What are these strange red patches on my face

[Kimmie2]

Hi there,

I was hoping you might be able to help determine what might be causing these red patches on my face. I have attached a photo. The patches tend to always be on my cheeks and right above my lip and sometimes a patch will appear on the bridge of my nose or right above an eyebrow. They come and go and will also be a little itchy and flaky. When they pop up, I typically refrain from wearing make up for a couple of days and put Aquaphor on them and they go away. Of course, they come back within a week or so. I guess I really starting noticing this about 6 months ago. I do have an appointment with a dermatologist but could not get in until mid November:( I do also have a couple of itchy/flaky areas right around my hairline that flare up from time to time and I've had that for years and notice it tends to get worse when I sweat a lot or don't wash my hair after a work out, etc. Could these 2 things be related?

Thanks in advance,
Kim254825482548

[Dr.Deepak]

Welcome to the forum Kim, the condition you have described looks like Seborrheic Dermatitis to me. For acute flares you may apply low potency steroids like 0.5% hydrocortisone (maximum 5-6 days) which will help reduce the inflammation. In addition to steroid, topical antifungal is a must (never use steroid alone) Definitive therapy is topical ketoconazole/clotrimazole cream in combination with topical metronidazole and 0.5% hydrocortisone.

For hairline you may apply the same medications. If its affecting your hair, you may wash with shampoo containing ketoconazole/tar/selenium/zinc/salicyclic acid every alternate days.

Another condition that might sometimes mix with seborrheic dermatitis is Rosacea, which tends to aggravated by several factors like heat, cold, hot and spicy foods, emotional stress etc. But the way u have described favors Seborrheic Dermatitis..

Anyway, if you have any questions, don't hesitate to ask.

[Kimmie2]

Hi there,

Thanks so much for your help! I had read quite a bit of info online and on this forum about the seborrheic dermatitis but wasn't sure if that was it since lots of the posts were talking about it typically appearing in the skins folds. (sides on nose, between eyebrows, etc) Mine is mostly on the side of my face in the cheek area and along my hairline near my forehead. I do have some hydrocortisone cream that my dermatologist prescribed me about a year ago and it is 2.5%. I use it on the flare ups typically for just a couple of days until they subside and then stop. Should I just continue for 5 days or so in a row regardless? Should I cut back to one that is .5%? Also, can I get any of the other creams you mentioned OTC? I do have an appointment with my dermatologist but it is not until Nov. 5 so I was hoping to get some relief before then?

[Dr.Deepak]

Well another condition with flaky hairline is scalp psoriasis...Does it bleed sometimes? can u get the pics of the hairline..The one on the cheeks, can u see any fine small veins around the redness on the cheeks. Do you have joint pain, on/off fever, swollen glands.. etc.. Not all seborrheic dermatitis are classical in look. Low potency steroid like hydrocortisone (0.5%-2.5%) can be used in case of inflammation for not more than a week. Hydrocortisone alone will work limiting the lesion but will not cure, recurrence is common. So applying antifungals along with low potency steroid can be effective. Well you may use hydrocortisone (check expire date) for a week along with antifungal. You can easily get OTC antifungal (Creams containing clotrimazole 1% (Candid) or ketoconazole 1-2% (Nizoral). You may apply for at-least 2 weeks.

What i would normally do is mix hydrocortisone 1% with clotrimazole or ketoconazole and apply twice daily for a week then stop hydrocortisone and continue clotrimazole/ketoconazole for another 1-2 weeks . I would also use face wash containing 2-3% salicyclic acid so the flaking would be gone.

[Kimmie2]

Nope, no little red veins that I have noticed. I have a few on my chin that look like tiny spider veins but those have been there for several years and I just assumed those come with a 43 year old face sometimes:) I will pick up that additional anti-fungal and try it as well. At the moment I do not have any inflammation. The pic I posted was taken last week but it comes and goes pretty regularly over the last 6 months or so. I will also look for the face wash you suggested. right now I am just using Cetaphil since it is very gentle. One more question, Can I still use my regular moisturizer and anti-aging serum that is part of my normal skin care routine or should I discontinue that for the next couple of weeks?

Thank you!

[kevinkrieger]

Keep clean your body internally and externally, So drink more water to flush out toxins and keep hydrated your skin.