Topical corticosteroids are inappropriate for long-term use. Pimecrolimus is much safer for long-term use and tacrolimus is more potent than pimecrolimus. Many who use azelaic acid use too much quantity and get irritation. Much smaller quantities are appropriate. Adding additional agents such as topical ivermectin and metronidazole may additionally help for rosacea, as could imidazole antifungal agents and similar for seborrheic dermatitis.
I 34(F) have been seeing a dermatologist over the course of several years, unfortunately Im in a healthcare system that is hit and miss with varying levels of doctors. Its also a healthcare system with a different first language to mine.I have been diagnosed with rosacea and seborrheic dermatitis. My skin goes from angry inflamed redness to dry and flakey.Initially I was advised to use steroids on the redness inflamed areas and to moisturise 2-3 times a day. To be honest, this doesnt work. Im using steroids weekly. I saw a good dermatologist who prescribed elidel cream which is ok, though it has not really worked well enough to prevent flare ups.Since then I was prescribed skinoren (which burns), told to wear sunscreen with multiple application daily and to start tacrolimus ointment. Avoid stress (Im a mum of 2 very small children and a critical care practitioner, so easier said than done).One dermatologist told me to stop steroids on my face as I had ?lines as a result of long term use. So should I completely stop?I cannot start tetralysal as Im breastfeeding.Are my options limited without oral medication? Will the results be worth me weaning?Im feeling pretty miserable as a woman when I can no longer wear make up without significant flare up and people asking what happened to your face?Advice is conflicting, often superficial and although I understand its chronic, will I ever have good enough skin to feel my normal self again? I only developed this in the past 6-8 years.Obligatory: BMI 20, non smoker, enjoy a glass of wine regularly. No other medical conditions or medication.