From: “Linda Sy MD”
Date: Thu Dec 7, 2000 4:55 am
Subject: Re: [rosacea] the cortisone story continues
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
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