FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[FACIAL RASH OF ROSACEA CAN MAKE YOU LOOK LIKE W. C. FIELDS]

Question: I have had redness on my face and went to my dermatologist. He said it was rosacea and didn't offer any help other than giving me a pamphlet that said there is treatment available. I've switched facial soap and also use Noxzema, but this doesn't seem to make much difference. I'd appreciate any advice you care to offer.

Answer: Rosacea, which is also called acne rosacea, is a common skin condition that occurs more frequently with increasing age. Rosacea causes redness over the central part of the face - particularly the cheek bones and nose, but the eyes and forehead can also be involved. In addition to the general increased redness, those with rosacea often experience frequent flushing of the skin brought on by drinking hot liquids, alcohol or caffeine, or by eating spicy food.

This chronic redness and the episodes of flushing are accompanied by a condition called "telangiectasia." This tongue-twister word describes a grouping of dilated capillaries that appear somewhat like small red spider legs and are clearly visible just beneath the skin. In addition, rosacea produces acne-like blemishes.

A very characteristic feature of this condition, when it is untreated, is swelling of the oil gland structures. The medical term for this is sebaceous hyperplasia. It causes prominent skin pores and a thickening of the skin. If you have a mental image of W.C. Fields with his red cheeks and bulbous red nose, then you know what untreated rosacea can look like.

We don't truly understand the cause of rosacea. Some authorities suspect that it is caused by infection from one of two bacteria - Demodex folliculorum or Helicobacter pylori. Regardless of the specific cause for the condition, effective treatment is available. Topically applied antibiotics (usually metronidazole, clindamycin or erythromycin) work well for most people. Oral antibiotics, particularly tetracycline, may also be necessary. Unfortunately, these must be taken for a period of years to control the condition. No cure is currently available.

If your rosacea is cosmetically unacceptable, it can be treated surgically - laser surgery is often best. I'd recommend that you avoid food and drink that worsens your rosacea. In addition, I'd return to your dermatologist and ask for help with your skin condition.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.