What's this weird rash on my face I've had for years?

[frustratedwimyskin]

I had acne bad so was using Duac for years. I stopped Duac in February and am using nothing on my skin.

Starting 2019ish I began to have episodes lasting months where my skin would look like this, followed by clear durations. Starting from 2023-2024 the rash has been there constantly, there's this weird clear defined patch immediately under my lip.

Anyone had or or knows what it is? My skin almost feels like sandpaper on my cheeks because there's so many of these dry feeling bumps and those bumps are on my nose and my forehead too. Like little red bumps?

It flares at night and tingles/stings and feels a bit like sunburn.

It's sensitive to the touch and my doctor said it looks "very sore" but can't work out what it is so wondering if anyone can relate?

The area of my philtrum and just before my lip is normal skin which is how my skin looked before this rash emerged

If the doctor doesn't know what it is, perhaps they should refer you to a dermatologist. Maybe go back to your GP and ask?

My doctor's off for a while so there will be a review in a few months I'm on lymecycline now

I'm just wondering if anyone on here has had this/ currently has this?

Looks and sounds exactly like perioral dermatitis to me. A gentle cleanser and light moisturiser (eg: Cetaphil) and an azelaic acid like Finacea for treatment. Azelaic acid absolutely saved my skin when I had this and I continue to use it if I feel or see the start of my skin flaring up again.
Do NOT use any steroid creams or “active” skincare retinol or exfoliants. Also avoid heavy or occlusive skincare and makeup products and use a light sunscreen - without oxybenzone. I find titanium dioxide based SPF worked best for me (I used Ultra Violette Clean Screen). Make sure you are properly cleansing your skin and not sleeping in sunscreen or makeup. You may also want to look at switching out your toothpaste for a fluoride free one until the rash has gone. It can take several weeks to clear. After this, slowly introduce other skincare and fluoridated toothpaste slowly one at a time for several weeks before adding another - this will help you identify if anything in particular is causing this.

Hi currently not using anything at all on my skin no makeup or cleanser just lukewarm water but it still flares up and gets noticably redder/more red bumps starting from the evening.

I was given azelaic acid which made the rash more red, raw and bumpy unfortunately..

thanks for the input it does look a lot like that. how long did yours last?

Azelaic acid can cause a purge effect when starting use that can last 2-4 weeks before starting to clear making your skin look temporarily worse before it gets better. This happened to me too but I persevered building up use from 2x per week to daily and it settled after about 2ish weeks. You really should to be using a gentle cleanser and an oil free moisturiser twice a day though. The idea is to rebuild your skin barrier. It can be worse in the evening as your skin is reacting to the daily build up of sweat and heat (you can also put azelaic acid on top of the moisturiser to buffer it). Putting any treatment on skin that hasn’t been cleansed and moisturised properly is going to cause discomfort and an increase in the severity of the flare up. Sunlight and heat can be a big trigger for PD so I would look into a gentle SPF for daytime.
I think mine probably lasted for about 3 or 4 months before completely going away, it reduced most significantly in 3-4 weeks but I was doing a strict treatment routine.

In case it helps, this was my entire skin routine that I used for months and these are still my ride or die products:

Avene Tolerance Extremely Gentle Cleanser (morning and double cleanse in evening)

La Roche-Posay Toleriane Dermallergo Serum or Avene Tolerance Control Intensive Skin Recovery Serum (on slightly damp skin after washing, before moisturiser)

Avene Tolerance Soothing Cream or Glossier Rich Face Cream (morning and evening)

Finacea Azelaic Acid (built up from 2x per week to twice daily morning and evening - used before or after moisturiser)

Ultra Violette Clean Screen SPF (every morning after moisturiser)

It sounds like rosacea to me but you should see a dermatologist. If you can afford to, go private - much quicker - and a £200 one off appointment could tell you everything you need to know.

Yeah am considering if it doesn't clear up in a few months.

I was given Skinoren, which is good for rosacea but it only made my skin more bumpy and inflamed and I used it for a month it just kept getting worse

Perioral dermatitis I would imagine, the fact that it gets worse at night I would suggest looking at demodex which is dealt with by ivermectin or ‘soolantra’ the brand name.
for general perioral dermatitis I’d ask for metronidazole cream (don’t let them fob you off with the gel) cream is called ‘Rosex’.
They may also give you long term antibiotics to treat it alongside the cream - often ethromycin