Hi - The biafine may be causing some issues, there are some pretty stern warnings that one shouldn't use unless a provider specifically asks you to. If you are seeing a steep decline after starting doxyclycline, you should call your dermatologist right away. Is it itching or painful? The yellow crust is probably a normal scab forming, but if you see puss or if it's still bleeding you need to go back to the dermatologist so she can take a culture and make sure it's not infected with resistant bacteria. I would go back to the same one you just saw because he or she knows what it looked like before and will be able to tell if it's really getting worse or if it's just healing.
I used Biafine 5 years ago when I had a very similar issue, and that's why I'm using it again. The wound is not bleeding, itching, or hurting, luckily. It is just weeping slightly when I wash it at night, and it's crusting over when I don't have Biafine on it. I take that as a good sign. It's not crusting all the way to surface level, unfortunately. I also don't see any pus. The problem is that the dermatologist I saw checked the scab out when it was crust above skin level, not an indented wound. The day I saw her, she put ointment and a Band-Aid on. When I took the Band-Aid off to reapply the ointment, the top layer came off, creating a bigger indent and wound. Back to square one. I saw her two days ago, and she saw a wound that looked totally different from what it looks like now. She told me to call her Monday if things don't look better. I'm waiting until then and praying for the best.
I don't think the Doxycycline had any impact on the wound since I first took it about 12 hours ago. I am scared, however, that my switch from Minocycline to Doxycycline (after having been on Minocycline for about 6 months) will create another breakout or slow the wound healing. The dermatologist said it probably wouldn't be an issue, but I can't take any other setbacks right now because this one is making me so depressed, among the other pimples and hyperpigmentation I have.
My parents said the wound looks better to them, but their eyes don't work so well. Plus, I think they're just trying to get me out of my funk. Bless them.
Hi -
No, I wasn't saying the doxy would cause a problem, only that if it isn't working it might be an issue, but you're right, 12 hours is to soon to tell. If it's not puss - y, bleeding or weeping (other than when you wash it, which is normal) then It is definitely healing. For now, touch it as little as necessary. Be careful when washing your face not to rub on the scab.
It may turn into a scar, unfortunately. There is nothing you can really do to mitigate whether or not that will happen until after the scab falls of *naturally. In my experience, it usually takes about a week for a scab to fall of naturally once it forms and dries out. Once it falls off naturally, and there is no bleeding or seeping (i.e., it should just look like newly healed reddish pink skin), you can try using scar healing ointment and colloidal bandages which have some scar prevention properties (although I don't think they are very efficacious for indented scars). I would encourage you to discuss your options with the dermatologist, she will probably give you some ideas on how to mitigate scarring or diminish it's appearance once it heals.
*DO NOT try to hurry that process. Even if the scab is hanging on for dear life by a thread of skin, LEAVE IT BE. It is very important that the scab falls off on it's own, because if you remove it before it is ready, it will cause another scab to form which will definitely cause a scar.
Thanks again. I really appreciate the advice. (I also appreciate everyone for putting up with my anxiety!) I feel like a scab isn't forming because it's deep and seems to no longer be weeping. It seems to be healed, but healed as an indentation. I keep checking it and then reapplying Biafine. The depth is what most concerns me. I have been researching dermal fillers and skin grafts and everything because I'm so panicked. Any idea on how long I can wait to get some kind of filler or solution to even out the skin? I'll probably end up at the dermatologist's office again this week. I went three times in one week, which I know is insane. Twice to my old dermatologist and once to another dermatologist. Stupid BDD is ruining everything.
Quick poll for you all. Would you walk around with an open wound on your face? I've been thinking about covering up the redness on the edges with a bit of concealer and just leaving all makeup and products off of the middle part, which is the indented, uneven, cratery, light green/white portion.
Update, just in case anyone is still reading this and hasn't gotten tired of my complaining by now. I went to my meeting today. I put on full foundation and concealer and powder and mascara and eyeliner and all that jazz. I still had a crater, but it was at least powder-colored. Tonight, I gently washed off the surrounding makeup but not the makeup in the crater. Some skin had lifted up around it, so I got that off. It seems to be just a bit deeper, unfortunately. I will probably never get another cortisone shot. This is ridiculously depressing. The skin will never level out. I have a deep indent on my chin from a cortisone shot a year ago. I have another rolling scar on my nose from where I squeezed four years ago. It took that about 6 months to get to its current state. I wish the current crater were on the bottom of my chin or on the side of my face or somewhere less noticeable. Ugh. But I got out today. I'm proud of that. Even if the other makeup is making my face break out more. I still got out.
