The Enid News and Eagle, Enid, OK

March 14, 2013

More than a blush

By Judy Rupp, columnist
Enid News and Eagle

— What do Bill Clinton, W.C. Fields, Santa Claus and Rudolph the Red-Nosed Reindeer have in common? A red face, of course, and a red nose — two traits that characterize a chronic skin condition known as rosacea.

Many people with rosacea first notice they are quick to blush. Depending in part on their personality, they may be embarrassed by this trait. And they soon discover that what they have is more than a blush, but rather a chronic skin condition, similar to adolescent acne.    

Symptoms also include: persistent redness of the nose and central face; acne-like red bumps and/or pustules or pimples; spider-like blood vessels (telangiectasia) on the face and sometimes a bulbous nose. About 50 percent of persons with rosacea have eye problems — a gritty feeling plus reddening of the eyes and eyelids.    

Many observers attribute the red face and bulbous nose to alcohol abuse, and W.C. Fields seemed to welcome this stereotype. In fact, some liver disorders can cause many of the same symptoms, and alcohol is one potential trigger of rosacea. Nevertheless, rosacea can and does occur in persons who do not imbibe.    

Unlike acne, which usually appears during the teen years, rosacea is more typically a skin condition of middle-aged and older adults, particularly women going through menopause. The condition is more common among women and among fair-skinned individuals of northern European descent. Thickening of the nose, known as rhinophyma, occurs nearly always in males.    

Rosacea is frequently made worse by sun exposure. Other triggers include emotional stress, hot weather, wind, exercise, alcohol consumption, hot baths, spicy foods and certain skin-care products and medications.    

Severity of symptoms vary, as can the overall effect on the individual. Some persons have few or no symptoms and are not bothered by rosacea. They may even like the ruddy glow of their complexion.    

Others have moderate symptoms that occur periodically, causing short-term embarrassment. These patients generally find treatments to manage their condition.    

Finally, some individuals find rosacea to be extremely bothersome. In the advanced stage, the skin may become a deep shade of red, and the eyes noticeably inflamed. Unsightly broken blood vessels appear on the nose and central face. Even when symptoms are less severe, rosacea can lead to low self-esteem and psychological, social and emotional problems.     

Although there is no real cure for rosacea at this time, the skin symptoms can be improved with treatment.    

Most persons with rosacea realize fairly early that good skin care is important — but not always easy or successful. Washing the face with a gentle cleanser twice a day is helpful; too much washing, on the other hand, may irritate the skin. Since sun exposure is nearly always a trigger, applying sunscreen lotion, with an SPF of 15 or higher, every morning is also recommended.

The biggest mistake many patients make is to try to treat the problem themselves with common acne therapies or natural remedies. Rosacea-affected skin is very sensitive, and these self-treatments, if not well chosen, can cause even greater irritation.    

Many common skin cleansers contain ingredients that are potential rosacea triggers — alcohol, witch hazel, peppermint, eucalyptus oil, clove oil, menthol, fragrance or salicylic acid.    

Natural remedies that may work include facial soaks two or three times a week with dilute vinegar or green tea. Vinegar is a natural disinfectant, and green tea is believed to have anti-inflammatory qualities.    

A better approach, though, is to seek out a dermatologist or a physician experienced in handling skin problems.     Topical antibiotics may be used initially to improve the condition of the skin. These can be effective at reducing the pustules and bumps. The redness and flushing, may be more resistant to treatment. For severe cases or for eye problems, oral antibiotics may be prescribed.    

For the persistent redness and broken blood vessels, many patients are now choosing laser and intense light treatments, even though some of these treatments may not be covered by insurance. Another option is photodynamic therapy, using a topical photosensitizer liquid and a light to activate the sensitizer. For persons who develop an unsightly bumpy, bulbous nose (rinophyma), excess tissue can be removed with a scalpel, laser or electrocautery.    

Although the symptoms of rosacea are more bothersome and embarrassing than anything else, they are usually progressive and worsen over time. With early recognition and treatment, most patients can go through life without being known as the “red-faced” one.

Rupp is a certified information and referral specialist on aging for NODA Area Agency on Aging. Contact her at 237-2236.