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5.06.2013

TL;DR: On Dermatitis [UPDATED 06/04/13]

If you've read any of my previous posts - specifically the beauty reviews - you've heard me complain about my skin. My complaints started showing up on my blog beginning with 'severe chapped lips' - this IceBlock post here is in fact completely dedicated to the solution I found for them, after nearly two months of being unable to wear lip products (they looked disgusting on my lips). In reality, my problem started before though, although it wasn't annoying enough for me to think much of it. It began with a dry patch on my left cheek - one that I kept picking and scratching at whenever it itched or got drier than usual. I thought it was just dry skin, and perhaps it really was, but once 2013 came around, that patch turned into a whole rash on my face that would soon be diagnosed as dermatitis.




First, a quick history about my skin: the only time I had truly oily skin was when I was a teenager going through my acne phase. After that, it was for the most part 'normal,' though my acne persisted for reasons that I would soon understand to be my screwed up hormones (a TL;DR post will be up on that eventually). So the only skin troubles I suffered through on my face were persistent acne, and additional breakouts/hives when I ate something that didn't agree with me. Birth control fixed the hormonal acne, but the acne from food allergies/sensitivities continues to this day, though not often since I'm pretty keen on what to avoid.

When I developed the dry patch on my cheek, and the eventual peeling around my mouth/eyes/nose, I thought, well damn, I have dry skin now. (I don't know if this is just me, but I don't associate 'dry lips' as a characteristic of dry skin - so my lips becoming severely chapped didn't support my theory - it just made me even more annoyed about the overall scaly look of my face.)

The progression of my dermatitis/excessive dry skin went as follows: the dry patch on my cheek got bigger and redder, the top of my lip (cupid's bow) got red and itched, my lips chapped horribly, I managed to cure my chapped lips within a month, I developed a red patch on my right cheek, both patches began to peel with my cupid's bow, my lower eyelid/inner corners began to peel and itch, my chin began to itch, and eventually work was a nightmare because several sections of my face itched like crazy all day long. It would calm down at home, but being at work made it so much less tolerable. This happened between February - when my chapped lips were pretty bad - and April, when I finally decided it couldn't just be dry skin and visited a dermatologist.

Here are some pictures to give you an idea of what my skin was doing. The first is a picture taken back in February (02/08/13) and the latter is a picture from April (04/05/13).

02/08/13: You can probably just make out the pinkish redness on my cheeks, but no flaking is present. 

04/05/13: Here is a close-up of the left half of my face - the worse half . You can see some red pores from the scratching and white flakes are definitely apparent.


Not only did the red, peeling areas itch continuously throughout the day (again, mostly at work), but the flakes looked awful and made me feel just as awful since (a) my job requires a ton of customer interaction face-to-face and (b) I couldn't cover it and exfoliating did nothing - it would simply begin to flake again after 5 minutes.

Over-the-counter hydrocortisone cream would make it itch more, moisturizers of all kinds wouldn't help with the flaking - I was a mess. Seeing a dermatologist was all I could do.

I was diagnosed quickly and visually with dermatitis, though he wasn't able to pinpoint which kind specifically since the cause of it was unclear. The biggest potential causes were products I used, since I use a lot of different makeup products, and my job, since my skin itched so much more there and...well...there is no denying that my job is dirty. Everything is dusty, overstock is kept in totes where shampoos spill on everything and fragrances mix into one perfumey mess...you get the picture. And on top of that, I never had this kind of reaction before, which made my job look even more likely to be the cause (to me at least) because back when I was 13 I used a TON of different lip glosses for about 2 or so years and never had any skin problems. Why would makeup start to bother me now?

In any case, the dermatologist prescribed Desonide, a topical steroid that would reduce the inflammation and itching, and told me to apply it to the affected areas twice a day for a week, and then once a day for another week. I would then have a followup to see if the problem cleared, and after that I would have to wait and see if it returned.

It took a few days for the Desonide cream to kick in, but when it did I was so thankful - my skin was finally not itching anymore! It itched occasionally at work, but nothing out of the ordinary. The followup came and went, with my skin looking fine when he checked it, and all was well for almost a week after.

