Struggling with Eczema and Facial Rosacea - Biologics Proving Ineffective
I really need some assistance! Hello everyone, and thank you in advance for your help. I’m a 26-year-old female who has faced significant skin challenges throughout my life. Having battled eczema since childhood, I’ve seen a marked increase in its severity over the years. In 2019, I was admitted to the ICU due to DRESS syndrome and, despite a prolonged course of prednisone, my skin issues persisted. I have consulted numerous dermatologists and experimented with an alarming array of treatments: Doxycycline, Methotrexate, Dupixent, Rinvoq, Ciclosporin, and Cibinqo. Most of these medications have either had no effect or exacerbated my condition. I did notice some improvement with Rinvoq, but it led to elevated liver enzymes. Dupixent, on the other hand, resulted in large patches of skin flaking off, alongside an overall reddening and purpling of my body. Currently, I’m using Cibinqo, which has offered some relief; however, I still struggle with facial redness and eczema on my upper body. My doctors seem to agree that I've simply been unfortunate, and they feel allergy testing isn't worthwhile. They continue to prescribe various medications, yet I see little to no improvement. For the past 18 months, I've been on different doses of prednisone, and whenever I attempt to lower my dosage below 5mg, I experience widespread rashes. At present, I’m on a 10mg regimen. I’m unsure of what to seek, but I feel overwhelmed and believe my healthcare providers are not acknowledging my concerns. I wonder if there might be an underlying issue causing my lack of response to these treatments. Here are the results from my recent blood tests taken on April 11 that are outside of the normal range: - WBC: 12.8 K/uL - RDW: 14.7% - Platelet Count: 428.0 K/uL - Immature Granulocytes: 0.9% - Neutrophils: 9.06 - Absolute Monocytes: 1.01 K/uL - Absolute Immature Granulocytes: 0.11 K/uL
Answers (1)
6/20/2025, 4:40:56 PM
OpenHealth AI
It sounds like you're facing a very challenging situation with your eczema and rosacea, and your frustration is completely understandable. Your history of complex responses to treatments indicates that you're likely dealing with a multifactorial skin condition that may require a customized approach. Here are some main points to consider as you navigate your options moving forward.
Explanation
Eczema, especially when combined with conditions like rosacea, can often be complicated by factors such as skin barrier dysfunction, inflammation, allergic reactions, and other underlying health issues. The fact that you've experienced adverse effects from numerous biologics suggests that your skin may have unique sensitivities or reactions needing special attention.
Next Steps
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Symptom Journal: Start by documenting your skin's condition daily, noting flare-ups, triggers (like foods, stress, products, or environmental factors), and any new symptoms, such as increased redness or itching. This can help identify patterns that may indicate underlying issues and inform your healthcare team.
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Topical Treatments: While you're managing systemic treatments, consider consulting a dermatologist about topical therapies. Options such as non-steroidal creams with ingredients like tacrolimus or pimecrolimus might help control inflammation without the side effects associated with systemic steroids.
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Gentle Skincare Routine: Implement a gentle skincare regimen using fragrance-free, hypoallergenic products. Creams containing ceramides can help repair the skin barrier, and avoiding harsh cleansers may minimize irritation.
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Diet and Lifestyle: Consider assessing your diet for potential allergens or irritants (like dairy, gluten, or other common allergens) that may exacerbate your skin conditions. Maintain hydration and include omega-3 fatty acids, which can promote skin health.
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Second Opinion: If you're not feeling heard by your current healthcare providers, seeking a second opinion from a specialist in complex dermatological cases may provide new insights or treatment options. A dermatologist specializing in chronic skin conditions could explore other treatments for immune modulation or different biologic classes.
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Blood Tests Review: Discuss your recent blood tests with your doctor to understand the significance of the elevated white blood cells and platelets, as these could indicate underlying inflammation or another issue. This might lead to further investigations or referrals to specialists, such as an allergist or rheumatologist.
Reassurance
It's important to remember that chronic skin issues can take time to manage effectively, and responses to treatments vary greatly from person to person. You deserve a treatment plan that acknowledges your concerns and experiences, so don’t hesitate to advocate for yourself and seek collaborations in your care.
Please keep track of your skin and overall health and stay proactive in discussions with your healthcare team. Let me know if you have more questions or need further details!
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