Steroid induced rosacea can be caused by the prolonged (usually daily) use of a topical steroid on the face. The presentation is typically of inflammatory acne lesions consisting of pustules, papules, and cysts. We treat steroid induced rosacea by gradually weaning the patient off the topical steroid while simultaneously treating with either a topical or systemic antibiotic. In my experience, steroid induced rosacea is not permanent when treated correctly. I recommend you consult with a board-certified dermatologist to make sure your condition gets resolved in a proper manner and time frame.
Use of QVAR with a spacer device in children less than 5 years of age is not recommended. In vitro dose characterization studies were performed with QVAR 40 mcg/actuation with the OptiChamber and AeroChamber Plus ® spacer utilizing inspiratory flows representative of children under 5 years old. These studies indicated that the amount of medication delivered through the spacing device decreased rapidly with increasing wait times of 5 to 10 seconds as shown in Table 2. If QVAR is used with a spacer device, it is important to inhale immediately.