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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 itchy flushed skin on my chest and neck area for

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I have itchy flushed skin on my chest and neck area for about 4 weeks. Extremely itchy on the nipples. My face was also red and swollen. What do you think is my problem?

Does this flushed appearance come and go or is it persistent?

Any hives since the flushing started?

Any diarrhea or asthma like symptoms?

Any acne like bumps on the face?
Customer: replied 5 years ago.

The flushed appearance come and go, but was never completely gone. So it is either light pink or bright pink.

First I have goose bumps then they truned into small patches of hives or rash, only on areas surround the nipple on both breasts. At its worst, they look red/purple, angry, painful and extremely itchy. Any clothing.would make me uncomfortable.

Diarrhea yes, asthma no.

Only mild acne-like bumps on the forehead.

Also at one time I scratched my right eyelid and it got swollen at one corner like a dark color blister. It got bigger today.

Some history - I have had experience itchy nipples in the past years, starting at around 3-4 years ago, but was never this bad.

I have had contacted poison ivory each year for the last 3 years. But I am not sure this is poison ivory, because the problem is limited to my chest, neck and face and I don't have blisters. Although I did touch some plants in the garden 2 or 3 days before all this happened.

One more thing...I also have itchness in my private part (down there), with very small rash around the rectum at the beginning but was gone now. The itchness still come and go.

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Thank you for all the information. You seem to have two distinct problems. The symptoms of the face and neck are suggestive of either Acute Urticaria or Rosacea. Rosacea seems more likely since the redness in Acute Urticaria (hives) is not persistent.

There are numerous medical options for treatment of Rosacea. I usually start with Capsule Doxycycline 100 mg twice a day for 1 month and then once daily for 2-3 months + Metronidazole gel applied over the affected area in the morning and Tacrolimus ointment at night. + an SPF 50+ sunscreen. Sun protection is extremely important during therapy.

Lastly if possible I would recommend getting urine and blood tests for a rare condition known as carcinoid syndrome before the diagnosis of Rosacea is established.

NOTE: All of the above are prescription drugs however. I would recommend seeing your dermatologist/GP/Family physician and discussing my recommendations with him/her.

The nipple syptoms are suggestive of Nipple Eczema.This should respond to a mixture of 1% Cortizone cream mixed in equal parts with Bacitracin ointment applied twice a day for 7-10 days along with liberal use of moisturizers. Also take Tab Claritin 10 mg twice a day to help with the itching. All these are available over the counter without a prescription.

Hope this information is useful, please feel free to ask if you have any queries.

Customer: replied 5 years ago.
Thanks for the information.

The hives or rash around the nipples is persistent, just at time it is better and other time is bad and angry.

Can you tell me the treatment for Acute Urticaria? What causes it?
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You're most welcome! Acute Urticaria is usually caused by either intake of a new prescription drug like penicillin or an OTC drug like aspirin, systemic infection (either bacterial or viral), food additives or seafood or intestinal worms. The last is usually only of significance in children. Stress is also a major cause of an outbreak. There are numerous rarer causes, however if all of the above are ruled out then I always get a patients thyroid function test done as hypothyroidism is often a cause.

Many times it is not possible to find out the cause, however most episodes of acute urticaria are self limited, usually within 6 weeks of onset of symptoms.
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