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October 13, 2012 1:17 PM   Subscribe

Please help me figure out what's going on with my skin. I have either a rash or acne or something on my face and I don't know why or what to do! I've used Dr. Hauschka skincare for years and would like to stick with that if possible, but I am getting desperate. Details and gross skin photos within!

So, I am a 32-year-old woman, and I've had really clear skin from when I started using Dr. Hauschka in 2004-5 (so, 7-8 years ago for you math fans) until a few months ago. I used to get a stray pimple or two in relation to my period, but now I have this gross acne/rash/whatever all over one side of my face and in a big patch on the other side. Here are photos if you want to look.

My skincare routine is:
Wash in the morning with Cleansing Milk, spritz with Facial Toner, apply Quince Day Cream

I haven't worn any makeup at all since I started having stye problems (I asked this question about it; I actually had to have one of them removed by a doctor, and I have some other stye-like issues going on -- perhaps they're related?), so I don't put anything else on my face typically. I might sometimes use Toned Day Cream on top of the quince, but usually I don't bother.

At night, I wash again with Cleansing Milk and spritz Facial Toner, then I go to sleep.

Each time I wash my face, I also use this foaming eyelid cleanser on my eyelids only (again, due to my stye issues).

My current skincare routine is informed by phone consults w/Dr. Hauschka folks. They had also suggested a course of Rhythmic Night Conditioner, which I tried over the summer, but it didn't help. I've also used the sensitive version of this before, and I have a box of it I could try, but I'm not confident it's going to do anything for this.

I'm going to graduate school (so I'm super busy) in a rural area two to three hours away from the nearest dermatologist (and I don't have insurance anyway) or Dr. H facialist. I have a drugstore and Walmart nearby and I can buy products online. I really would like to keep using my Hauschka stuff since it used to work so well and it's so expensive (I have a couple of bottles of everything stockpiled)... but I really really really would like my skin to be clear and healthy. I know YANMDr/Derm, but I hope you can help me determine what's going on and what to do!!

Other potentially relevant info... I drink lots of water. I try to eat pretty well, but my diet isn't optimal (see above re: grad school, rural area [this particular rural area is a food desert]). I do try to eat lots of veggies and good stuff, but I'm not super consistent, except with the water. I don't think I'm unusually stressed out. Sleep is ok too. I don't take any prescription medications, but I do take Zyrtec and Prilosec every day and Lactaid when I eat dairy. If you have any questions for me about anything, please ask away! I appreciate you looking at my question and my gross photo and trying to help.
posted by pupstocks to Health & Fitness (25 answers total) 3 users marked this as a favorite
I think you should see the doctor that is available, not necessarily a derm as soon as possible since this seems to have come out of nowhere.

Is there one on campus?
posted by discopolo at 1:24 PM on October 13, 2012 [2 favorites]

It looks like it could be Rosacea.
posted by Jandoe at 1:26 PM on October 13, 2012 [9 favorites]

When did this appear? Was it overnight or gradual? Have you had any prior issues with redness or flushing? If it was gradual and/or there was prior redness/flushing issues I would definitely consider rosacea (which is good news and bad, there is no cure so not having access to a derm isn't a huge loss, there are tons of home remedies online but they're all hit and miss, what works for one person doesn't work at all for someone else but there is no cure, there are things that can be done and things a dr could prescribe that you could try that will improve it but it will likely never 100% go away) It looks a lot like my skin which was diagnosed as seb derm+rosacea but you really should see a dr about it, really, while its most likely just an unsightly rash/skin condition it could be a symptom of something more systemic, I don't want to make you an internet hypochondriac so I wont name names but you should really see a Dr just to be sure. If you really can't see a Dr, at least see a pharmacist.
posted by missmagenta at 1:30 PM on October 13, 2012 [2 favorites]

I'm just a person on the internet and have no personal knowledge of rosacea, but that was my first thought when I saw your photos. Looking on the website that Jandoe posted, there are some good photos in the Faces of Rosacea section. If you scroll all the way down there's even mention of an ocular form of rosacea which can cause styes (which was news to me).
posted by SweetTeaAndABiscuit at 1:34 PM on October 13, 2012

I'm not familiar with Hauschka but it could be that they changed their formula just enough to cause a reaction in you. I've had that happen with deodorant.
posted by thatone at 1:36 PM on October 13, 2012

Response by poster: Hmm! Perhaps rosacea is what's going on. I'll look into that.

No doctor on campus; we have a nurse practitioner, but honestly... the level of care is not great.

I have had some redness before, but not really this rash-iness. I think it happened gradually, by which I mean it started small and took a few months to get to this point.
posted by pupstocks at 1:39 PM on October 13, 2012

I nth rosacea. I also think you have an allergic reaction to something. Are you stressed out about something?

Don't put anything on your face for a few days and wash with Trader Joe's facial wash or J&J baby shampoo. Get yourself a bottle of honey and every other day, slather the honey on your face and wait 15-20 mins. Wash gently with a washcloth and warm water.

