Clinically, we have always seen some male and female patients with burning, flushing, itching, pain, tightness, ants, abnormal dryness, etc., caused by using hormone creams or cosmetics mixed with hormones, which do not heal for a long time and repeatedly affect their daily life. “Their painful and tearless situation prompted me to introduce this harmful skin disease so that the majority of patients can understand it and avoid it.
Hormone-dependent dermatitis is due to long-term topical use of glucocorticoid-containing preparations (the characteristic of this drug is an immunosuppressive, immediate effect of use), once the drug is discontinued leading to the recurrence or aggravation of the original skin disease, forcing patients to continue using glucocorticoids, as if drug addiction to produce dependence, this kind of non-purulent inflammation of the skin caused by the topical use of hormones is hormone-dependent dermatitis.
The harm of long-term topical glucocorticosteroid preparations is that the skin becomes thinner, inflammatory reactions occur, the skin barrier function is damaged, and the sensitivity of the skin to various external physical and chemical stimuli increases, and the symptoms described at the beginning of the article will be aggravated when exposed to sun and rain, wind and heat, and spicy and irritating food.
Hormone-dependent dermatitis has various names, such as hormone-dependent dermatitis, glucocorticoid-dependent dermatitis, corticosteroid-dependent dermatitis, steroid dermatitis, hormonal rosacea, hormone-induced rosacea-like changes, and so on. According to the theory of topical glucocorticosteroids and the clinical manifestations, it is now uniformly named “glucocorticoid-dependent dermatitis”, or “hormone-dependent dermatitis” for short.
Hormone-dependent dermatitis is divided into three types according to the location of the lesions.
1. perioral type; 2.
2. Central facial type.
3. diffuse type. The patient above is a diffuse type.
Patients with hormone-dependent dermatitis often have the following manifestations.
Self-perceived itching, burning, dryness, tightness, swelling, and ankylosis of the affected area; lesion characteristics: polymorphic. Chronic phase: dryness, flaking, roughness, erythema, papules, hyperpigmentation, capillary dilation, thinning of the skin, thickening and elongation of the hair. Acute phase: marked swelling and redness. Thus, the clinical manifestations of hormone-dependent dermatitis lack specificity and have different performance characteristics.
According to the clinical manifestations it can be roughly divided into five types.
1, dry and flaky type.
2, inflammatory papule type.
3, pigmentation type.
4, abnormal sensory type.
5. acute swelling type.
These five types can appear at the same time when, but often a certain type is predominant.
Diagnostic points.
History of the patient’s continuous use of hormone (including the use of topical strong, medium and low glucocorticoid use time) drugs for more than several months (or hormone-containing skin care products); rebound of a variety of symptoms a few days after discontinuing hormone drugs, peaking around half a month; this is the basic condition, plus one or two clinical manifestations mentioned above, according to the onset of the site can be clear this disease. Generally, patients first have ordinary dermatitis, because of the formation of hormone-dependent dermatitis after topical application of hormones.
Hormone-dependent dermatitis treatment strategy.
1. first stop using hormone creams or cosmetics containing hormones (something equivalent to drugs).
2, topical: medical skin care products such as dry, flaky: such as soothing moisturizing mask + soothing moisturizing repair cream; mild, redness: soothing moisturizing milk; obvious, redness: the first step: blue skin care; the second step: such as soothing moisturizing milk,
3, cold spray, cold compress: burning sensation, flushing, swelling.
4. For those who cannot completely “detoxify” themselves from hormones at once, they should gradually reduce their medication, such as changing from strong hormones to weak ones, high concentrations to low ones, and using them more often to less often.
5.Replacement of glucocorticoids such as fluphenazine topical cream, tacrolimus or pimecrolimus (use with caution for inflammatory papules): apply to patients who cannot be controlled by the above methods, gradually reduce the number of times after the condition is controlled → gradually overuse only medical moisturizing and repairing cream alone.
6.Oral: (1) hydroxychloroquine; (2) vincristine capsules, clarithromycin (with inflammatory skin lesions).
7. tretinoin polysaccharide: (1) as a second-line drug; (2) or when accompanied by facial swelling.
The key to hormone dependent dermatitis treatment – the key to successful “detoxification”: patients must be patient, the first half to one month is the period of rebound and aggravation of the disease. The first 2 months: systemic treatment combined with local treatment; the second 2 months: consolidation of local treatment; adjustment of local treatment plan according to the individual; careful use of “alternative treatment” – immunosuppressants.
Having said that, the main thing is prevention.
Scientific and reasonable use of glucocorticoids, for facial and infant lesions finally avoid the use of medium and strong glucocorticoids and corticosteroids containing fluoride. If you must use them, you should try to use weak, non-fluorinated glucocorticosteroids for no more than 1 month. Do not use cosmetics that contain glucocorticoids. Of course, there is no need to talk about hormones. As a revolutionary drug for skin diseases, hormones also have advantages that cannot be replaced by other drugs, but the key is to consult professionals in professional institutions to choose good hormones. The key is to go to a professional institution and consult a professional, choose the right hormone, use the right hormone, and make the best of its strengths and avoid its weaknesses, so that it can really serve our face.