Rosacea Fulminans aka Pyoderma Faciale 

Pyoderma faciale is definitely stress-hormone related. It tends to affect only the face in women in their 20′s to 30′s and is characterized by large, very red painful lesions that occur mostly down the middle of the forehead, cheeks and chin. You can see the pattern in the photograph below – notice how the inflamed lesions are only in the center of her face. Her cheeks are completely clear. This condition can affect women who have never had acne in their life and then they have this horrible breakout right after a very stressful time in their life.

So, what looks like severe inflamed acne is really a severe form of rosacea – rosacea fulminans.

Severe emotional trauma usually precedes the onset and is usually preceded by a period of extreme oiliness. (like hair needing to be washed twice a day). It affects only certain women who have a specific enzyme deficiency. This deficiency suppresses the adrenals’ output of hydrocortisone and instead prompts the adrenals to dump out excessive amounts of testosterone.

The condition can be detected from blood samples, and a drug called dexamethasone can slow down testosterone production and reverse the condition. Because the drug dexamethasone is a corticosteroid, our client was reluctant to take it.