In clinical practice, we find more and more patients with particularly sensitive facial skin, mainly manifesting as slightly red, irritable and highly sensitive face, and in severe cases, capillary dilation, erythema and papules. And the disease is prolonged, sometimes mild and sometimes severe, often accompanied by the patient’s agitation, depression and lack of self-confidence. Clinicians are often given the diagnosis of sensitive skin or facial dermatitis and treat the symptoms hastily. If we take a careful history and analyze the causes, we will find that most of them belong to hormone-dependent dermatitis. Moreover, the incidence of this disease is high and the misdiagnosis rate is high. In the past, many of those clinically diagnosed as sensitive skin, facial dermatitis, facial seasonal dermatitis, etc. were hormone-dependent dermatitis, and the misdiagnosis rate reached 76% due to the clinicians’ lack of awareness, attention and responsibility. In addition, this disease is very harmful. The state of hormone dependence on the face often lasts for several years or even a dozen years, and the skin changes from sensitive discomfort to erythema, papules, and hair expansion, and most critically, the prolonged course of the disease can bring about serious psychological problems; What is hormone dependent dermatitis? Glucocorticoid-dependent dermatitis refers to the sudden discontinuation of glucocorticoid-containing drugs or preparations after long-term topical use, resulting in the recurrence and aggravation of the original skin disease, forcing patients to continue using glucocorticoids. These include hormonal drugs and skin care products and cosmetics containing hormones. What are the main manifestations of hormone-dependent dermatitis? How can we tell if it is hormone dependent dermatitis? Professor Xie Hongfu of Xiangya Hospital of Central South University proposed the following three elements for the diagnosis of hormone-dependent dermatitis: ① one of the following three types of lesions: rosacea-like lesions; contact dermatitis-like lesions; eczema-like lesions; ② unpleasant triad of symptoms: obvious itching, obvious burning and obvious dryness (appearing about 3 d after stopping the use of hormones); ③ more than 8 weeks of external use of glucocorticoid drugs or skin care products of unknown composition. Judgment points: one is the presence of uncomfortable symptoms, and the other is the aggravation of the original skin symptoms about three days after stopping the use of hormone drugs or suspicious products. There is also a situation where the patient’s skin is very good when using a certain cosmetic product, but after discontinuing it, the skin becomes very poor, or there are skin redness and swelling, etc. This situation also cannot exclude hormone dependent dermatitis. What are the causes of hormone dependent dermatitis? The causes of hormone dependent dermatitis are generally divided into hormone drug abuse and adverse cosmetic reactions. Long-term improper topical glucocorticoid use is the main cause of hormone dependent dermatitis, including:? ① Wrong choice of hormone preparations, ② Excessively long medication time. Experts believe that hormone-dependent dermatitis may be formed by using high-efficiency hormones for >20 days and low- and medium-performance hormones for >2 months. ③ Abuse and long-term use of cosmetics containing hormones or unknown ingredients, and aggravation of capillary dilation, acne-like rash, and fine hair after discontinuing use. How to crack hormone-dependent dermatitis? The main treatment is to restore the skin barrier function, anti-inflammatory and anti-infection treatment. The treatment cycle should last for at least 4 weeks, especially the first 2 weeks of treatment is the key period of withdrawal, after discontinuing the use of hormones, the original skin disease will relapse or even break out, and the skin lesions will be unusually serious. During this period, patients should be given the necessary oral and topical medications to relieve their painful symptoms, of which psychological guidance is particularly important. The specific methods are as follows: ① Immediately stop using topical hormone drugs or suspicious products, and do not use hormone drugs orally. ②Communicate fully with the doctor and patient: clearly tell the patient that the symptoms will start to rebound (i.e., the triad of dryness, itching and burning) about three days after stopping hormone use, but the symptoms will improve significantly in about two weeks. ③Apply topical moisturizing skin barrier repair skin care products. ④Combine with local cold compresses or cold spray when burning is uncomfortable. ⑤ oral medication. Breakthrough method two, anti-inflammatory, anti-allergic This is mainly for the attack period, with obvious rash and discomfort symptoms. Since the disease has the characteristic of recurrent attacks, the treatment is mainly carried out in stages. During the flare-up period, it is recommended to visit a hospital dermatology outpatient clinic for face-to-face consultation and prescribe treatment medication according to the specific situation. When the face is red, swollen, dry, itchy and symptomatic, medication should be applied orally combined with topical medication. Oral medication is mainly anti-allergy medication, plus anti-inflammatory medication. You can use Desloratadine tablets together with Mennen tablets. If the effect is not good, you can consider taking hydroxychloroquine orally. If there is inflammation of the hair follicle, take