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Rosy Cheeks, Red Face Could Mean Rosacea: Your Health
By Rallie McAllister, M.D.
By Rallie McAllister, M.D.
Rosy cheeks look great on Santa, but having a red face year round is nothing to be jolly about. It could be a sign of a serious condition known as rosacea.
While an estimated 14 million Americans have rosacea, a Gallup poll found that 78 percent of Americans don't know anything about the condition, including how to recognize it or what to do about it.
Rosacea is a chronic skin disorder that causes redness of the cheeks, chin, nose and forehead. Left untreated, it can lead to the development of acne-like pimples and visible blood vessels on the face. In severe cases, the skin around the nose swells and thickens, giving it a bulbous, bumpy appearance.
In approximately 60 percent of rosacea sufferers, the eyes are also affected. Signs and symptoms include swollen eyelids and bloodshot eyes that water, sting, and burn.
In spite of ongoing research, the exact cause of rosacea remains unknown. At one time or another, scientists have speculated that the condition might be caused by bacteria, skin mites, fungus, or a malfunction of the blood vessels underlying the skin, but to date, none of these theories has been proven.
There's some evidence to suggest that heredity may play a role: Many rosacea sufferers can name at least one relative with similar skin problems. Folks of European descent appear to be especially susceptible to the condition.
According to John Wolfe, M.D., professor of dermatology at Baylor College of Medicine, "Generally, this is a disease of middle age. Rosacea tends to arise when people are in their thirties or forties, and it typically gets worse in their fifties and sixties."
The first signs may be deceptively mild, and patients with undiagnosed rosacea may attribute facial redness to sunburn or irritation caused by skin care products. The inexplicable blush may disappear as suddenly and as mysteriously as it appeared.
Inevitably, the redness returns. Rosacea is a condition characterized by repeated flare-ups and remissions that can come and go without warning.
Over time, the redness becomes more pronounced and more persistent, and pimples and pustules may start to crop up anywhere on the face. To make matters worse, the skin changes are often accompanied by burning, stinging, and itching.
In addition to the physical discomfort of rosacea, affected individuals frequently suffer a great deal of embarrassment and emotional pain. In response to a survey conducted by the National Rosacea Society, 70 percent of patients reported that the condition had lowered their self-confidence and self-esteem.
Over a third of surveyed patients said that a rosacea flare-up had caused them to avoid public contact, cancel a social engagement, or miss work.
"The bad news is that there is no cure for rosacea," said Wolfe. "The good news is that there are lots of treatments that can bring it under control, and most are safe to use as long as necessary."
Treatment often begins with an oral antibiotic, such as tetracycline, and a topical antibiotic, such as MetroGel, although it isn't entirely clear how or why the drugs work. The results of several studies suggest that it is the anti-inflammatory properties of the antibiotics, rather than the bacteria-killing properties, that help alleviate the signs and symptoms of rosacea.
"These medications are very effective, as long as they're used," said Wolfe. "If you stop using them, the condition will come right back."
In addition to medical therapy, rosacea sufferers can improve their chances of staying symptom free by identifying and avoiding substances and conditions that trigger flare-ups.
"Not every person with rosacea reacts to the same triggers," said Wolfe. "Patient surveys show that the three most common triggers are sun exposure, emotional stress, and heat, followed by alcohol and spicy foods."
Although there are no specific medical tests for the condition, dermatologists typically make the diagnosis based on a patient's history and physical findings. In some cases, blood tests are performed to rule out the presence of other conditions that can mimic rosacea.
If you suspect that you have rosacea, you should see your doctor sooner rather than later. Early diagnosis and treatment reduce the likelihood that the disorder will progress to an advanced stage.
"Rosacea doesn't go away on its own," said Wolfe. "Without treatment, it just gets worse."
Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is http://www.rallieonhealth.com.
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