Hello doctor, Three months back, I started to have a small red dry patch on the skin developed on my chin. I tried to keep it moisturized but it seemed to get very dry so I put some Hydrocortisone cream on it for a few days, it seemed like it was gone so I stopped using the cream but within a week it was back but bigger now. I used Hydrocortisone cream for a few more days then stopped for a few days and the same thing happened, only it was spreading by the corners of my mouth now. I tried putting Zinc diaper cream on it and my skin got very inflamed. At this point, I went to walk in clinic as I do not have a family doctor, he was not sure but thought it could be rosacea and gave me Metro gel prescription. I have been using it for about three weeks and the bumps have gone down, but not as much from the Metro gel and the fact that I stopped putting anything on my face, I only wash with Cetaphil and use Cerave moisturizer. I wear makeup for even one day the bumps start coming back all over my chin and around my mouth. I did not use any new products just the same old makeup face wash and moisturizer I had been using for years. The only thing I did differently was my skin was getting really dry so I used a microdermabrasion device just before the red patch developed.
Hi. From your picture (attachment removed to protect patient identity), it is steroid induced rosacea or acneform eruption. Whatever was the original disease, you used steroid over it that altered the picture and now you have developed problem due to steroid (Hydrocortisone). First advice for you is that never apply steroid on the face and that without prescription. Now, regarding its management, you have to use a sunscreen of SPF 60, Metronidazole gel 0.75 % is correct treatment but mix it with cold cream and then apply, take non-sedating antihistamine tablet, once bumps will disappear then we will manage redness but in a step-wise manner. Wash your face with mild soap and water. Avoid Dettol and other irritants. Do not scratch or rub the lesion. Steroid induced rosacea, contact dermatitis, steroid induced acneform eruption. Sunscreen of SPF 60 from morning till evening. Apply Metronidazole gel 0.75 % plus cold cream at night. Take antihistamine tablet OD. Wash face with mild soap and water. Avoid using Dettol and other irritants.