Rosacea, an embarrassing dilemma

DEAR DR. GOTT: I am a 49-year-old white male, non-drinker. I’m very shy and embarrass real easily. I have rosacea and the condition has me very angry. People comment all the time “What’s wrong. Your face is red”. It makes me mad hearing it every day from strangers. Is there any help from home remedies? I take Zoloft but nothing is working.

DEAR READER: Rosacea is a chronic but harmless skin condition that makes the face turn red and inflamed. The lesions resemble acne, the face may burn, and the skin may be covered with red pus-filled pustules.

Rosacea does not have a cure but treatment is available to help reduce the symptoms that appear. Small blood vessels on the area of the nose will become visible, [Read more...]

Oh, those eyes!

DEAR DR. GOTT: My questions are regarding my blepharitis/ocular rosacea/dry eyes. Right now my eyes are inflamed and my eyelids are reddish so I am assuming it’s a combination of any or all of the above problems. My ophthalmologist gave me a prescription for ophthamolic steroid eyedrops and they cleared up in a very short time; however, I know that they aren’t for permanent use. I have done a lot of research online regarding ocular rosacea and it seems to me that a longer term low dose of doxycycline would be the answer. Do you have any suggestions or comments?

DEAR READER: Before getting into treatment options, I’ll first give a brief explanation of ocular rosacea and blepharitis.
[Read more...]

Burning face needs diagnosis

DEAR DR. GOTT: I am a 60-year-old cleaning lady. In January 2009, my face felt like it had menthol on it with a burning sensation on both cheeks that has continued 24 hours a day since then. Even the corners of my mouth burn. I went to a skin specialist three times. He prescribed Pramosone, Doxycycline and Prascion, none of which worked.

What kind of doctor do I go to next? I hope you can help me.

DEAR READER: I am confused why you experience symptoms now unless you have been exposed to an allergen, are on a new medication, herb or other supplement, or have had an unidentified occurrence in your life. [Read more...]

See dermatologist about rosacea

DEAR DR. GOTT: For about two years, I had constant facial pain in my cheeks, jaw and behind my eyes with a feeling of constant pressure in my upper palate, sinuses, jaw and cheek, in addition to the pain and pressure in my front teeth. I also had redness on my cheeks, nose and down the left side of my neck. I consulted with my dentist who fitted me with upper and lower mouth guards, which I wear at night. He told me that I grind my teeth with a side-to-side motion and push my upper front teeth forward with my bottom front teeth. After a year and a half, the guards still had not relieved any of the pain.

Recently, I consulted with my primary-care physician regarding flushing and the redness on my cheeks and nose. I was diagnosed with rosacea and prescribed metronidazole gel to be applied twice a day. [Read more...]

Daily Column

DEAR DR. GOTT:
I would like to share with you and your readers something that has helped me with dandruff and rosacea problems.

For many years I was embarrassed by problems with dandruff and flaking on my clothes. I would also have facial skin problems related to rosacea. My dermatologist gave me several different prescriptions but none ever seemed to give me any long lasting relief.

Somehow or another, I found a very simple solution that has helped me tremendously. I use a product called Brass, ZP-11 Anti-Dandruff Hairgroom. I rub it into my scalp after shampooing and then rub a light application onto my face and eyebrows. Something in the formulation works for me. It is a very inexpensive product at about $6 a bottle. Perhaps some of your readers will benefit from it as I have. [Read more...]

Sunday Column

DEAR DR. GOTT:
When I was 19, I had my acne burned off with X-rays. Twenty years later, it came back so I took tetracycline for thirty years. My acne didn’t disappear but started to change so my primary care physician sent me to a dermatologist. I was told that the acne was being replaced by rosacea.

I couldn’t tell the difference in the early stages of the transition. About a year later, however, the change was very apparent. At this point I was put on minocycline twice a day and have taken it for over six years.

My skin has always been very oily and I have inordinate amounts of seborrheic keratoses, some too big to freeze off. Now, if I stop my minocycline for three weeks, what looks like pus drips off my nose. Once I start the medication again, it takes another four months to get back to normal.

Is there any way off this treadmill? Like me, it’s old.

DEAR READER:
Rosacea is an increasingly common, chronic condition with about 14 million sufferers. It primarily affects the face but can also appear on the chest, scalp, ears and neck. It is generally characterized by redness on the checks, nose, chin or forehead. There are four types of rosacea, subtype 1 (flushing and persistent redness), subtype 2 (persistent redness with red bumps and pus-filled pimples), subtype 3 (thickened skin usually with enlargement of the nose) and subtype 4 (affects the eye, usually dry eye, tearing/burning, swollen eyelids, recurrent styes and more).

Rosacea has no known cause but it is believed that those with fair skin who blush/flush easily are at higher risk than others. It occurs in women more frequently. However, affected men tend to have severe or advanced cases. There is no cure but, with early treatment, it can be controlled.

Treatment generally starts with oral antibiotics and topical creams. These usually bring the condition under immediate control and is then maintained with long-term use of topical therapy. Some individuals may receive treatment with intense pulsed lights or lasers. Some may have visible blood vessels removed, nasal deformities from excess tissue corrected or doctors may attempt to reduce extensive redness.

If you would like more information, I recommend you visit the National Rosacea Society’s website, www.rosacea.org.

You also mentioned seborrheic keratoses. These are benign, non-invasive skin growths that usually develop around midlife or after. They generally appear as sharply margined, raised, yellow/light tan to black waxy or scaly oval lesions on the face, chest, shoulders and back. Because they are benign and harmless, you do not need to worry about them. They can be a nuisance if they are irritated or rubbed by clothing or are cosmetically unsightly. Your dermatologist may be able to remove or reduce the appearance of the larger lesions with other procedures, such as curettage (scraping) or electrocautery if they truly bother you. In some instances, two of the procedures will be used in conjunction (usually cryosurgery and curettage or electrocautery and curettage). Seborrheic keratoses have no known cause but may be related to sun exposure. Normally only one or two will appear over many years. See your dermatologist if the lesions start to bleed or if they appear rapidly because this may be a sign of skin cancer.

A dermatologist is your best bet. Ask him or her about possible treatment options and express your concerns about the current treatments you are receiving for your skin disorders. You may choose to go to another dermatologist for a second opinion. Your dermatologist appears to be handling your care very well. Good luck and let me know how this turns out.