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Dry Skin And Red Blotches On The Face After Hot Showers. Diagnosed With Seborrheic Dermatitis. Takinfg Elidel, Sulfacetamide Sodium. Permanent Cure?

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Posted on Wed, 3 Oct 2012
Question: Hi, I started dry skin on my face about a year ago.. It has progressively gotten worse. Over new years I was hung over and took about 5 hot showers to sooth my headache and to help me sleep off the hangover. When I woke I had red blotches all over my face...mainly on my cheeks under my eyes. Since then I've see two dermatologist who say I have seborrheic dermatitis... I've been prescribed Elidel and that seem to help with the heavy flaking but I still have dry, wrinkly skin... it looks like I've age considerably in the last year. So today I took a mildly warm shower...the first one on months and I have red blotches around my eyes up above my eyebrows, down my cheeks and speckled under my chin. Also, to note, I was also prescribed a wash off cream called Sulfacetamide Sodium & Sulfur as well as a sleep on foam called Clarifoam...which I had a terrible reaction to. I broke out with, no lie, 50+ tiny whiteheads and my face even swelled up a bit...my doctor told me to stop and I am only using Elidel now. I am 36 years old, had already dealt with acne as a teenager and am incredibly frustrated now...so much so I'm becoming a hermit because of this condition. Your advise is sincerely wanted and welcomed. Thank you.
doctor
Answered by Dr. Sudarshan (9 hours later)
Hi XXXXXXX,

I understand your problem and will advise you accordingly.

After going through your photographs I feel that you are having contact dermatitis due to sulfur containing face wash.Which has occurred on pre existing seborrheic dermatitis.

Also I would like to know
-Are you having itching/burning/irritation pain over face?
-Do you get dandruff/flaky scalp?
-Do you have whitish lesions on eyelids/behind ear?
-Apart from elidel have you taken any other treatment?

Please answer the above questions to help you better.

Anticipating your response.

Dr Sudarshan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan (12 hours later)
Hi Doctor -

Thank you for your response. Here are the answers to your questions:

-Are you having itching/burning/irritation pain over face? - When my cheeks are red they will start to burn when I sweat. There is some mild itching but its mostly under my chin and neck areas when my facial hair is growing in..

-Do you get dandruff/flaky scalp? I've never had a problem with this.

-Do you have whitish lesions on eyelids/behind ear? No - I occasionally get dry skin that peels off in small chunks under my eyebrows.

-Apart from elidel have you taken any other treatment? The first doctor who saw me prescribed me medicine for Rosacea, it was a Gel who's name escapes me at this time. That irritated my face, burned and did not help at all.. The next appointment I was told I have Seborrhec Dermatitis. The mistake in diagnoses was blamed on the fact that I had purchased some moisturizers that made me break out with large bumps (no white heads) and the moisturizers hid the extent of dry flaky skin so I was then prescribed Elidel. Elidel lessens the dry skin but does not stop it completely (lessens the dry skin by 50% max) and does nothing to protect me from getting the red blotches on my face after taking a warm showers. I then started trying some things on my own like African XXXXXXX Butter & Nobel Cream (I was told this has the same active ingredients as Head n' Shoulders. I've has some mild success with the combination of the 3: Elidel, XXXXXXX butter, Nobel Cream...maybe taking my dry skin down to 25%. Other things of possible note that I use and have used for years now without any issues that I'm aware of have been: Nizoral shampoo (for it's supposed hair loss prevention effects - for 1 year+), Minoxidil (from various manufacturers for about 8+yrs), and Neutrogena oil-free moisture SPF 15 (has been my daily sunscreen/moisturizer for 4+ years now).

And as I mentioned before I had a terrible reaction, swelling, dozen upon dozens of small raised bumps with white heads as a reaction to, what I believe to have been, the ClarifoamEF because I had used the Elidel with the Sulfacetamide Sodium & Sulfer lotion as a cleanser where I was instructed to leave on for 10 minutes and wash off... and I had no real positive or negative effect. It wasn't until I added the ClarifoamEF for two nights as a leave on foam that I work up and with the break out.

The last two days I have only been using the Elidel and the XXXXXXX butter and Neutrogena sunscreen. The redness has subsided about 75% since the photos I sent, the dry skin is still there but probably about 50% of it's worse case scenerio. But there is no doubt in my mind that if I were to take a warm or dare a hot shower I would have the same red blotches as resulted last time.

Sorry for the long note but I wanted you to see the whole picture. Thank you in advance for your help.
doctor
Answered by Dr. Sudarshan (2 hours later)
Hi XXXXXXX,

Thanks for the details provided.

My advise to you would be
-Continue using the Elidel cream and the XXXXXXX butter and Neutrogena sunscreen.

-Use nizoral shampoo twice a week . It helps in seborrheic dermatitis.

-Do not use Sulfacetamide Sodium & Sulfer lotion .

-You can use cetaphil cleanser for washing the face.

-Avoid Hot shower.

- You can take effective Antihistaminic like Fexofenadine with doctors prescription .
It will help in both allergic reaction and seborrheic dermatitis.
-You can also use mild steoid over face like Hydrocortisone .
It helps in seborrheic dermatitis.
-Use the moisturizer frequently .Dont allow the skin to be dry.
- Avoid any other home remedies or over the counter preparations.

If you need any further clarification do let me know.
Hope this helps you.

Wishing you speedy recovery.

Dr Sudarshan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan (18 hours later)
Thank you doctor - I will follow you suggestions.
-XXXXXXX
doctor
Answered by Dr. Sudarshan (3 hours later)
Hi XXXXXXX

If you dont have any further queries ,then please accept my answer and rate it at the end.

Wishing you speedy recovery.

Dr Sudarshan.

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. Chakravarthy Mazumdar
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Answered by
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Dr. Sudarshan

Dermatologist

Practicing since :2005

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Dry Skin And Red Blotches On The Face After Hot Showers. Diagnosed With Seborrheic Dermatitis. Takinfg Elidel, Sulfacetamide Sodium. Permanent Cure?

Hi XXXXXXX,

I understand your problem and will advise you accordingly.

After going through your photographs I feel that you are having contact dermatitis due to sulfur containing face wash.Which has occurred on pre existing seborrheic dermatitis.

Also I would like to know
-Are you having itching/burning/irritation pain over face?
-Do you get dandruff/flaky scalp?
-Do you have whitish lesions on eyelids/behind ear?
-Apart from elidel have you taken any other treatment?

Please answer the above questions to help you better.

Anticipating your response.

Dr Sudarshan