Hello everyone, I am writing here to have an opinion or at least to know what this skin condition is, of which I will now explain the anamnesis in detail. This dermatological situation has persisted since 2019, diagnosed for years as acne and therefore treated as such without ever having a positive outcome. In 2023 I was diagnosed as pyoderma, therefore subjected to multiple topical antibiotics (ozenoxacin, mupirocin, retapamulin, aureomycin, clindamycin and erythromycin) and systemic (Erythromycin, Klacid, Bactrimel, Amoxicillin and two cycles of doxycycline and one of tetracycline and one of minociclin) without ever having a minimum result, indeed if anything it was evidently getting worse. Consequently I performed several swabs directly on the liquid (all negative results) and two nasal swabs (also negative) and one pharyngeal (negative). I follow a healthy and active lifestyle, I don’t drink or smoke, and I am very careful about my diet (followed by a nutritionist). I also had tests to exclude immunological problems and fortunately none, followed by tests for intolerances. I also did various tests to check if it was a mycosis.The lesions appear, sometimes as hard, shiny red plaques that within a few hours become orange and release yellow liquid with the formation of myeliceric crusts and they cause a lot of itching.Their formation is preceded by a thickening of the skin followed by edema and yellow crusts. Many times instead they appear as yellow dots always with a light crust, very often they also form directly under the eye area. Doctors continue to say that it is not an infection, but at this point I no longer know what to think having tried everything. Only one doctor had suspected a possible cutaneous leishmaniasis, I don’t know what to think. Could it be? And above all, what could cause these things to come out? Thank you.
@Haflinger98 this condition isn’t well understood by the medical profession. Doctors usually think it’s impetigo or some other kind of infection. However, tests for infection always come back negative as in your case. People just have theories. My theory is that it’s demodex mites. My symptoms seem a very close match with those caused by increased numbers of Demodex folliculorum. The treatment that works for most of us is Soolantra cream. It’s primarily used for rosacea treatment but it can also be prescribed off label for a number of conditions like seborrheic dermatitis, perioral dermatitis and acne. The active ingredient is ivermectin. Shortly after I started using Soolantra it became obvious to me that things were changing with my skin. It wasn’t instant for me but after about 4 weeks there was significant improvement. I don’t get lesions very often now and they don’t ooze anymore. My dermatitis has cleared up and my skin is much less dry and irritated. My journey is well documented on this forum. I think it’s worth you trying this product. I’m quite confident that it’ll change things for you in a really good way. I wish you all the best. Please let us know how you get on.
I believe it’s some type of papular rosacea, which has a range of triggers (spicy food, sun exposure, temp changes, exercise, etc). It’s characterized by red/pus filled bumps around the T-Zone (forehead, cheeks, nose). Many users here have reported success with Soolantra (prescription required) which helps treat rosacea. You can also try over the counter options like sudocream (zinc helps treat rosacea) and azelaic acid. Foods that help manage Rosacea can also help (fish, whole grains, leafy vegetables, etc). Interestingly fermented foods are also beneficial and users here have reported success with incorporating Sauerkraut into their diet.
Personally, Soolantra helped me for awhile (1-2 years) but the bumps eventually started returning even after applying it everyday. Went on long-term low-dose accutane afterwards + diet changes and that keeps me nearly clear year-round.
Best of luck!
I can’t take Accutane due to a heart’s congenital issue. However it’s strange that after a couple of years taking Soolantra your lesions came back, maybe they weren’t caused by demodex. On this site I read that another user after taking Accutane he had not seen any improvement, only with Soolantra he cleared up his skin. So Accutane in my case isn’t recommended. Every dermatologist he advised me against it.
Thank you very much 
.
Papular Rosacea can be difficult to treat as there is no “cure” and a wide range of possible triggers/causes. Personally, it took a very long time and multiple dermatologist to finally conclude it wasent just acne. We made the connection b/c my eyes were frequently irritated (ocular rosacea) and this led us to the papular rosacea diagnosis.