The followup was a Tuesday. The Saturday of that same week was when it started again.

But then things didn't make sense. I thought my job was the true cause of the problem, but I was off both Friday and Saturday, and my upper lip/cupid's bow was the first to get red and itch. By then I wore a few lipsticks with no problem, so I thought maybe it was a certain line of lipsticks in my collection causing the problem. The ones that felt like the culprits were my Milani Color Statement lipstick and my YSL Sheer Volupte Candy lipstick - both which I wore for the first time that day.

On top of that, I was using a lotion with SPF that my dermatologist told me to use to moisturize my face, and I noticed it was giving me little bumps on my skin (not something alarming, since that was a normal skin reaction for me, unlike the dermatitis) so I decided to use my facial wash with salicylic acid. The next day at work, my skin was itching nonstop again. Suddenly even the facial wash seemed to be a potential cause.

After a few days of no lipstick, my cupid's bow went back to normal, but my cheeks kept itching on and off. I tried a few more lipsticks and had no problems but, again, other parts of my face seemed to fluctuate in terms of how much they itched. A week after my follow up I decided to schedule another appointment with my dermatologist, letting the secretary know that my dermatitis was resurfacing. By Tuesday of this past week - the day of my appointment - my left cheek had become red again and my face didn't only itch at work - it itched in the subway, too, which was new for me.

The dermatologist scheduled me for an allergy test and told me to use the Desonide cream once a day again. I noticed results within a day - the redness and dryness on my cheek went down and the itching nearly stopped. And then came yesterday, the day of my allergy test.

back patch test is used to test for chemical allergens characteristically known to be causes for a type of dermatitis called contact dermatitis - that which I seemed to be experiencing. And at first I was grateful that a back patch test meant no needles, but now I can say that every test must have its drawbacks because my back has been feeling so annoying.

The dermatologist's assistant pretty much put rectangles of tape on my back - tape with sections of 80 different common chemical allergens (those found in cosmetics, lotions, washes, shampoos, etc.) - and then covered those rectangles with layers of paper tape. All across the top two-thirds of my back.

Take a look:



Not only does the tape feel tight on my back, but it's constantly peeling off the edges and when I woke up this morning, it was sticking to my pajama shirt in a ton of different places. I'm glad I showered/washed my hair yesterday before the appointment, because until tomorrow night I can't get the area wet, which means careful washing of my body and no washing of my hair. And the tape itself itches on and off.

On the bright side, I've had no persistent itching that would signal the development of dermatitis on an affected patch of skin. Which is good news to me because it means I may not be allergic to chemicals in a majority of cosmetic product labels. The thought of skimming labels during every shopping trip is...frustrating.  But, of course, I still have until tomorrow to know for sure (it takes up to 2 days to feel a reaction, if there is one). If all 80 chemicals come out negative, then that means we have to move forward to other kinds of tests, including those for dust and those for food. For now I just have to wait and see.

I know this post is kind of messy, but I wanted to put it out there to describe the progression of my dermatitis and give you insight on how the testing is done/feels. I'm clearly not at the end of the road with this one yet, but I'll update further as I get test results/take more tests if necessary.

Tomorrow I have to go to work with this tape...I am dreading that. -_-

[UPDATE 05/13/13]: Last week was the week of the two followups, and I'm so glad that is over (though I may as well put it out there: I'm still not done with my problem). When I went to work with the tape on my back on Tuesday, it felt so hot and disgusting. On top of that, my back waited until work to start itching - full-blown. It was making me squirm it was so bad. Going for a walk during break calmed it down, but for some reason when I was working it itched all over nonstop. -_-

Anyway, that Tuesday night was thankfully the first followup, which at least meant that the damned tape would be removed. That alone made me feel 10xs better, but I still could not scratch or wash the area until Thursday mornings final followup. At the time of Tuesday night's appointment, I had no reactions on any of the spots that had chemicals applied to them, but I still had until Thursday before I could rule out that I was not allergic to any of the test's 80 chemicals.