Hopefully it calms down a bit, but go to a dermatologist if you could.
posted by Yellow at 1:47 PM on October 13, 2012 [1 favorite]

I agree, it looks a lot like rosacea. I'm not sure the products you're using are all that benign- the second ingredient in the cleansing milk is alcohol; it's also the third ingredient in the toner and they both contain fragrance, which should be avoided in skincare products if you have sensitive skin. Check out this list of common irritants:

In surveys conducted by the National Rosacea Society, many patients cited the following ingredients as triggers for irritation: alcohol (66 percent), witch hazel (30 percent), fragrance (30 percent), menthol (21 percent), peppermint (14 percent) and eucalyptus oil (13 percent). Most respondents said they avoided astringents, exfoliating agents and other types of products that may be too harsh for sensitive skin.

That site also has recommendations for treatment. I would immediately stop using the toner, and look for a much more gentle cleanser. I always plug Skinactives products because I have such good results from them, and they are fragrance free, generally very concentrated, and don't use a bunch of cheap ingredients or fillers. I'm sure other people will chime in with their recommendations.
posted by oneirodynia at 1:50 PM on October 13, 2012 [1 favorite]

It looks like rosacea but IANAD.

It could be folliculitis. I thought I had rosacea and it was folliculitis. I would see a dermatologist even if it's three hours away and you have to pay cash for the visit.

If it's folliculitis it could be bacterial or, in my case it's just this inflammatory reaction that happens and there is nothing you can do for it (except topical steroids and waiting).

If it's rosacea, there are treatments.

I would experiment and drop all skin care products (no creams or "treatments") and just cleanse with something very gentle and leave your skin alone.. The cleansing milk you have might fit the bill as gentle. If not try Cetaphil or Dove. If it's bacterial the creams and treatments might be harboring something. I don't know. It can't hurt to leave your skin alone and see what happens.
posted by Fairchild at 1:50 PM on October 13, 2012 [1 favorite]

FWIW, milk cleansers and any product with rice milk in it tends to exacerbate all my skin conditions toute suite so your milk cleanser may be having the opposite effect of what you want right now.
posted by These Birds of a Feather at 1:56 PM on October 13, 2012

Can't get your photos to load, but: I had a growing rash thing that appeared out of nowhere, which I thought was either cystic acne or rosacea or even god forfuckingbid herpes, and it couldn't be fixed by anything OTC I tried and was persistent like whoa. IIRC it turned out to be some kind of staph infection or something - my dermatologist gave me a long-term rx for low-level antibiotics and some Duac gel and it was gone in 3 days. I didn't even have to bother with the pills.

If you've had this for months and it's not going away but is actually getting WORSE, go see a doctor.
posted by elizardbits at 1:56 PM on October 13, 2012 [1 favorite]

Definitely at least see the NP. She may not be perfect, but she's better than the Internet and maybe able to prescribe something to calm that down. It just sounds so sudden that it doesn't seem like pimples/acne.
posted by discopolo at 2:01 PM on October 13, 2012 [1 favorite]

Is it possible you've developed an allergy? I recently found out that a lot of what I thought was acne was actually a reaction to a preservative in my shampoo and body wash. Anyway, I'll nth seeing the NP--if I've learned one thing battling my skin over the years, it's that nothing I do will have the results that a doctor and prescription products will.
posted by serialcomma at 2:05 PM on October 13, 2012 [1 favorite]

it also looks like keratosis pilaris. if you have it on the backs of your arms or tops of thighs too, it might be KP. my KP and other skin issues are kept in check by treating it like a vitamin A deficiency - I take a tablespoon a day each of cod liver oil and butter fat oil. a little quick googling shows that some individuals respond to treating rosacea like a vitamin a or d deficiency in the same way - might be worth checking out.
posted by par court at 2:07 PM on October 13, 2012 [1 favorite]

Hrm. I am also NAD, and I, too, think it looks a little like rosacea. But maybe rosacea + something else?

I started with symptoms about a year ago, and coincidentally, ran into a Dr. Haushwhatever rep at the cosmetics counter and she convinced me to try their Rose Day Cream, which is specifically for rosacea. I actually found it made things worse, wasn't particularly soothing and gave me zits and milia, so there's that.

What soothed things for me was using NOTHING to cleanse my face, just warm water in the shower, not even a face cloth to scrub with, and only a bit of coconut oil to moisturize after. I don't even know what made me try the coconut oil (my skin is oily, so it really doesn't make sense) but it was light and soothing and lovely.

Later, I saw my doc and she gave me a prescription for Metrocream, which also made me break out. Now I use a half/half of Metrocream and Metrogel, and it's great. I still don't use any kind of cleanser or scrubbiness on my face, though.
posted by looli at 2:14 PM on October 13, 2012

Your photos aren't gross. Your skin looks irritated, but you'll have to work harder to gross me out :-)

If the blemishes appeared very suddenly, this could be a reaction to a chemical irritant (like alcohol or fragrance) or something you're genuinely allergic to, or, possibly, an infection.

