A Dermatologist’s Take on Facial Breakouts and Rashes:

Facial eruptions are most commonly due to either allergic causes – such as contact dermatitis – or else different types of yeast infections – such as what’s called seborrheic dermatitis. Sometimes the culprit is as simple as a preservative or fragrance in a new skin care product or makeup. After my 28 years as a practicing Dermatologist, let me share some common diagnoses for facial eruptions, and what can be done about them. After all, your face gives your image to the world around you, and there's a lot that can be done to help the health of your face.

Dermatologists often can diagnose the cause of facial eruptions or rashes based upon our prior experience in treating people with similar conditions. We also sometimes perform different types of skin testing, to help to sort out the diagnosis, such as a KOH test or a fungal culture. If a fungus grows out, we can identify what type of fungus is at fault, to help to sort out where that fungus came from, for instance from a cat or from the yard. Sometimes we do a skin biopsy, which means taking a piece of skin surgically to send into the lab to be stained, to look for certain patterns of cells in the skin. Sometimes we do a type of skin allergy testing, called allergy patch testing, to check for reactions to preservatives, fragrances, dyes, or the hundreds of other chemicals that can cause skin allergies.

This is myself, George Woodbury Jr MD, in my Dermatology office, at Rheumatology and Dermatology Associates, Cordova, Tennessee.

Perhaps the most common cause of facial eruptions or rashes is what’s called seborrheic dermatitis. ‘Seb derm’ for short is a type of skin yeast infection that can start in either childhood or adulthood. Seb derm is perhaps one of the five most common skin conditions worldwide, and it consists of dry or itchy patches on the face, neck, chest, and/or back. It can sometimes overlap with a type of genetically-sensitive skin condition – atopic dermatitis – or eczema.

The above individual has a pretty severe pattern of what's called seborrheic dermatitis, now felt by many Dermatologists to be a type of yeast infection. We sometimes use both prescription topical steroids and topical antifungals to control this condition.

One of the other common causes of facial eruptions is acne vulgaris, or common acne, which is due to a clogging of the openings of the oil glands to the skin surface, i.e. clogged pores. Acne is common on the face, neck, chest, and back, and it can sometimes be associated with nodules in the skin, called follicular inclusion cysts, or ‘sebaceous’ cysts, which at times require surgical removal. The good news is that ongoing research in Dermatology has led to newer, more effective ways of treating it, from prescription topical agents like azelaic acid and retinoids, to newer oral antibiotics, and a systemic drug called isotretinoin (Accutane).

In 2016, I founded a company - Big River Silk Skincare Inc. (www.Bigriversilkskincare.com) to provide cleansers and moisturizers for people with problem skin, to complement the prescription therapies that their Dermatologists may have already recommended. Big River manufactures a really helpful cleanser for people with oily skin and combination skin - AmberSoy Soap Gel - and also a moisturizer containing an Alpha-Hydroxy Agent - an "AHA" - for people who need help smoothing the appearance of fine lines in the skin - called GlycoShea Facial&Neck Cream - which can be called an anti-wrinkle cream.

Rosacea, sometimes also called acne rosacea, is another common cause of facial eruptions. It is often genetic, meaning that it runs in certain families, and breakouts of rosacea also be triggered by certain dietary factors, such as alcohol consumption.

There are dozens of other causes of facial eruptions, including systemic conditions such as sarcoidosis and lupus, and even types of skin cancer, such as mycosis fungoides, which is a type of lymphoma in the skin, so it’s often a good idea to get evaluated by a Board-certified Dermatologist. There are over 12,600 of us in the United States, and you can find one of us in your area by going to the American Academy of Dermatology website, AAD.org, and the plugging your zip code into the “Find a Dermatologist” tab. Even if you’ve been evaluated in the past, ongoing medical research has provided many advances in treatment of skin

conditions, so the bottom line is “Don’t delay. Get evaluated today.”