From: “Linda Sy MD”
Date: Thu Dec 7, 2000 4:55 am
Subject: Re: [rosacea] the cortisone story continues
Hi Patricia,
Yes, what a bummer. There is no easy way to manage steroid induced dermatitis. Your skin has become addicted. How does one treat addiction? You either go cold turkey (in which case, you will undergo dramatic flares not just once but perhaps multiple times); or you can go easy on yourself and withdraw gradually (in which case, you may be delaying the eventual total withdrawal). The latter method of course, is probably more practical, especially if you are working. One way of doing this, is to decrease potency & frequency of use (ex. from daily use to 3X per week, 2X, 1X etc. etc.) and keep stretching the duration. Then start diluting the concentration with a moisturizer. Skin is resilient and can adjust. Either way, you will get flare ups, sometimes even in other parts of your body (sort of metastatic rebound phenomenon). So, do not be discouraged or surprised when you have a flare - it is not a set-back. Just keep on your program. Meanwhile, when you do get a flare, here are some ancillary suggestions:
- Apply cool water compress on your face 3-4 times a day for 5 to 10 minutes.
- Follow immediately with lubrication. If skin gets tight during the day, keep applying your lubricant as often as necessary.
- Take an antihistamine to help contain the itching.
- Use a lubricating foundation to camouflage the erythema (for emotional support).
- Keep up with your oral antibiotics if you are on this for your rosacea. This is not the time to phase out on this.
- Last but not the least, patience and give it time.
Some good news: There is a topical medication called Tacrolimus ointment. I read that it will be available in the near future. From published reports, Tacrolimus has been impressively effective in treating the “red face syndrome” induced by long-term continuous use of steroids in atopics. So,
you may not have too long to wait…
Linda Sy M.D.
Linda Sy Skin Care
http://www.lindasy.com
Voice:Toll-free 877-Lindasy (546-3279)
Outside US: 925-256-0178
FAX: 925-939-5207
See Also
Rosacea News Articles: moisturizers, cleansers and steroids,
3 comments ↓
I have been struggling with a very red face for the last year and a half. In the beginning I went to the doctor and he diagnosed me with contact dermatitis and prescribed mometasone cream along with Zyrtec. I put this on, and my symptoms lessened but the next day it was worse. I stopped taking it. I went to a dermatologist and he gave me Elacon Cream and Hydroxyzine. Same thing happened. Then my doctor prescribed predinisone 10 mg. As guessed same thing happened. In the beginning I was told that I had tested positive for EBV and that could be contributing to my symptoms. But after a year and a half??? I have heard of chronic mono but I dont have the symptoms such as fever,severe fatigue etc.
MY QUESTION IS THIS: How do I know if I have rosacea, steroid induced rosacea, or is it just an atypical presentation of the EBV(mononucleosis virus)?
Hello, everyone:
I suffered with acne for 15 years. 10 of those 15 years it was severe. I finally found a dermatologist who prescribed me two courses of Accutane. For the first time since I was 9 years of age, my skin began looking incredible. I was very happy. There was just one problem: the small, flat, red spots my previous acne had left behind were taking an abnormally long period of time to heal. For most people they normally take 3-4 months to completely fade away, but a year came and went and mine were still clearly visible. So I decided to ask my dermatologist if there was anything she could give me that would help quicken the pace they were fading and make them heal faster. She gave me a small tube of Tri-Luma and told me it would help.
HUGE MISTAKE!
I used it the night before Christmas Eve ‘07 and put it on in an upside down triangular shape on the side of my right cheek (because that’s where most of the flat, red spots are located). The next morning I woke up and everywhere I put the Tri-Luma was a dark purplish/reddish color and it felt like my face was on fire! And the flat, red spots were an even deeper color red! I obviously had some type of allergic dermatitis reaction to it.
HOWEVER, the story doesn’t end there….the first 3 or 4 days after the intense flare-up, the color faded to a light pink, but the pink upside down triangle was still clearly apparent. Keep in mind, that was THREE MONTHS ago and the pinkness still has not faded away. Now all the surface area of my skin that I put the Tri-Luma on acts like Rosacea. So imagine a large, pink, upside down triangle on the right side of my cheek that constantly flares up whenever I get hot, or anytime I’m near sunlight, or anytime I do strenuous activity, etc. It’s a nightmare.
I am scared to death that permanent damage has been done. By the way, Tri-Luma has a steroid in it as one of its ingredients (which I didn’t find out until after the fact).
*Tri-Luma ingredients:
– fluocinolone acetonide 0.01%
– hydroquinone 4%
– tretinoin 0.05%
I have heard of people who use steroid creams long-term and end up suffering with permanent damage to their skin, but I have never heard of permanent, intense damage being done to a person’s skin after only ONE use. The thought alone blows my mind and makes absolutely no sense whatsoever. I even called the makers of Tri-Luma and spoke to their “medical liaison representative.” He said he had never heard of anyone experiencing permanent damage to their skin after only one use of their product either. He kept telling me not to worry and that he didn’t believe it was permanent (even though I don’t see how he can make that evaluation when he’s never even seen the current condition of my skin.)
But my question is this: If the pinkness and the flare-ups are not signs of permanent damage, then wouldn’t they have been gone a long time ago? How could I still be having a problem with pinkness and flare-ups, THREE months after the initial flare-up, if the current condition of my skin is not permanent?
Right after it happened (back in late December), I panicked and made an appointment with my derm. She told me not to worry and that it should fade within a few weeks. When I went back to see her about a month ago and told her I was worried that the pinkness still had not faded away, she got very defensive (a side of her I had never seen) and told me my face was just pink because it was still sensitive from the Accutane. BULL. I told her it obviously was due to the Tri-Luma because the discoloration and the flare-ups were/are in the exact same pattern I put the Tri-Luma on my skin. She tried to blame it all on me and said: “Well, YOU’RE the one who asked me to give you something to fade your red spots…..” Then she just rolled her eyes and said to come back and see her in June. She acted very rude and unprofessional. She was not helpful at all and the entire appointment with her was a complete waste of my time.
That said, I want to issue a warning to anyone thinking about using Tri-Luma to be careful! Try it on a pacth of skin on your arm or something first to make sure you don’t have a negative reaction to it. My derm told me to do that, too, AFTER I had already experienced the massive flare-up. By then, her suggestion was way too late.
Can anyone PLEASE help me or give me any advice on what you think might have caused such a severe reaction? Has anything like this every happened to anyone else? Do you think the damage is permanent? Do you have any suggestions on how I should treat it to help it go away?
I would be very grateful for any opinions or advice.
Thank you.
Hi Christian,
Do you think it could have caused vascular damage on your face, thus, you now have broken capillaries under your skin, which are causing the redness? That is what I currently have, on one particular spot on my right cheek. My dermatologist is suggesting that I do IPL therapy. Thinking about it… I would def. go to a dermatologist that you feel you can trust and respect, and respects you back. It made a huge difference for me. Good luck, keep your chin up.
Leave a Comment