I’m a mid-30s man who practices consistent skincare. I have facial hair. I first noticed that I started experiencing redness in the middle of each of my cheeks in August 2025. I thought this was just some type of dermatitis, as I’ve had that from time to time. I changed my routine to be gentler, and I stopped using beard products (i.e. beard oil). I wouldn’t describe the redness as extremely severe (it’s kind of more pink than red), but it is definitely noticeable and looks irritated.
I sort of neglected the issue for a number of months as I thought it would go away on its own. People around me told me that it may be stress. I was working a very stressful job and had other stressors in my life. I have now changed jobs and I think my life stressors have been significantly reduced.
Earlier this year, I started noticing that my redness was leading to hair loss on my cheeks. Probably at around February/March is when I really started to notice hair loss. The right side of my face has more hair loss than the left side—there is a very noticeable patch there. So I decided to get my life in order and see my dermatologist. Here’s what we’ve tried:
· Zoryve for two weeks
· Elidel for two months
· Ketoderm for four weeks.
None of these are working. In between the Elidel and Ketoderm, I also tried zinc pyrithione soap and Azaleaic acid for two weeks.
In addition, I’m noticing that I’m starting to have the same phenomenon on both my left and right upper moustache area (i.e. redness and hairloss). I also have a feeling its starting in my chin a bit too, but I could be overly worried. But I’m concerned because it is July 2026 now and my issue is definitely spreading/getting worse as the hair loss was not as noticeable before as it is now.
In terms of these issues, I would say that I only have redness and hair loss. The patches are not itchy. They are not flaky. They don't hurt. What I will add is that on the right side of my face, I see a few almost whitish/discolored patches on my cheek. On my right side moustache I see a number of whitish “bumps”. Sometimes when I trim the cheek patches do get redder.
I’m trying to figure out what caused this. I thought maybe it was my facial hair trimmer but I’ve switched facial hair trimmers since then. I thought it was my beard oil but I’ve stopped using it for many months now. My skincare routine has totally changed from when this first started and I use fairly gentle/neutral stuff; thus, I’m doubtful it’s anything in my skincare routine. The last thing I would add is when I look at older photos of myself prior to when I first noticed this in August 2025, I can see little hints of the redness (probably as early as at least May 2025).
Given that this has been gradual, my patches are fairly symmetrical and given that nothing topical seems to work, based on my research I am wondering if this is some sort of autoimmune disease that needs to be managed with oral medication. I'm wondering if anyone out there has any insight. As I'm researching I'm seeing terms like scarring vs. non-scarring alopecia, lichen planopilaris, discoid lupus, tinea baraae and demodex mites...but I'm really not sure.
In terms of alopecia, I note that in 2019 I’ve actually had random patches of facial hair alopecia in the past which resolved after a few months I put minoxidil on them. Those alopecia did not have any redness or discoloration…it was literally just hairloss.
I'm getting worried that this may be permanent. I have a follow-up appointment with my dermatologist next week. Any insight on what I should be asking for/about?