By the time I was getting ready for bed, one itchy bump surfaced on the lower right side of the test site. My back itched in other places too, thanks to the leftover adhesive from the tape, but my mom only noticed redness in that one area.

Work on Wednesday was tolerable but annoying still. And so I was thankful when I was getting to bed early for my appointment Thursday morning, when I would maybe finally have an answer to my problem.

WELL! - That bump ended up being a reaction, and it was in the area that chemical #70 was applied - benzoyl peroxide.

What?

I haven't used benzoyl peroxide in YEARS. I've only used salicylic acid when I have acne. The dermatologist said that was strange, and decided that I could do the blood test for dust allergens. Regardless, I'm still allergic to benzoyl peroxide, so now I tend to avoid touching the acne medications (which are totally sealed in packages...) at work.

Aside from the fact that I never use benzoyl peroxide, though, the stranger thing about the whole ordeal is that the small itchy bump from the test stopped itching within a day, while my face itched like crazy at work that same week. How can benzoyl peroxide be the same cause of my dermatitis if the reactions differ so vastly in severity?

And so the search continues...I haven't yet scheduled an appointment for the blood test, but I remain frustrated as my upper lip randomly goes red and itches, and my cheeks itch over and over again at work. I never thought this would be so damn hard but it seems like I never get anything simple anymore.

[UPDATE 06/04/13]: Back again! And this may be one of the last updates for this topic, because it's FINALLY healing.

I never did the blood test because of my surgery that came up, and because I didn't want my mom to shell out another $30 for a stupid followup appointment. I figured I'd get to all that once I was recovered and well. But I may not have to (saying that first day post-op by the way).

Between the last update and this one, my dermatitis continued to flare up. I stood off ALL cosmetic/facial products for two weeks and saw that the problem was still fluctuating, to the point that it started burning again. My dermatologist had prescribed a different cream - less concerinng than the Desonide steroid - called Elidel (not a topical steroid), and I used that on my my hot spots: my cupid's bow and my cheek.

Well, by the next morning at work, my lips were cracked, burning, and peeling. It was awful. It took almost a week to recover from that, during which I applied the Elidel cream a few times more, until the redness toned down a lot.

Of course, it flared up again after a week, and I experienced cracked lips again after reapplying the Elidel cream. This time, I discontinued my use of the treatment after the first application.

I'll get more into this in an IceBlock post, but while all of this was going on, I was aware of my (then) upcoming surgery and the fact that I would most likely quit my current job after that. I also planned to clean my room in preparation for that surgery, since it had become quite dusty (I'll admit it; I'm lazy when it comes to cleaning) and still had traces of Lola-hair since she shed her winter coat. Since both the dust and my ferret were personal causes of concern for my dermatitis, the cleaning had to be done.

Additionally, my mother - fed up with the side effects of my Rx treatments - purchased Prosacea, a homeopathic gel for a different skin condition with similar redness and irritation, Rosacea.

In the end, I managed to find another job that will be hiring me once I'm done recovering from surgery, so my last day at Duane Reade was this past Sunday. Between that happening (which lowered my stress level a lot), cleaning my room, and the use of the Prosacea cream, I cannot pinpoint if it's a single one of the three changes or a bit of all of them - but my dermatitis has decreased significantly. I even used some makeup this past weekend and suffered no flare ups, which really put me at ease because I've been so scared it was my cosmetics screwing my skin up.

My skin hasn't looked healthier - I mean, I've been looking at a face filled with redness and rashes nearly nonstop since the beginning of February or so, and I really notice a difference in my skin now. It barely itches in the 'hot spots,' it has a glow to it as its natural moisture has been returning, and it is so much more even/less red.

Since I don't know the cause, I cannot say this will be my final update or not, as my dermatitis may return at any time. But, for now, I actually feel healed. And I'm so thankful for that, because I have many other things to be concerned about/work on these upcoming months.

Anyway...once more:
'Til the next update (which will be on this post!). ('<>')>

~nikki

Please share your experiences with dermatitis, allergy tests, or any skin problems you've dealt with below! Reading up on these things (and peoples' experiences, especially) is both informative and comforting/encouraging for others going through the same nightmares. 

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