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Rosacea Leaves Patients Red-Faced

Doctors say embarrassing skin condition helped by antibiotics

By Nancy A. Melville
HealthScout Reporter

SUNDAY, Feb. 4 (HealthScout) -- Red cheeks and a bulbous nose may be cute on Santa Claus, but for many it means a flare-up of an embarrassing skin condition known as rosacea.

Marked by redness in the cheeks, nose, chin or forehead that can come and go, rosacea affects more than 13 million Americans. In more severe cases, the condition can cause pimples, ruddiness and a bulbous nose.

Santa Claus aside, the best-known sufferer of rosacea was probably the actor W.C. Fields, whose trademark nose and rosy cheeks were widely attributed to alcoholism -- another frustrating misconception that many rosacea sufferers face.

In truth, alcoholism can cause a flare-up, although experts say the symptoms can be just as severe in a teetotaler.

"People are often even more embarrassed because there is that belief about the cause being alcoholism, but that's just one of a variety of factors that trigger problems," explains Dr. Jerome Z. Litt, an assistant clinical professor of dermatology at Case Western Reserve University in Cleveland.

Other leading triggers, according to the National Rosacea Society, include wind, cold weather and high indoor heat. Heated beverages and even stress also scored high as triggers for flare-ups.

"I call it the SWAT factors," says Litt. "Stress, worry, anxiety and tension."

Litt says that while the condition occurs more commonly in fair-skinned women in their 40s, 50s or 60s who are of northern Celtic heritage, it also occurs in men and is then typically more severe. The bulbous nose symptom, caused by a buildup of fibrous tissue, for instance, rarely occurs in women.

The good news is that medications -- usually oral or topical antibiotics -- are very effective.

And according to Dr. Robert Jackson, professor emeritus in dermatology at the University of Ottawa, the popular acne drug Accutane is helpful in more severe cases.

"It's extremely effective in severe cases, and will often work when antibiotics won't work," he says.

Because of potential side effects, however, patients are warned not to stay on Accutane for long.

"You can't stay on it for too long because there are side effects that can include liver problems and triglyceride levels," warns Jackson. "But it certainly will help the very severe kind of rosacea."

Like other unpleasant skin conditions such as herpes and psoriasis, there's no known cure for rosacea. But Litt says if treated early and effectively, disruption in a patient's life can be minimal.

"Rosacea is likely to be an unwelcome guest for the rest of a patient's life, but it can be kept to the point where you don't even notice it," he says.

What To Do

Visit the National Rosacea Society for more information. And go here for more on treatments for rosacea.

SOURCES: Interviews with Jerome Z. Litt, M.D., assistant clinical professor, dermatology, Case Western Reserve University, Cleveland; Robert Jackson, M.D., professor emeritus, dermatology, University of Ottawa; National Rosacea Society press release

Copyright © 2001 Rx Remedy, Inc.


Treating Rosacea

Do your cheeks and face flush easily by certain foods and/or environments, which takes longer than usual to return to its normal color? Do your friends or family members always seem to have a red nose and/or cheeks or seem to “blush” rather easily? The above signs could be the acne-like condition called Rosacea. Sometimes referred to as “adult acne,” Rosacea (pronounced rose-ay-shah) affects as many as 13 million people in the United States. Do you think you may have Rosacea or know someone else who does? If so, the following article will describe exactly what this condition is, what it looks like and how to live with the disease.

A Brief Definition

Formally defined as a chronic disease affecting the skin of the face mostly where people flush easily, Rosacea usually occurs in adults between the ages of 30 and 60. Although woman are more often affected by the mild or moderate symptoms, men who have the disorder suffer more severely. The condition can develop in any skin type but it tends to be more frequent in fair skinned people and it does tend to be hereditary. Often several people in a family suffer from the disease.

What causes Rosacea? No one knows for sure. Some scientists believe it is caused by Demodex folliculorum, a tiny mite, which lives in the facial hair follicles and may clog the openings to glands causing inflammation. While other doctors believe it to be linked to Helicobacter pylori, a bacterium that causes infections in the gastrointestinal system. Still some researchers believe the disease to be primarily a disorder of the blood vessels where something causes them to swell and become flushed and/or red. However, most doctors strongly believe there is a link between genetic predispositions with the combination of different types of environmental factors.

Since the exact cause of Rosacea is still unknown perhaps the best prevention may be to avoid several factors, which are proven to aggravate or cause it to worsen. Avoid drinking alcohol (which causes flushing and redness), heat, strenuous exercise, direct sunlight, wind, cold, hot drinks, spicy foods, emotional stress, coughing, and irritating skin cleansers or moisturizers. Every person is different and some people may not have as severe of a reaction to certain stimuli while others may suffer tremendously. It has been suggested that a person maintain a journal with the date of the episode flush and any corresponding “trigger,” such as overexposure to the sun, spicy food, etc. This condition can get worse the longer you have it, especially if you don’t
seek treatment.

Signs and Symptoms

Prerosacea is the earliest noticeable stage of the disease. Signs of this stage include frequent episodes of flushing or redness of the face and/or neck that come and go. Things that can cause an episode are exposure to the sun, emotional stress, alcohol, spicy foods, exercise, cold wind, hot foods and beverages, and hot baths. Again, each person is different and what might affect one person might not bother the next.

Vascular rosacea is where blood vessels under the face swell and it is most common in women. Redness and flushing become persistent and eventually permanent as a result. The skin that is affected could be slightly warm or swollen.

Inflammatory rosacea often develops in people who’ve had a history with vascular rosacea. As the small blood vessels of the face get larger and show through the skin, little red lines, similar to a map, appear. Little pink bumps or pimples may also occur.

Rhinophyma is the most severe type of rosacea, which usually strikes men. An enlarged, bulbous nose is a characteristic of this type of the disease. Thick, knobby bumps can develop along with swelling in both the oil producing glands and the tissues surrounding the nose.

Please note, some people have more than one of the above types of Rosacea at a time and can develop any one type without ever having had any of the others. It’s not predictable or follows a strict cycle.

Is there a Cure?

Unfortunately, there is no known cure. However, this disease can be controlled if properly treated. Usually a patient’s goal in seeking treatment is to control the condition and improve the skin's appearance. In a more mild to moderate case, the doctor may prescribe a topical antibiotic, such as metronidazole, which is to be applied directly to the affected skin. For patients with more severe cases the doctor may prescribe doxycycline, tetracycline, or erythromycin, oral antibiotics, which are to be taken by mouth. Also, use of a sunscreen with a SPF of 13 or higher is suggested to all people living with Rosacea.

Quick tips to help you cope with Rosacea and help your doctor provide
the best treatment:

*Start a journal or notebook of your “flare-ups” and any accompanying

*Plan to avoid or minimize your contact with those “triggers” and you will surely reduce or even eliminate your need for antibiotics in helping to
control the condition.

*Try to use sunscreen EVERY DAY with a SPF of 13 or higher.

*Avoid the use of irritating skin care products (cleansers, moisturizers, cosmetics), especially if they contain alcohol or other irritating ingredients.

*Try to lower your stress levels

With the proper knowledge and treatment options, people can LIVE with Rosacea and not let the disease run their lives. For more information contact the National Rosacea Society by mail at 800 South Northwest Highway, Suite 200, Barrington, Illinois 60010.

Written by Leah Saylor-Abney

Copyright 2000 by PageWise, Inc.

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