I was going to show you a picture from this morning, but the picture attachment feature isn't working. The crater is still deep. Still scabbed in some parts. Showing pink, indented skin in other parts. I'm waiting another week to go back to the dermatologist. I'm thinking it has to heal fully before I get a collagen injection. I'm afraid they'll tell me it's too deep for an injection, but I hope not.
I'll try to post a picture later when the website is working properly.
Edit: Here is the picture. The site started working again.
I don't put much stock in specific diets. I know tons of people who follow lifestyles of being gluten-free, dairy-free, vegan, yada yada yada, and their skin is crap. I also know tons of people who eat McDonald's and other junk for every meal and have the most radiant skin ever. Thanks for the suggestion, though.
The rest of my face continues to break out as I battle the crater. Forehead and around the mouth, specifically. I'm gonna have a consultation for a dermal filler next week when this thing is a little more healed. Looking forward to it. Also guzzling water like it's my job!
The scab is finished, I think. A chunk of dead skin lifted up on its own tonight, revealing a deep pink crater of living skin. I'm applying Biafine and am hoping to get a collagen filler next week. The first pic is the crater doused with makeup and powder (a long process) in flattering lighting. The second pic is the newly-revealed pitted scar. Any recommendations for the best and longest-lasting dermal fillers that plump up immediately and do not cause other skin issues in the meantime or require downtime?
Update: It's no longer open, but every night when I wash off my makeup, a layer of skin comes off. (It doesn't bleed, but it stings.) That happened tonight, and I feel like it's deeper. Any idea of how soon I could get a dermal filler? I don't want to go see the dermatologist and have him tell me that it's too soon in the healing process to fill it.
Another update. Went in for my routine Spiro bloodwork today. Derm looked at the atrophy from the cortisone shot and suggested a saline injection to break up any remaining cortisone and to promote healing. So I got the saline injection. It didn't matter because the skin was already red and cratery and hard to cover, so I figured why not? It's a bit brighter red now but has no visible pinprick from the needle. It may look a bit less indented for the time being. I'll keep you posted with how it goes and if the saline shot seems to have helped. From what I understand, only a series of saline injections will be truly effective, but the derm said the skin would level out on its own eventually. First pic is before the shot. Second pic is about 15 minutes after.
I think it got deeper again after I showered this morning. And the rest of my face continues to break out despite being on 75 mg Spironolactone now and 200 mg Doxycycline, plus Retin-A at night. I'm sure it's related to the colder weather, but I don't know how to stop it. 
It's been a week since the saline injection, and three and a half weeks since the initial event and cortisone shot. I think the indentation is raising a little bit. It may be wishful thinking, but I'll take it. Still hard to cover, pretty deep, and quite red, but it's better. No longer beet red, painful, or green, so that's good. Ideas for how to get rid of this thing? I have similar scars on my nose and in the middle of my chin. Fillers? Lasers? Thoughts?
Doxycycline has made me extremely nauseated, so I'm stopping that and restarting the Minocycline 200 mg. Still taking the Spironolactone 75 mg as well. I also think switching from Doxy to Mino caused a breakout, so I'm hoping it subsides now that I'm switching back to Mino. Could be stress about breaking out and having this crater to deal with, too.
In this case benadryl for its antihistamine properties might have helped with the surrounding swelling and inflammation along with advil/aleve/ibuprofen which you did take. On and off cold therapy is better than prolonged icing. I've heard after the infected part has subsided and it starts to shrink one should massage the area to promote break up of the scar tissue and promote healing. But i have not tried it myself.
Word of advice. Do NOT go fishing for the deep, dermal cysts. They are your worst enemy. They will scar.
If they come to a head or can be "lightly" squeezed with ever so light pressure that they drain mostly on there own.I find applying some sort of tea tree oil or alcohol base helps dry them out faster promoting them to reduce in size and shrink, peel, and go away completely.
But sometimes temptation gets the better of us, including me last week