Hello, I’ve been dealing with a skin condition on my face for several years now that tends to come and go in terms of severity and appearance (pictures below). *I’ve been going to a dermatologist for several months and I’ve tried all of the treatments below to little or no effect. My derm claims that his recommended next step would be to go forward with a biopsy on my face, but that would lead to scaring that may be just as noticeable as the condition itself (that's my sense, at least).

I have a couple main questions for anyone who may have experience with anything similar:

1. Does this match any known skin conditions?
2. Are there any other recommended treatments (over the counter or otherwise) that would be worth trying?
3. If you've had a skin biopsy on your face, how was your experience? What was the effect of the scaring and can it be reduced or eliminated with any treatments?

Skin condition details:

  • Recurring red spots on my face, primarily on my cheeks and under eyes, occasionally also can show up beneath eyebrows
  • Overall redness of spots varies significantly day-to-day and specific spots seem to come and go
  • Spots feel rough to touch, but do not itch nor feel irritated
  • Spots tend to get dry and sometimes develop a layer of white flaky/dead skin, especially after a warm shower
  • Sun exposure seems to make redness worse, but I’ve always had skin sensitive to the sun

My background:

  • Completed Accutane treatment 7-8 years ago successfully to eliminate most acne on face with minimal side effects beyond common, expected ones
  • I’ve always had very sensitive skin (unable to use normal sunscreen, etc)
  • My mother’s side of the family does have a history of skin cancer
  • Age - 29
  • Sex - Male
  • Race - White/caucasian

Treatments tried (minimal/no effect):

  • Ketoconazole Shampoo - seemed to help with scalp redness, but less so on my face
  • Hyrdrocortizone - to treat potential allergic reaction
  • Lamisil - anti-fungal
  • Rosacea treatments (Rosacea cream and Prosacea) - not by recommendation of my derm, but my own volition

Pictures here (all taken at different times):


Thank you in advance for sharing your experience and any suggestions!