OpenHealth Q&A

Dealing with Eczema and Skin Reactions

Age: 27, Gender: Female Weight: 128 lbs, Height: 5’5" Since 2021, I have been struggling with eczema on my upper lip, characterized by yellow, oozing crusts that appear when I wake up. Initially, I managed this condition with Desonide and Tacrolimus, but I was unable to reduce the usage without triggering a flare-up. Consequently, I opted for a natural healing approach, which led to significant improvement over the next two years, achieving about 80-90% recovery. At the beginning of 2025, I resumed Tacrolimus in hopes of complete healing, and since 2023, I have not experienced any oozing or crusting. However, in April and May of this year, I faced a minor flare-up that mostly resulted in dryness and flaking without any oozing or itching. Towards the end of May, I became ill and was prescribed Azithromycin on May 29. While my health improved, so did my skin condition, which cleared up entirely. But shortly after finishing the antibiotics on June 8, I encountered another flare-up with yellow crust reappearing on my upper lip and the return of itchiness. Despite my continued use of moisturizers and Tacrolimus, there was no significant change in the crust formation. On June 17, I decided to discontinue Tacrolimus, believing it was best to let my body address what appeared to be a bacterial issue naturally. I then began applying Fucidin 2-3 times daily. By June 19, the crustiness subsided, leaving only dryness in its place. On June 20, I introduced azelaic acid to my facial routine (avoiding the lip area), but my face reacted with persistent itching and burning sensations, which I still can’t ascertain were connected. The next day, my skin felt excessively tight and parched, prompting me to cease using the azelaic acid. From June 22 onward, the tension and dryness intensified to the extent that moving my facial muscles became painful, regardless of moisturizing efforts. Overnight into June 23, I experienced severe itching across my eyes, forehead, jawline, and cheeks, waking up with hives on my eyelids and cheeks, accompanied by puffiness, redness, and an irregular texture. Despite taking Benadryl, the discomfort persisted. On June 24 and 25, the area around my eyes remained extremely itchy, red, and dry, with new eczema patches appearing on my eyelids and the outer corners of my eyes. On the morning of June 26, I accidentally scratched my lip during sleep, reigniting oozing and crusting. The following day, June 27, I awoke to significant swelling on the left side of my face; it felt inflamed, tight, itchy, and burning. After visiting the ER, I was instructed to discontinue Fucidin and to begin a five-day course of Cephalexin. By this point, my skin was at its driest and most painful state, requiring cold compresses for relief. On June 28, I noticed reduced swelling and redness, but my skin continued to suffer from dryness, tightness, and flakiness. Participating in a tournament that day caused my eyelids and upper lip to become aggravated and reddened, although this calmed down after a while. On June 29, I found more crust on my lip than before and renewed swelling on the left side of my face, with reduced tightness compared to earlier. By June 30, I still experienced swelling in my left eyelid and under-eye area but less than before, while the crust on my lip persisted and was worse than prior to starting antibiotics. I have seven pills remaining from the original supply of twenty, but I'm noticing improvement elsewhere on my face—the dryness is flaking away, revealing smoother skin beneath.

Answers (1)

6/30/2025, 4:31:12 PM

OpenHealth AI

It sounds like you're experiencing a complex situation with your eczema, influenced by various treatments and recent health changes. Your primary concerns seem to be managing flare-ups, addressing the crusting on your upper lip, and finding a way to reduce overall dryness and irritation. Let's focus on actionable steps to help you navigate these skin challenges effectively.

Main Points

• Your eczema has shown improvement with previous treatments but has recently flared up, causing discomfort.
• It's essential to address both the immediate symptoms and underlying inflammation.
• A systematic approach to identifying triggers and managing flare-ups will be beneficial.

Explanation

Eczema can flare up for various reasons, including bacterial infections, allergies (like skin products), or stress. The yellow crusts and oozing indicate an inflammatory response, possibly exacerbated by scratching or external irritants. Given your recent experiences with antibiotics and various topical treatments, it’s important to be cautious and focused on a gentle, supportive skincare regimen.

Next Steps

1. Continue Antibiotics: Complete your course of Cephalexin as prescribed, as it may be targeting any underlying bacterial component in your eczema flare-up.

2. Gentle Skin Care:

   • Moisturize Regularly: Use a thick, fragrance-free moisturizer (like a thick cream or ointment) on affected areas at least twice daily to reduce dryness and irritation. Look for products with ceramides or hyaluronic acid.
   • Avoid Irritants: Stop using any potential irritants, including azelaic acid and harsh cleansers. Opt for a mild, hydrating cleanser (like a gentle gel or cream wash).

3. Cold Compress: For immediate relief from itching and inflammation, apply a cold compress to affected areas for 10-15 minutes as needed.

4. Monitor Triggers:

   • Keep a diary of what you eat, use on your skin, and activities to help identify any potential flare triggers (like certain foods, stress, or skincare products).

5. Short-Term Corticosteroids: If the crusting returns or worsens, consider asking about a mild topical corticosteroid to manage inflammation temporarily. This can be particularly helpful if used strategically.

6. Avoid Scratching: Cover areas that are itchy to prevent scratching, which can lead to further irritation and infection.

7. Follow-Up: If you don't see improvement within a week, or if your symptoms worsen, seek further evaluation for a tailored treatment plan.

8. Consider Allergy Testing: If skin irritation persists, you might benefit from consulting with a dermatologist for allergy testing or a patch test to identify possible allergens.

Support and Reassurance

It's understandable to feel frustrated with the ups and downs of managing eczema, especially when you're trying to avoid certain treatments. Focus on these steps, and remember that healing takes time. Being gentle with your skin and monitoring your responses to various treatments can make a significant difference. If you need more specific advice or support, please feel free to ask!