Severe rash on face, painful on nose, prescribed Metrogyl for Roseacea, getting worse. Solution ?
Patient: I have a severe rash on my face.  I cannot wear my glasses its VERY painful especially on my nose.  My checks are raw also.  I have been using metrogel prescribed for roseacea but it is making it worse. I have triple antibiotic applied now which seems to reduce the pain.  but I cannot use my cpap which means very little sleep and my glasses make it much worse.  It is now starting to peal which makes it itchy.  I am miserable.  everything that touches my face burns.  it hurts to lay down.  my neck aches.  and my checks feel swollen and are very red. Doctor: Hello Welcome! I would be pleased to answer your question . Persistent photosensitivity or seborrheic dermatitis are other causes of facial redness. It might be worthwhile trying 1% cortizone cream mixed with 1% clotrimazole cream on the red areas - twice a day for 14 days - to see if this helps. If it does then seborrheic dermatitis is the most likely diagnosis. If it does not then and given the fact that you have no history of reacting badly to the sun it might just be that you have sensitive skin and this is what is causing the redness.  You might also need a course of an oral antibiotic which will need to take by prescription.It will be worthwhile seeing a dermatologist about this. Please feel free to ask if you have any queries.. Lastly it will also be worthwhile getting your blood ANA levels done to rule out Lupus. This is not likely form your clinical picture but must be ruled out.