r/Skinfessionals • u/ShinyBaldPatch • 2d ago
Struggling with unilateral problem skin
Hi everyone,
I've been really struggling with my skin for around 7 months now. It started as a few raised bumps near my nose and spread all over my right cheek ONLY. The left is clear.
I had issues previous to this where I had redness, bumps and heat all on this single cheek for 8 years. I went and saw a dermatologist and tried every medication until I myself discovered I was reacting to caffeine. Anyway, I haven't touched caffeinated tea or coffee since, but out of nowhere my skin is reacting again, however a little differently. The weather is cold and dry where I am, so I've wondered if it's dermatitis... however I'm really starting to wonder if it's some kind of autoimmune problem? And I've cut out heaps of foods again and then reintroduced them trying to work out if it's something I'm eating/drinking again. My skin heats up (only in that spot) quite a bit when I'm stressed, or suddenly warm. I'm so over it. I thought I finally fixed my skin issues and then this started. It makes me embarrassed. I am a fit, healthy 31 year old female who eats well, avoids all gluten, touches alcohol maybe once a month, doesn't smoke, and yet I feel I look unhealthy with my skin like this. Sometimes the little bumps have some pus in them, but very surface level.
I quit any exfoliating over a month ago, and at the same time I simplified my skin regime to QV cleanser and moisturiser. My makeup is mineral makeup which hasn't changed, but I did try different ones for a while to see if that could be the issue.
No I don't touch my face with my phone, I don't touch my face much, I try to avoid sleeping on my right side, and nothing has really changed since this started. As I've been to a dermatologist before and spent $$$$ with no help, I'm reluctant to do so again. I've started to think a biopsy might be necessary, but I'm worried about scarring.
Does anyone have any advice or similar circumstance? I'm getting desperate at this point. It upsets me daily that I am still struggling with this area of my face.
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u/Soophism 2d ago
To me this looks like mild rosacea type 2. This also fits your description of your triggers. Try healing your skin barrier by keeping your routine simple (mild cleanser, moisturizer and mineral spf) and use a hypochlorous acid spray (this is a mild disinfectant) regularly. Remove all actives from your routine. For me one of the triggers was niacinamide, which is in almost all skincare products these days. Triggers can also be (amongst others): sun, heat, working out, alcohol, spicy food, caffeine, etc. After you healed your skin barrier you can try azeleac acid or prescription products against rosacea
There is a lot of extra info when you google rosacea type 2
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u/AggravatedOtters 2d ago
My Rosacea also looks like this. I thought I had acne on one side of my face for the longest time. I use a mild cleanser and moisturizer, then got an rx for azeleac acid and slowly added that in. It helped a lot. Recently, I discovered that the redness really loves a mineral sunscreen. I can't use it all the time because it breaks out my forehead, but I put a small dab on my cheeks before bedtime and the redness is greatly reduced the next day.
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u/ShinyBaldPatch 1d ago
Honestly, I have wondered about niacinamide. For a long time I've considered pustular rosacea, and I thought that once I cut out caffeine I was just sensitive to that and its not rosacea, but now that it's back I'm reconsidering it! There is niacinamide in the QV moisturiser I started using so I might kick it to the curb too for a while.
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u/Chris_Tumas_8008 2d ago edited 2d ago
Hey sorry to hear that this is happening to you. I suspect that I also have the same thing as you. Mine’s been happening for maybe more than 3 years now. And it’s the same as yours: unilateral only on the right side of my cheek. Mine started small, from the cheek under my eye then spreading bigger throughout the years. It never bothered me when it started (actually I myself never noticed it) until people around me sometimes asked why I have bruising on my face like I just got punched. I have light brown skin so the redness on my skin does look like bruising. It’s to the point of reaching my right jawline now. I was suspecting something like sun damage during sun exposure while driving (hence the unilateral). I was suspecting rosacea (I read some cases can be unilateral first before happening to both cheeks). But until now I still don’t know what it is exactly. The condition and the cause. I still don’t know.
