Medical questions & health advice by board certified doctors
"Blotchy red patch - what is it?"
I'm a woman in her mid 30s and I have a blotchy red patch on the back of my neck. I tried using an anti-inflammatory cream on it from an old injury, but this did not help. It's persistent. What could this be? What should I do about it?
One very likely possibility is that this blotchy red area is an area of contact dermatitis. Contact dermatitis is an inflammatory reaction of the skin provoked by exposure to some irritating agent, usually a chemical. Common offending agents in this part of the body would be new shampoos or laundry detergents. Treatment would be discontinuation of the offending product and application of a topical steroid cream, available over the counter at your pharmacy. Another possibility would be seborrheic dermatitis. This is an inflammation of oil producing areas of the skin, usually in the scalp and along the hairline (such as the back of the neck). It is usually characterized by red, itchy areas of skin with scaling or greasy patches. In addition to switching to a shampoo containing selenium sulfide, topical steroid or antifungal creams can often be helpful. Finally, a photodermatitis, or allergic reaction caused by exposure to the rays of the sun, is a possibility. This would be more likely if you also have some redness on other sun exposed areas, such as your face, forearms, or chest. Treatment includes steroid creams, sun screen, and avoiding of the sun. The best first step for you, as always, will be to talk to your primary care doctor who can help you determine which of these (or other) possibilities are most likely and decide on a treatment.
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