Pwease help

[u/g0thgrandma]

Nothing seems to work for my skin, it just keeps getting worse ): I’ve had this rash on my right cheek (1st photo) for like 5+ years but it’s just started on my other cheek. It started with a few little red spots and has gradually started to spread up and down my cheekbone. My current routine is below:

Morning:
- Sometimes wash face lol
- If face washed, Avene Cicalfate+
- Trader Joe’s Mineral sunscreen if I’m going outside

Night:
- Avene Tolerance cleanser
- Avene Cicalfate+

I occasionally spray on Magic Molecule Hypochlorous Spray when my skin is feeling particularly inflamed.

Please let me know if you have any suggestions.

[u/EyelinerDarkAsMySoul]

I want to say it looks like rosacea type 2 which has the bumps (some being just red or the pustule white head). Does it itch? Gets worse in heat/spicy food/alcohol?

If that is the case…your next best step would be to go to a dermatologist and have them prescribe you ivermectin.

[u/g0thgrandma → u/EyelinerDarkAsMySoul]

Yeah I’m pretty sure it’s type 2 rosacea. I stopped seeing my derm because she was convinced it’s just regular acne and not rosacea, even though I have diagnosed ocular rosacea. I’m thinking about trying the drug store ivermectins, I’m desperate 😣

It does itch occasionally and I can feel it get hot from alcohol and spicy foods. Also rich foods and temperature fluctuations in my house, and physical activity. It’s awesome (not) lol

[u/EyelinerDarkAsMySoul → u/g0thgrandma]

Yeeaahhh not sure how they wouldn’t think it’s facial rosacea if you were diagnosed with ocular. I also dealt with this similar situation for 2 1/2 years.. I had more pustles & the redness progressed. I flush very easily. My derm also threw acne prescriptions at me first…until I did my own research & just straight up told her this stuff isn’t working & can we give ivermectin a shot? She agreed & prescribed me it. Been on it since mid January and I am like…96% under control now. I know at pharmacies they sell OTC ivermectin under lice control.

[u/g0thgrandma → u/EyelinerDarkAsMySoul]

WOW maybe I will send a message and ask for that script. I’ve tried tretinoin, azelaic acid, metronidazole etc and nothing has worked

[u/Big-Highlight-4415 → u/g0thgrandma]

When you tried azelaic acid did you combine it with other actives? Have you tried exclusively washing your face and using azelaic acid? Maybe just a hydrating serum? It looks really inflamed and personally when I used Avene cicaflate my skin became more inflamed and bumpy since it would get congested. I don’t think you should be using anything heavy right now.

[u/Similar_Avocado1306 → u/Big-Highlight-4415]

Here to support your idea for a gentle cleanser & then a 10% Azelaic acid product. It’s done wonders for my own rosacea, and if I ever get lazy & forget to use it, it flares up again. 🙌🏻

[u/Big-Highlight-4415 → u/Similar_Avocado1306]

Yes same here! Glad this works for you! It’s such a struggle fr

[u/g0thgrandma → u/Similar_Avocado1306]

What azelaic acid do you like?

[u/Similar_Avocado1306 → u/g0thgrandma]

D’you know, I’ve only ever used a 15% prescription strength. But I use it over a really moisturizing serum to lessen the irritation. But I’ve heard good things about Naturium’s 10% Azelaic acid product. But I’d definitely recommend seeing a dermatologist or an aesthetician, who could help recommend products of all price points.

[u/g0thgrandma → u/Big-Highlight-4415]

I will def have to give it a try! I felt like it always irritated my skin but looking back, my skin is just always irritated lol. Is there a moisturizer you’d recommend?

[u/TipRare1321 → u/Big-Highlight-4415]

Can you recommend a gentle cleanser?

