A man in his mid-30's we'll call Rashad consulted with me complaining of severe burning pain in his face. It began suddenly about a half-year earlier. He just woke up one morning and it felt like his face was on fire. The episode lasted nearly a week then disappeared. Ever since, the burning returns without any discernable pattern either in terms of the timing, duration or the area of the face, excepting the fact that it was always symmetrical. Along with the burning, his face felt extremely dry and the skin stretched tight.
Rashad went to a dermatologist who put him on a series of medications: analgesics, anti-anxiety pills, muscle relaxers and even steroids, but these had no effect on his condition. An antidepressant lowered the intensity of the burning, but it still was barely tolerable and appeared randomly.