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How to prevent redness and peeling skin around the eyes?

Hello, I have redness and...

Hello, I have redness and peeling skin around my eyes. It is right below the eye lid on my right eye and my left eye has a big spot above and below my eye lid. It tends to happen (as far as I can remember) more during the winter when it is really cold outside. It appears to be very itchy, and looks almost like it is cracking as well. If I do peel the dead/loose skin off, it tends to burn on touch. I want to know how to prevent this

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Answered in 1 hour by:
12/16/2010
Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9,191
Experience: MBBS, MD (Dermatology, Venereology & Leprology)
Verified

Can you please take a photograph of your eye condition?

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Customer reply replied 6 years ago

Sure, here you go. In this picture its not all that red, but at times especially when I apply lotion, etc it becomes so red I would not like to go out looking like that.

Hope that helps...

Thank you for the photograph. Do you have any dandruff?

Does sunlight make this rash worse?
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Customer reply replied 6 years ago

My head does itch a lot no matter what I do or use, so yes I do. And again in the summer time I am great. Its just when its cold it seems like this.

I am also a JA Expert in the Computer Field so I am pretty much behind my laptop all day, but when I do go out, I cant really say to be sure but if I had to guess I would say no.

that helps a lot! Nice to be dealing with another expert on JA :). Give me about 5 minutes. I'm typing out your answer.
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Customer reply replied 6 years ago

Take your time, I'll be here for a long time lol

:)-

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, eyelids and the area around the eyes, 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 should also take care of the scalp itching.

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.

NOTE: All of the above are available without a prescription. Steps 4 & 5 though non essential, will help prevent a recurrence of the condition. Hope this helps!
Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9,191
Experience: MBBS, MD (Dermatology, Venereology & Leprology)
Verified
Dr. Nair and 87 other Dermatology Specialists are ready to help you
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Many thanks for the bonus and lovely feedback :)! All of the products are fine barring the Biotin and the Beta Carotene (there dose per capsule is too low). I usually recommend these from amazon.com. Here are the links:

http://www.amazon.com/LumiteneTM-30mg-100-capsules-Protoporphyria/dp/B001J7O8XI/ref=sr_1_1?ie=UTF8&qid=1292468140&sr=8-1

http://www.amazon.com/gp/product/B000BY2N7S/ref=s9_simh_gw_p121_d9_i1?pf_rd_m=ATVPDKIKX0DER&pf_rd_s=center-2&pf_rd_r=0E2G2FV42JHPTWD052KP&pf_rd_t=101&pf_rd_p=470938631&pf_rd_i=507846

Let me know if you need any more help.
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Customer reply replied 6 years ago

Your Welcome! That's all I needed your awesome!

:)-

Have a great day :)!
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Customer reply replied 6 years ago
Is there any way to permenantly fix this or do I have to KEEP applying those creams for the rest of my life? After doing what you suggested it only cleared up for a couple of weeks but it came right back grrrrr!
HI again,

Sorry I just noticed your PM and reply to the question. Did you continue using the shampoo as I had advised? And did you take the biotin and beta carotene?
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Customer reply replied 6 years ago

Yes, I sure did and to be honest I have to keep using the Shampoo to keep my skin from being so dry and flaky seems like which isnt a big issue for me to do. However, the redness around my eyes drives me insane and if I stop using the creams you told me, it comes back in a matter of a few days so your answer seems like a workaround rather than a complete fix which is fine, however if you can tell me to try someone else that might fix it I would be happy.

Thanks!

Okay. The thing is seborrheic dermatitis is a chronic condition - once the body losed tolerance to the malassezia yeast it does not regain it. So maintenance treatment focusses on keeping these yeast counts low with the shampoo. So in a sense treatment for seborrheic dermatitis is a workaround since there is no cure. That said most patients only flare occasionally after a course of treatment, usually during the change of seasons and the winter months which is not that big a problem since they learn to use the creams for a short while to contain it.

Some patients however are more severe cases and flare soon after treatment is stopped. These patients require prescription medication and here is what I usually prescribe:

Cap Itraconazole 100 mg twice a day for 7 days followed by 100 mg on the first two days of every month for 12 months.

Mometasone cream + Terbinafine cream twice a day dor 7 days followed by Elidel cream twice a day over the affected area for 6-8 weeks. Elidel is non-steroidal and this safe for even long term use.

Continued use of the Nizoral-AD shampoo.

With this I have had numerous patients go into remission for years even after therapy is stopped. However getting the medicines would require seeing your doctor in person. There really is nothing else that is available over the counter apart from the cortizone and miconazole cream.

Lastly its not good to use cortizone cream for months on end below the eyes and since your skin condition has been requiring this it really is time to get the prescription meds. Regards.
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Customer reply replied 6 years ago
ok thank you for the info.
Good Morning,
You're most welcome! Regards.
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Dr. Nair
Dr. Nair
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