Red Facial Rashes Adjacent to Nose

Q: I am a 40 years old male, having red rashes beside my nose since 9 years. These rashes are very light red surfaced during the noon to night; every morning comparatively very low in appearance. Detailed background is as under.
Earlier, in the year of 1999-2000, some pigmentation appeared on my face. I had applied lot of medicine but nothing happened. Then in the year 2004, I contacted one skin specialist; he gave a few medicines to apply, which I did. After 6-8 months, pigmentation was same but these red rashes appeared beside my nose. I don’t know if this was a reaction of those medicines I applied, but since then these rashes are part of my life. initially, I had applied betnovate tube and these rashes cleared up after one or two applications only. But it was a usual routine to apply betnovate after every two to three days. Then I decided to contact the same skin specialist again and he gave some different medication to apply. After that I had contacted various skin specialists but the problem has remained the same. Each doctor has suggested that it’s sun allergy and advised to use sunscreen, few medicinal tablets and application of tubes. I have changed 4-5 doctors but could not succeed. Presently, I have very light red granules beside the nose around 5 cm area on each side; skin of that area is also different from the other side of face. Kindly suggest the following:
1. Can it be cured or not?
2. Is it related to sun allergy or not, because I used to work full day inside my office. I was only exposed to sun during 9 – 9.30 A.M. for 5 minutes; after that out of office at night.
3. Can you suggest any medicine? I can upload a photograph of my face if it is required by you. Thanks and Regards.

Reply:

Since the skin is red there, this is definitely some kind of inflammation or irritation of the skin. We can call this dermatitis, a reaction of the skin against something that irritates it.

Sometimes similar rashes are also seen in certain autoimmune conditions, such as SLE. You probably have dermatitis, but keep these conditions in mind as well especially if you have problems with other body organs as well.

Types of Dermatitis

Dermatitis is of many types depending upon its cause and presentation.

Contact Dermatitis

Typically red, swollen, blistered lines appear on the skin which has reacted. This allergy is not on your whole face. It is localized to areas beside your nose. Such a condition is called contact dermatitis.

Could there be an allergen to which only this part of your skin is exposed?

Eczematous Dermatitis

Alternatively, there is a condition called eczema or eczematous dermatitis. This is happens due to irritation of the skin by some irritant. Stubborn inflamed rashes appear which show phases of inactivity and flaring.

Do your rashes show such changes, that is, phases of flaring and inactivity?

Atopic Dermatitis

Any part of the face manifests rashes in reaction to some allergen, stress, food allergy, asthma, hay fever or diabetes. Do you have any other form of allergy like running nose, asthma etc.

This needs to be worked out. What kind of dermatitis are you suffering from? You are welcome to give us more details for further work up.

Management

  • As far as treatment is concerned, usually a mild steroid cream is used for topical application. However, this should only be used sparingly, otherwise side effects of steroids may appear.
  • If an allergic cause is detected, it needs to be avoided. Cover the face with a hanky while outdoors.
  • An anti allergic medication can be taken for sometime, like antihistamines, such as diphenhydramine (benadryl).
  • A mild tranquilizer can be taken for short duration to reduce stress, if any.

Other Helpful Measures

Meanwhile, the following tips would help –

  • Drink lots of water to wash off any product of allergy from your body. Clear water is the best cleanser.
  • Take plenty of fresh fruits and vegetables (the ones that suit you) in your diet.
  • Exercise adequately and stay physically active. This has been linked to allergies.

Take Care,

Buddy M.D.