By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER’S MENOPAUSAL HOT FLASHES MAY BE TRIGGERING HER ROSACEA

Question: My face has been flushing quite a bit lately. I thought it was menopause, but I noticed it was happening more and more. I went to my doctor, and she said I had rosacea. She put me on some antibiotic cream and said I may have to use it forever. Can you tell me more about this condition?

Answer: Rosacea is an inflammatory condition of the skin that causes a red-faced look. Though it may appear to be an adult form of acne, it’s actually an entirely different disease. It affects about 15 million adults in the United States -- most commonly fair-skinned women between the age of 30 and 60.

While not a life-threatening disorder, Rosacea can be very upsetting to the sufferer because it primarily affects the face. Although rosacea has periods of flare-up and relative calm, it never really goes away. That’s why it’s classified as a chronic condition. While men are less likely to get rosacea than women, this disease in men can be more disfiguring.

Rosacea usually starts out with facial flushing -- a disease stage that some physicians call “pre-rosacea.” This flushing is commonly brought on by hot, spicy foods, alcohol, exercise, hot baths and certain medications. Also, for some women the hot flashes of menopause can trigger pre-rosacea facial flushing. This may be what’s happening in your case.

As rosacea progresses, other symptoms begin to appear. These can include small red bumps on the nose, cheeks and face, visible blood vessels on the cheeks and nose, and increased sensitivity of the skin. At this stage rosacea is called vascular or inflammatory rosacea. Additionally, rosacea can causing burning sensation in the eyes, as well as dry, red eyes. This is ocular rosacea.

No one is sure what the cause of rosacea is, but some suspect bacteria in the hair follicles may play a role in the development of this disease. Other speculation is that a chronic stomach infection with Helicobacter pylori bacteria may be the cause. This is the same bacteria now known to cause most ulcers.

Since this disease tends to come and go, it often takes quite a while for people to become concerned enough to seek medical attention. An early diagnosis is important, as getting treatment started early in the disease process can prevent permanent damage to the skin.

Initial treatment for rosacea is usually oral and topical antibiotics. Oral antibiotics are also used for ocular rosacea. In women whose hot flashes trigger rosacea symptoms, treatment for the underlying symptoms of menopause can be helpful. You may be one of these women.

In some cases there can be extensive skin damage -- including a build-up of tissue on and around the nose called rhinophyma. When this happens, surgical removal of the excess tissue may be indicated.

In the meantime, preventing flare-ups can be helped by using sunscreen, covering your face in the winter to prevent wind damage, avoiding skin products that are irritating or contain alcohol, and using a moisturizer after your topical medication has dried.

If you’d like more information about this bothersome disorder, I’d recommend taking a look at the National Rosacea Society web site. The URL is: www.rosacea.org.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.