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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9116
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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I have a red patchy scaly /flaky rash all over my face. It

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I have a red patchy scaly /flaky rash all over my face. It started on one eyelid and seemed to keep spreading. The edges of each patch are defined. It is very itchy. I went to my family doctor and she gave me Keflex. It has been two days and it seems to be a tiny bit better but not as much as i expected. It is so itchy it is driving me crazy. It is not oozy or any raised bumps/whiteheads. I take plaquenil could that be suppressing my immune system enough to get this infection? I have taken it for 6 years and have never had this. It almost seems like a skin yeast infection. Is there anything I can try at home?
Submitted: 5 years ago.
Category: Dermatology
Expert:  Dr. Nair replied 5 years ago.
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Your history is consistent with a diagnosis of 'Seborrheic Dermatitis'. This is a condition where the body loses tolerance for a yeast called Malassezia (which is present normally on all our skins) and starts attacking it leading to redness and scaling. Itching is variable but can be severe.

The highest concentrations of the yeast responsible are present in the scalp and face (especially the sides of and below the nose, central part of the face including eyebrows and behind the ears) so these are the sites most frequently affected. They may be involved singly or in combination.

Here is what will help:

1. 1% Cortizone cream + 2% Miconazole cream: Mix and apply twice a day for 14 days over the affected area on the face. Then once at night for 4 weeks.

2. Nizoral-AD shampoo: apply and leave for 5 minutes on the scalp after working up a lather. Do this every alternate day. (e.g Mon-Wed-Fri). Use regularly for 4-6 weeks then start decreasing the frequency of application gradually till you reach once a week and maintain. This is important even if there are no scalp symptoms as in your case. Johnson & Johnson baby shampoo on a cutip should be used to carefully remove the scales from the eyelashes if they are stuck there.

3. Tab Claritin 10 mg morning and evening for 10-14 days.

4. Cap Lumitene (Beta Carotene) one morning and evening for 1 month. This is an excellent anti-oxidant and decreases the inflammation associated with this condition.

5. Tab Biotin 5 mg - morning and evening for 3 months.

6. If sunlight aggravates the condition then try and stay out of direct sunlight as much as possible or use a sunscreen.

NOTE: All of the above are available without a prescription. Plaquenil does not cause seborrheic dermatitis, so you can keep taking it.

Edited by Dr Nair on 12/11/2010 at 5:23 AM EST
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