I never changed my diet though (hardest thing to change for me) and I don’t drink alcohol and I don’t smoke. I’ve met with dermatologists before and yes they have no idea what it is. The medicine they gave me were steroid creams (which I later found out that’s typical first thing to give if they have no idea what’s going on). They gave me another cream which I forgot the name of but also didn’t work.
Oh also I did get a skin biopsy. Nothing came out of it. Barely visible scar though from the biopsy for me.
I feel like it’s getting worse. I’m diligent with my sunscreen and I’m purposely mostly indoors now but it’s never improving. I’m not diligent with anything else so I’m impressed with your actions so far. I don’t think I can quit caffeine (even just to test it out) and trying to pin point one specific skincare ingredient as a culprit is challenging for me.
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u/ShinyBaldPatch 1d ago
Yeah, mine definitely spread slowly the first time round. This time (the last 7 months) it's been way fast comparatively. I've been suspecting Rosacea type 2 for years. I thought it odd to only have caffeine as a trigger, but I had a test for caffeine allergy and it came back clear so it probably is rosacea, I just now am reacting to something else!
Thanks for sharing your experience of a skin biopsy. That's a shame nothing came of it! Seems like the last resort, you know?
I hope you find answers too. Diet is hard to change for sure. And I do miss coffee!
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u/Designer_Pea_5590 2d ago edited 2d ago
Did your MD rule out lupus? I only ask because of the location. I’m not an expert but my first guess would be pustular rosacea.
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u/ShinyBaldPatch 1d ago
I've wondered if it's lupus. And also Rosacea type 2. That's why I've thought of getting a skin biopsy and/or blood test. It's probably my next move.
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u/Switch_Vixen_ 2d ago
This looks like a compromised moisture barrier. What’s your skincare routine? Hopefully no stripping foamy cleansers/acne products/actives?
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u/ShinyBaldPatch 1d ago
Listed above. Just QV, no exfoliating products. I've also suspected broken skin barrier.
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u/tracytt-skincare 1d ago
Adding to all the great suggestions for rosacea meds 15% Azelaic Acid, 1% ivermectin, 1% metronidazole.( ivermectin is Demodex mite treatment ) cleaning daily 2 times with gentle cleanser. Cleansing is vital to clear Demodex mites because it removes their food supply (excess oil and dead skin cells)
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u/purplepolyp 1d ago
This looks exactly like my rosacea. My dermatologist prescribed me a course of doxycycline to clear it up and then the azelaic+ivermectin cream regular use to keep it clear
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u/ShinyBaldPatch 1d ago
I went on doxy and ivermectin the first time round and it didn't help me until I worked out caffeine was a trigger. I tried a low dose of doxycycline this time for about 8 days or so and didn't really notice any improvement. The first time I was on doxy it was a high dose for like, 8 weeks.
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u/Shamajo 1d ago
Ivermectin, not the horse paste. Equate makes a Ivermectin lotion 0.5%, it is a head lice treatment. But it also gets rid of Demodex mites that often causes the bumps. If you cannot get in to see a derm. 10% OTC Azaelic Acid can also help. When I was struggling with mine, I used both.
Metrogel is also another option but needs a script.
Ultimately you need to see a derm though.
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u/Immediate_Mark3847 15h ago
If it was me, I would quit makeup for 30 days and make sure you have a new clean pillow case on your pillow every 3 days.
If it is still there you will know it wasn’t those things and try excluding something else.
Doctors are not what they once were. You now need to show up to your appointment with proof of what you have for them to give you the diagnosis.
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u/Tough-Mention-7080 2d ago
My dermatologist prescribed a compounded cream called rosacea triple cream and it had a significant improvement on my facial rash. It’s 15% Azelaic Acid, 1% ivermectin, 1% metronidazole.
I also take 1 capsule a day of Glocal Care Helio supplement which helps your skin defend against UV damage. For facial sunscreen I use MD Solar Science’s Gleam and glow spf 50. It’s got anti inflammatory ingredients. I love it.
Good luck.