Skin Republic

Dear Dr. Jen,

I've recently started on a new pimple treatment for my face.  I put five kinds of creams on my face.  I've noticed that I seem to get red a lot and I am getting dry on some patches on my face.  My doc says it is okay, but sometimes I worry because it stings even when I am washing my face. Is my regimen too strong or is this normal?

Eddie

Dear Eddie,

Anti-acne treatment usually includes medicines like retinol, retinoic acid, tretinoin, adapalene, or tazarotene all of which are great for treating acne.  The retinoid group of medications are useful in decreasing oil secretions, suppressing inflammation and redness, as well as helps promote normal desquamation.  Due to the exfoliating nature of retinoids, it can also cause too much desquamation rendering the patient very sensitive to sun, to other creams and even to facial cleansers. 

Adding salicylic acid or alpha hydroxyl acids (AHA) to your regimen will worsen the redness and stinging.  You can temporarily stop these meds until your skin gets better.

Using the milder form of retinoid, such as adapalene, can help.  Signs of redness, stinging or peeling show that you might be using too much of the medicine on your face.  You can lessen the amount being applied. Your face should not be thick with cream but rather, the cream should disappear right away on your skin.  Lastly, you can decrease frequency of application to every other night if your skin is too sensitive. 

Dear Dr. Jen,

I have eczema on my arms and legs that usually disappears after I apply my medicines.  Lately, however, I've been having the red, itchy rashes on my face.  I applied my eczema meds and it helped for a bit, but suddenly it comes back worse than ever.  Could I have developed immunity to my creams?  What else can I apply?

Pam

Dear Pam,

Red, itchy lesions on the face may not necessarily be eczematous in nature.  For example, it could be an allergy or even a fungal infection.  If cortisone or steroids are your go-to creams for eczema, this may alleviate an allergic reaction temporarily.  But if your skin continuous to be exposed to the causative agent, then the allergy will persist. 

If it is a fungal infection, it can temporarily stop the redness but it will cause the fungal organisms to multiply.  Hence, a rebound of the infection will occur.  At this point, it is difficult to say what it is you have.  It may be best for you to proceed to your PDS derma to have it checked out rather than do trial and error on your treatment.  This will save you money from spending on unnecessary medicines, as well as save you time.  Like any medical condition, the most important thing is to get a correct diagnosis which leads to the correct treatment.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with Perpetual Succour Hospital (PSH). For information on PDS, check http://www.pds.org.ph/. For questions or concerns, please text to: 0932 857 7070; or email to: [email protected]; or call The Freeman: (032) 2531276, or PSH: (032) 233 8620 and 232 5929. Your inquiries will be forwarded to Dr. Tan.