But since you have said that you have had the redness for a long time, and the blemishes appeared slowly, I think it is more likely that you have rosacea that is going through a flare-up phase. You look to be the fair Celtic/Scandinavian type, who often start showing this as early as their twenties. The gentle rosy pink across your face is in a pattern typically found in rosacea. You may finds that heat, wind, cold, hot showers, hot drinks or stress can make the pink more intense. Those kinds of stresses may also make you break out more.

I looked at an earlier question from you where you mentioned eye irritation: that can be one way rosacea expresses itself, too. And the slowly increasing redness of rosacea may lead you to think that teenage acne is hanging around longer than it should, so people often try medications or skin treatments targeted at acne that is inappropriate for skin with rosacea, which is very sensitive.

IANAD, nor is anyone else here, so when you have the chance to consult a doctor, you should. If it is rosacea, there are some prescription treatments that can help soothe your skin and heal the blemishes. If it is not rosacea, you can get another appropriate treatment. Be sure to mention your eye issues, too.

For now, the number one rule for rosacea is BE GENTLE. Stop using those specialized products. Splash your face with tepid water in the morning. If you think you need to clean before you sleep, use a mild soap or cleanser like Cetaphil or CeraVe. If you think you need moisturizer, choose the mildest one you can with some SPF (sun exposure is also something to avoid). Avoid any scented products as much as possible.

Your eyes need gentle treatment, too. If you are still waking up with irritation or discharge, dip a CLEAN washcloth into warm water, squeeze lightly, and lie down and relax with the cloth across your eyes for a few minutes.

Good luck! Relax for now, see what you can do to calm your skin down a bit with benign treatment, and talk to your NP or doctor when you have the time to see them.
posted by maudlin at 2:16 PM on October 13, 2012 [3 favorites]

Have you been tested for lupus?
posted by mrfuga0 at 2:32 PM on October 13, 2012 [1 favorite]

It looks like possibly rosacea to me also (though I may be "biased" b/c I have that too) or just plain old acne. (Not a Dr but have had lots of past experience with wacky, sensitive skin.) One thing about going to the dermatologist, if it's rosacea that should be pretty easy to diagnose, and the treatments shouldn't require you to go back that often if it's difficult for you to do so. For me it was antibiotics (even a rural pharmacy should be able to provide those) and two Rx creams, which while expensive, come in such huge containers that I won't have to refill them for a year or more. So I'd go to the Dr even if it's an all day thing, because finding out sooner is a better use of your time than trying a million things yourself first.

One other thing to think about - have you been pressing anything against or touching anything (phone? your hand? your hair?) to your face more lately?
posted by DestinationUnknown at 2:51 PM on October 13, 2012

This reminds me of an answer I saw on Ask earlier regarding roseacea. Could you have been consuming more cow's milk products as of late?
posted by french films about trains at 3:19 PM on October 13, 2012

The Dr. Hauschka stuff is not working for you right now. Could be the alcohol, could be the witch hazel, could be all the plant extracts (they are from nature, but they are not benign. Choosing one at random, limonene: It can be a skin irritant.) I would stop using them immediately. You could have developed an allergy or sensitivity to them suddenly, even though you've been using them for years.

I would also see a dermatologist, even if it involved a long drive and paying out of pocket. You'll probably have to wait a few weeks for an appointment anyway, so if eliminating the products clears it up in the meantime you can always cancel the appointment.

(Also, I would not trust any brand-affiliated consultant, facialist, or expert. Everything coming out of their mouths is marketing-speak and is probably, at best, half-true.)

(I wish I could favorite tel3path's comment about nutrition and skin health more than once.)
posted by purpleclover at 5:06 PM on October 13, 2012 [1 favorite]

A dermatologist is eminently more qualified than any non-doctor here (well-intentioned and helpful as they are) to help you.
posted by Dansaman at 5:48 PM on October 13, 2012

nthg rosacea. I used to have it years ago.
posted by michellenoel at 6:34 PM on October 13, 2012

While I totally agree with tel3path in general I do think some sugars and alcohols can affect rosacea. Based on some people I know who suffer from it If you drink beer or mixed drinks with sodas maybe try quitting for a while and see if it helps. Also remove all sunscreens from the equation for now.

In general though skin conditions seem to be genetic so can you ask female family members? I have, literally, my mothers skin and we shortcut the what-to-buy routine by asking each other.
posted by fshgrl at 7:10 PM on October 13, 2012

Mod note: A couple of comments deleted; this is not the place for rants, and please don't preach at the OP. Offer helpful advice or move on.
posted by taz (staff) at 6:42 AM on October 14, 2012

Response by poster: Thanks, Taz. And thanks all! I will see a dermatologist and look into some of these other suggestions. I appreciate the help!
posted by pupstocks at 9:44 AM on October 14, 2012

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