to protect my face indefinitely.
Thank you very much, XXXXXXX
Dear XXXXXXX
Thank you for following up.
1. You may use the Locoid cream on your nose without worrying about thinning of the nasal skin.
2. The stinging and burning of the nasal skin is related to your condition. The underlying mechanisms are multiple and occur in complex different combinations at different times. There is no unified explanation.
Chemical mediators are the substances released in the body due some inflammatory process or injury, like histamine, leukotrienes, and cytokines, etc. Edema is swelling.
3. You must take precautions to avoid sudden temperature change.
I believe that your stress levels are also under control now. Wish you a good recovery.
Regards.
Thank you for following up.
1. You may use the Locoid cream on your nose without worrying about thinning of the nasal skin.
2. The stinging and burning of the nasal skin is related to your condition. The underlying mechanisms are multiple and occur in complex different combinations at different times. There is no unified explanation.
Chemical mediators are the substances released in the body due some inflammatory process or injury, like histamine, leukotrienes, and cytokines, etc. Edema is swelling.
3. You must take precautions to avoid sudden temperature change.
I believe that your stress levels are also under control now. Wish you a good recovery.
Regards.
Above answer was peer-reviewed by :
Dr. Jyoti Patil
Thank you, Dr. Bhatti for your quick response. I am hoping that I am getting my condition under control and with that, my stress levels will be better. You have been extremely helpful by answering all of my questions and I appreciate that so much.
I have one more question about my nose... sometimes it gets extremely cold and tingly...it is very uncomfortable. I noticed it last night when I was exercising on the treadmill, my nose got very cold. It happened later in the evening as well. My nose got really cold and then I had this sensation of pins and needles. Could this be a result of the propranlol that I am taking. I take 40 mgs a day? I also read that nasal turbinates warm the air that we breathe and wonder if my aren't working properly due to my sinus issues and allergies. Could this be a possibility?
You believe that the burning on my nose is from the inflammatory process?
Thank you so much, XXXXXXX
I have one more question about my nose... sometimes it gets extremely cold and tingly...it is very uncomfortable. I noticed it last night when I was exercising on the treadmill, my nose got very cold. It happened later in the evening as well. My nose got really cold and then I had this sensation of pins and needles. Could this be a result of the propranlol that I am taking. I take 40 mgs a day? I also read that nasal turbinates warm the air that we breathe and wonder if my aren't working properly due to my sinus issues and allergies. Could this be a possibility?
You believe that the burning on my nose is from the inflammatory process?
Thank you so much, XXXXXXX
Dear XXXXXXX
Thank you for writing back.
1. Propranolol is a Beta 2 antagonist, mainly causing smooth muscle relaxation. This leads to hypotension, dilated blood vessels, broncho-dilatation and many other effects and side effects.
2. This would explain low blood flow and pins and needles due to a beta blocker. You may reduce the dose of Propranolol and decide optimal dosage.
3. Nasal Turbinates warm and humidify the air we breathe by regulating the blood flow through their abundant blood supply. This system heats up inspired air more quickly in cold climates than it can cool the air in hot climates. Sinus and allergy may interfere in this function.
4. The sensory nerve supply of the outside and inside of the nose on each side is supplied by the respective Trigeminal Nerve (Vth Cranial Nerve) of that side. Hence if the burning on your nose is symmetrical on both sides, then it has to be due to a common process such as inflammation or dryness.
Hope this answers your query. Should you have any additional concerns, I will be available to address them.
Regards.
Thank you for writing back.
1. Propranolol is a Beta 2 antagonist, mainly causing smooth muscle relaxation. This leads to hypotension, dilated blood vessels, broncho-dilatation and many other effects and side effects.
2. This would explain low blood flow and pins and needles due to a beta blocker. You may reduce the dose of Propranolol and decide optimal dosage.
3. Nasal Turbinates warm and humidify the air we breathe by regulating the blood flow through their abundant blood supply. This system heats up inspired air more quickly in cold climates than it can cool the air in hot climates. Sinus and allergy may interfere in this function.
4. The sensory nerve supply of the outside and inside of the nose on each side is supplied by the respective Trigeminal Nerve (Vth Cranial Nerve) of that side. Hence if the burning on your nose is symmetrical on both sides, then it has to be due to a common process such as inflammation or dryness.
Hope this answers your query. Should you have any additional concerns, I will be available to address them.
Regards.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Yogesh D
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