doxycycline or minocycline. You can also go to the hospital for red and blue light treatment. In addition, 5% glucose injection with 10% calcium gluconate 2.0g and vitamin C 3.0g can be infused intravenously to reduce vascular permeability. Chinese medicine also has good effect on this. The main treatment principle is to clear heat and detoxify the blood. It is recommended to get a prescription from an experienced TCM practitioner. The main care measure for this period is to take cold and wet compresses. Cold spray can be used if available. If the skin is red and swollen with oozing, a cold wet compress is needed. Cold and wet compresses can be applied to the face several times a day after refrigerating saline. Or Chinese medicine decoction cold compress. We recommend a Chinese herbal remedy for wet compresses: 50g of Amaranth, add 500ml of water to the decoction, let it cool and apply it cold. Usually the redness and swelling will subside in three to five days. The cold compress can be combined with topical application of tacrolimus ointment. No topical application of tacrolimus should be applied to the broken areas. After the skin symptoms have basically subsided, tacrolimus ointment begins to reduce the dosage. 1 to 2 weeks to reduce the dosage, reduce to every other day every two days, gradually reduce the dosage until once a week can control the symptoms when try to stop! In addition, some experts have found in clinical practice that tacrolimus can also be dependent on long-term use, so it is recommended to withdraw it quickly after controlling the symptoms. Throughout the process, unless there is oozing when no moisturizer is used, the entire process requires the use of skin moisturizer. Breaking down method three, proper skin care must be taken. Whether in the attack or remission period must take good care of the skin, mainly to do two things: reduce irritation and skin moisturizing. Reduce the stimulation of one is to pay attention to sun protection, the second is to reduce the number of face washing, about 30 ° temperature warm water to wash the face, not with cold water, and not with hot water. Reduce all kinds of external skin irritation. Moisturizing is a constant topic, to apply moisturizer several times a day to keep the skin from drying out. If the economic conditions allow, you can use pharmaceutical soothing moisturizer. And gradually transition to ordinary moisturizer. This period can also find experienced herbalists to prescribe some Chinese medicine for physical conditioning. Or take some oral immune boosting drugs, such as transfer factor capsules, mushroom mushroom polysaccharide, etc. By improving your own constitution, you can achieve the purpose of avoiding recurrence. The Chinese medicine treatment has a good effect on hormone dependent dermatitis. Chinese medicine believes that the attack period of this disease is caused by wind-heat and poisonous evil contained in the skin. The author often uses Wu Wei disinfectant drink combined with Er Miao San orally, prescription composition: Cang Zhu 15 grams, Huang Bai 15 grams, Gong Ying 15 grams, Di Ding 10 grams, Sheng Di 15 grams, Dan Pi 10 grams, Danshen 20 grams, Xu Changqing 15 grams, Mandarin 10 grams, Chuan Bei 10 grams, Jin Yin Hua 15 grams, Ling Xiao Hua 15 grams, licorice 6 grams. Decoct twice with water and take 400ml of juice, divided into two morning and evening half an hour after meals. Chinese medicine cold compress Chinese medicine cold compress commonly used formula 1, horsetail 50 grams, water decoction into 500mL, take the supernatant cold compress face, each time?30min, 1 to 2 times / d, 7d for a course. 2, or honeysuckle 30 grams of raw licorice 10 grams, decoction cold compress. 3, mugwort 50, add water decoction into 500ml, cold compress. Chinese herbs need to be clarified after decoction, use clarified liquid, not cloudy. Due to the abnormal sensitivity of the skin of this disease, any topical medication may cause irritation. It is recommended in the Chinese medicine that cold compress medication be as simple as possible, and do not use more than two kinds of medication if a single medication is effective. Bloodletting therapy, selected to release 1-2ml of blood by puncture at the back of the ear and the tip of the ear, can effectively relieve inflammation in the acute stage. Self-blood therapy, extracting its own blood and injecting it in the Hegu acupuncture point, the foot three li acupuncture point and other parts, can improve immunity. Breakthrough method five, laser treatment IPL strong pulse laser can improve the patient’s skin oil secretion, regulate skin pH, enhance skin elasticity, and the laser will not cause the loss of skin moisture, thus it has a better effect on hormone dependent dermatitis. The skin barrier can be restored by using IPL at the right dose to irradiate the skin. It is also possible to use IPL with medical skin care products to control the symptoms. The point to emphasize is that hormone dependent dermatitis itself is prone to recurrence during the treatment process. This phenomenon is in no way a detoxification of the skin as stated on the internet and in beauty salons, that would be a big mistake; this flare-up of inflammation needs to be controlled with medication. Through proper treatment and care, the application of different oral and topical medicines, combined with herbal conditioning, most patients can receive good results. To sum up, the treatment process of this disease is slow and requires sufficient confidence and perseverance and persistence.