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Severe persistent reactions: Skin not improving after 2 weeks of stopping all actives Progressive worsening despite removing triggers Pain that interferes with daily life Routine dermatologist visit recommended: Persistent problems after 4-6 weeks: Ongoing sensitivity despite gentle routine Breakouts that won't resolve Unusual pigmentation changes Texture changes that concern you Pre-existing conditions worsening: Rosacea flare that won't calm Eczema spreading or worsening Seborrheic dermatitis not responding to usual treatments Uncertainty about what's happening: You're not sure if reaction is normal Conflicting advice from online sources Want professional assessment before continuing General skin health evaluation: Haven't seen dermatologist in years Starting serious anti-aging routine Want baseline assessment and professional product recommendations Don't wait if you're concerned

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Am J Ophthalmol 1995