Medication Induced Rosacea

Many of the products and treatments commonly used in the for eczema, psoriasis, and dermatitis are harsh for the skin resulting in a medication induced rosacea.

Use of steroids may be beneficial in treating severe eczema, psoriasis or dermatitis on the facial skin but steroidal must be limited to no more 7 to 10 days and closely follow the directions for use. Always use the minimal amount possible. Continued or over use of steroids can result in thinning of the skin as well as a skin dependency on the steroid or ‘steroid addiction’.

When a rosacea patient is erroneously treated for a prolonged time with topical steroids the disorder may at first respond, but inevitably the signs of steroid atrophy emerge with thinning of the skin and marked increase in small blood vessels or telangiectases. The complexion becomes dark red with a copper-like hue. Soon the surface becomes studded with round, follicular, deep papulopustules, firm nodules, and even secondary comedones. The appearance is shocking with a flaming red, scaling, and papule-covered face. Steroid rosacea is an ‘avoidable condition’ which in addition to disfigurement is accompanied by severe discomfort and pain. Withdrawal of the steroid treatment is inevitably accompanied by exacerbation of the disease which if very painful and irritating condition for the patient. (Drs. Gerd Plewig and Albert Kligman).

Other medications used in treatment of dermatitis or eczema, which can result in a medication – induced rosacea include a group of non-steroidal creams and ointments such as Pimecrolimus Creamsold under the brand name Elidel. Known by its generic name pimecrolimus cream.

Before using Elidel or Pimecrolimus Cream its best to discuss possible side effects and warnings of this drug with your doctor it is not unusual to experience skin burning, stinging, itching, or soreness at the site of application of the medication. These side effects are most common during the first few days of treatment and typically improve as the lesions of atopic dermatitis heal.

Other, less serious side effects may be more likely to occur:

  • Irritation of nose and throat
  • Cough
  • Headache
  • Diarrhea, constipation, or upset stomach
  • Skin infection

The FDA has issued a public health advisory to inform healthcare professionals and patients about a potential cancer risk from use of Elidel (pimecrolimus). This concern is based on information from animal studies, case reports in a small number of patients, and knowledge of how drugs in this class work. It may take human studies of ten years or longer to determine if use of Elidel is linked to cancer. In the meantime, this risk is uncertain, and FDA advises Elidel should be used only as labeled, for patients after other treatments have failed to work.

It is often not the diagnosis of eczema or dermatitis that is in error but the choice of treatment that leads to a pre-disposition for rosacea.