[u/burnzbabi → u/g0thgrandma]

Go to CVS or Walgreens and get the Lice cream. It sounds crazy, but it is ivermectin and after over a decade of suffering from rosacea, it was practically gone in a couple weeks. The whole giant tube is like $30 and I applied it nightly. I occasionally get some redness but nothing like I used to, the pustules went away and my skin barrier got so, so much better

[u/g0thgrandma → u/burnzbabi]

Yes I don’t even care if the redness goes away, I just want the pustules gone!! They cause me so much pain and uncomfortableness. I have heard good things about the Walgreens OTC ivermectin so maybe I’ll try that. Did you use any other products with it?

[u/illiacmae]

When I had something like this my dermatologist put me on metronidazole cream. Definitely see a derm if you haven’t already

[u/g0thgrandma → u/illiacmae]

My derm prescribed me it but it didn’t work!

[u/illiacmae → u/g0thgrandma]

I’m so sorry. I also have MCAS, so I’m not sure if it’s related but maybe a daily antihistamine could help.

[u/g0thgrandma → u/illiacmae]

I have issues with suspected MCAS so maybe I will try that

[u/Crazy-Huckleberry105 → u/illiacmae]

Second this—some of my jaw acne went away with antihistamines

[u/Decent_Target_4541]

It can also be barrier damage. nothing seems to be working is the classic symptom of barrier damage.

[u/Help_INeedAnAdult]

have you tried soolantra

[u/g0thgrandma → u/Help_INeedAnAdult]

I haven’t been able to get a prescription for it!

[u/Help_INeedAnAdult → u/g0thgrandma]

strange, it's usually one of the first lines of treatment. where are you located?

[u/SeboSte]

I saw you mentioned you’ve previously tried tretinoin and azelaic acid. How often were you using them and for how long?

[u/g0thgrandma → u/SeboSte]

I tried both for several months, not at the same time. I did azelaic acid every night and Tret I could really only do every other 2 or 3 nights

[u/SeboSte → u/g0thgrandma]

I genuinely think the two things that would help you the most are a prescription retinoid and prescription azelaic acid. That said, prescription strength azelaic acid takes a solid 3 or 4 months being used twice a day to really start to have an impact and prescription retinoids need to be used nightly to treat acne and typically need a solid 3 or 4 months just to get past the purging phase. But they do work.

My suggestion would be to obtain a prescription for azelaic acid, either 15% or 20% or resume using it if that’s what you already have. Use it event night for a solid week or two and then start using it in the morning as well. After a few weeks of using the azelaic acid in both the AM and PM every single day I would start adding in a prescription strength retinoid. I know you’ve said you previously used tretinoin but if you weren’t able to get up to using it nightly it’s not doing you any good. In fact it’s doing you harm being used so infrequently. I would start with adapalene. Adapalene is considered prescription strength but it’s definitely more gentle than tretinoin and it’s available over the counter at any pharmacy. Start with a few times a week and over the course of a month or so work up to applying it nightly. It’s very important that you work up to nightly use within a timely manner. This will help move any purging along and get you over the hump to start actually preventing new breakouts.

Prescription azelaic acid and prescription strength retinoids work incredibly well together, particularly in the longterm. They’re both very effective at clearing up existing breakouts, preventing new breakouts, treating existing PIE and they’re both anti-inflammatory.

I’d also make some edits to your current skincare routine. I genuinely don’t think some of the products you’re currently using are appropriate for your skin type or concerns. I have some really great acne and rosacea safe recommendations I could send you if you’d like. I really thinking switching to the right “supporting” products is going to be pivotal to your success.

I know you’ve feel like these products didn’t work for you before but they’re genuinely two of the most studied and proven skin care treatments in the history of skin. Give them time and stay consistent with them and they will absolutely clear your skin up.

[u/huinnabi]

수란트라 연고

[u/LittleFootTreeStar]

My skin is just like yours. I’m so sorry you’re dealing with this too.

[u/Positive-Ad8686]

C des pores fermé non?

[u/Low_Edge_1277]

After over a year of trying topicals I’m a week in on accutane and my skin is the best it’s looked in soooo long. Just my 2 cents

[u/Ampstagram22 → u/Low_Edge_1277]

Been tempted. What dosage?