I’ve been on accutane 9+ times, and it works well, but as soon as I’m off the medication the lesions start to return. So my case is a bit extreme. I’m considering transitioning back to Soolantra to give my body a break and see if it holds up now that I’m managing my triggers and diet better.
In your case I’d suggest giving soolantra & the other options listed a try & see how it goes!
Ok, thanks. In my case infact it isn’t rosacea. I’m glad you’re feeling better now.
The oozing and yellow crusting is not something that is typically associated with papular rosacea. My dermatologist was completely stumped. But Soolantra worked for me.
My thoughts as well. However we pulled up some case studies where people with Type II Rosacea were getting these oozing lesions & crusties. I’m also active on the Rosacea subreddit and a fair amount of people experience this condition. The lesions pop up with/without the hallmark facial redness of rosacea.
https://www.reddit.com/r/Rosacea/s/kt1PaVEDIQ
For most of them, soolantra, accutane, or lifestyle changes was the fix, although many report the same issue as me (accutane only works while you’re on it). So, I’m hoping another round of soolantra does it for me.
@Mkvm1469 all the best with it. Fingers crossed.
Here’s what I got from my derm:
The yellow oozing + crusting is serous fluid (plasma), it’s stuff that seeps out of a wound (I.e if you scrape your knee deeply or get a bad sunburn) & it’s a normal part of the healing process (also why impetigo, staph, infection, etc tests usually come back negative in our case). For some reason our pustules & lesions develop into deep/open wounds and the continuously leaking fluid is our body trying to scab it over, whereas traditional acne is just filled with pus.
For active oozing lesions, treat it like an open wound (clean with saline, apply healing ointment, apply breathable bandage).
Since accutane is not an option in your case, I’d again still recommend Soolantra. It’s traditionally used for Rosacea, but it’s particularly effective in preventing pustules and reducing inflammation.
Hopefully this info helps!
Must i do soolantra on active oozing lesions?
Your info is very good.
I personally avoided applying Soolantra onto active lesions, instead focusing on speeding up the healing process. I cleaned them with a saline wash, applied Sudocream or Neosporin then a breathable bandage. Once the oozing stopped (1-3 days) I’d apply Soolantra over the spot.
Thanks for your answer. I hope soolantra wil help
Does soolantra realy helps. Because if i take antibiotic it helps. But when i stopped it come back. Is it a bacterie than and wil soolantra helps. Culture was negative for stafylokokken
Many users here (95%) report success with Soolantra, & no effect with antibiotics (me included). So, good to hear antibiotics helps you.
Soolantra works by killing demodex mites on your face, which can cause redness + pustules on your face. It’s also an anti-inflammatory. All of this helps prevent the oozing lesions.
Everybody’s skin is different however! What works for others might not work for you & vice-versa. That being said, since you’ve already been prescribed Soolantra I’d run the course to see the effect (usually takes 4-8 weeks). The first few days/weeks are usually the worst (die off phase) so don’t lose hope!
My Dermatologist said me to apply the cream for 4 days.
I started using soolantra in 2016 and it’s worked great since then. I’ve stopped using it several times for up to 3 months. After 3 months the lesions start to return so I just start using soolantra again. A 60g tube usually lasts me 2-3 years.
It’s unclear what this disease exactly is.
Most doctors don’t go further than swabs, blood tests and trial-and-error medication. But what is usually missing is a very skilled dermatologist with experience in diagnosis by microscopy. Most dermatologist that I’ve seen, don’t perform microscopy. But the last dermatologist that I’ve seen (which I believe is a very skilled person in identifying skin disease), looked a bit surprised when he asked me if the others did microscopy, and I said they did not. But just right before I met him, my skin disease was already almost gone, so I could basically only show him photos, so I couldn’t go back with a good skin lesion for biopsy.
Today i get soolantra, do you use it 1 or 2 times a day? I hope it wil help. And do you wash your face with soap every day?