Please help identify this rash

[teaandtoastwithmarmite]

I've had this rash for a few months now. Had a telephone call with gp and she prescribed a cream which doesn't do an awful lot. I think I'm allergic to something and have tried the following
Stopping using charcoal face wash, then a different face wash and now using dove soap
Am about to change shampoo
Tried not wearing make up
Tried using just Nivea soft and not my usual anti aging cream
Cancelled my next hair dye appointment
It seems to die down then starts up a bit and it's starting to get me down.

It's also a bit on the other side of my face but not as close to my hairline. I was getting it on my neck previously

Rashes are notoriously hard to diagnose… I think you need to see the doctor face to face.

Ah it's such a PITA to get an appointment. This was telephone and sending pics over. I called them a couple of weeks ago about a pain in my arm and she referred me for physio without even seeing me lol

I get bupa through work. Would you just go for that. I guess they would be better with allergy testing and stuff

Ugh I know, it's a nightmare trying to get f2f; I'm a GP frequent flyer unfortunately, due to several chronic conditions, and haven't met a GP in person since joining my practice in 2020. If you have Bupa then personally I'd jump at it, you might get referral to a specialist.

I would go through bupa, they may have a private gp service who could refer you to a dermatologist. I would just use warm water to wash your face, no creams and no make up at the moment, maybe hypoallergenic baby shampoo.

Could it be your pillow or washing powder

Does it go into the middle of your face or across your nose? Looks like a Lupus butterfly rash. I have Scleroderma, a condition very similar to Lupus and when i see the specialist I see other people waiting with a rash like this. Any other symptoms? I would ask GP for bloodwork.

it does look like it could be an allergic rash

i actually cringed when you said you switched to dove soap. I can’t even be a few feet from a bar without getting a rash.

Of course there is no way of knowing what is causing your reaction. What is safe for one person is horrible for another.

if you are having trouble getting treatment and are just trying random products for relief, you should try going fragrance free. It is the most common allergen. That doesn’t mean unscented. You have to get truly fragrance free which is harder to find. I’m not in the UK so we have different brands, but here Vanicream would be my starting recommendation to look for. Whatever you get, for some reason the packaging is almost always extremely plain and white and blue. It all looks very medicinal.

I wondered about that but OP said it was asymmetrical… I thought malar rash was usually symmetrical? But I don't know nearly enough as a random internet layperson to suggest or discount possible diagnoses (and doctors don't tend to do that either, but for ethics and liability reasons) — the possibility of serious conditions is one of the reasons I think OP needs to seek further medical evaluation, along with the fact that the first treatment given by the doctor didn't work.

OP if you do go to Bupa they might not have all the info your own GP has access to, so you should make a note of what the cream was that your GP prescribed you, so you can tell them it doesn't work — it might help with diagnosing the problem, and will prevent wasting time trying the same thing again

Thank you everyone. Re dove soap id used it for years before the charcoal face wash so it's very unlikely to be that. It's not across my whole face. Didn't want to post a pic of whole face but will for this purpose lol.

Gosh that is an awful picture 😂

And I do appreciate you're not all experts just trying opinions really so thank you.

Ouch. Looks uncomfortable :(

Can you book to see a dermatologist?

I'd usenothing at all on your face while this is going on. Just a very gentle pat with a damp cotton flannel to clean. No creams or anything. Give your skin a break for a week or so.

Have you tried an antihistamine like allevias fexonfendaine? It's available OTC now.

What shampoo are you using? I know it's harder not to wash your hair, but if you can, I'd stop doing that too, just for a week.

Are you using a steroid cream any where else on your body or any cream anywhere else that you're applying with your hands?

It looks sore. Try the fexo. If it's an allergic reaction, that should sort it. If it's not, then you'll have pretty well ruled it out!

All the things you have previously put on your face are notoriously irritant.
Send several photos to your GP.
If your GP suggests referral to dermatology, check how long the wait will be, as there is a very long waiting time IME.
If it is a long wait, if you can possibly afford it see a dermatologist privately.
Meanwhile use nothing but warm water on your face.
Splash it on and gently dab it dry using a soft flannel that has been washed in non-bio powder and well rinsed with no fabric softener.
Wash your hands frequently and try not to touch your face.
Try taking an antihistamine and see if it calms it down a bit.

Nivea gives me a similar rash so I would scrap that for now. I agree with just water on face for now or if you are desperate something like cetaphil which is not harsh (One of the only products I can use on my sensitive skin but obviously everyone is different)

Are you on any medication OP?

Could it be the beginning of Rosacea?
That came to mind because of the red veins on your nose. Don't panic about your veins though! They're likely to be noticeable only because we're looking at close up photos.

I've had a similar rash from mould. Went into a cellar at work to archive a load of dusty damp old files. Next day had a full on almost burnt looking rash that felt like sand sort of rough?
Antihistamines and time got rid of it for me.
It was a very similar face rash.

We do get mould in the bathroom but keep cleaning it off. Not got rosacea. Quite paranoid about the nose veins lol but had them for ages and ages. Annoying thing is the charcoal face wash was helping with that.

Sertraline

A rash is a possible side effect of sertraline. That doesn't mean your rash is related though. It might not be, but maybe worth reminding your GP or telling the dermatologist, if you see one, that you are on it, so they can take that into account.

Have you noticed it coming or going after any particular situation? eg - when you're hot, after certain foods or alcohol, after you've put anything on your face, after being in sunlight? I would try and keep track of what you eat and put on it vs when it appears to see if there is anything you can learn.

Is it sore, itchy, flaky, feels hot etc?

What cream did the GP prescribe and what diagnosis did they give?

I would try antihistamines to see if they bring it down and switch to using just fragrance free things to wash and moisturise with.

It's a bit hard to see the rash placement properly in the photos (and I appreciate putting one up is nerve wracking!) but if the rash is focused more in a butterfly shape across the nose and cheeks I would try to get an image of that and ask the GP what they think. Otherwise it looks more like rosacea than anything else I recognise (as someone zero medical qualifications but a lot of autoimmune problems and endlessly fighting off rashes)