Help! I have pimples on my face — at 59

I’M a 59-year-old and never even had a spot as a teenager. Over the past two months I have started to get bumps and pimples on my cheeks and chin and also redness that looks like blushing. Surely I’m too old for acne?

THIS sounds like rosacea, a skin condition most common in Celtic, fair skinned women between 40 and 60. It is unrelated to adolescent acne. It may result in red bumps, pus-filled spots, spider veins, facial flushing and blushing.

It affects the cheeks, chin and forehead, and tends to run in families.

Although there is no specific cause it can be triggered by stress, sunlight, spicy foods, alcohol and exercise.

Firstly, eliminate anything that you think may be making the symptoms worse. This is important, as the triggers listed are often the key offenders.

Protect your skin from sunlight by wearing sunblock. Make sure your cosmetics are water-based, not alcohol-based. Avoid using any oils or any alcohol-based cleansers.

Don’t scrub your face as this can aggravate rosacea, and make sure any products you use are unperfumed.

Next, see your GP. They are likely to give you a prescription for antibiotics.

As there is no cure for this condition, it is often necessary to take lengthy courses of treatment in an attempt to break the cycle.

If you are adverse to taking pills there are some prescription creams that you could consider trying. Bear in mind that nothing is likely to have an immediate effect — so you must be patient. OUR daughter has had a burning tongue for months. It feels strange to her and she finds it uncomfortable. To look at the tongue also has also has red patches on it. She has been to the GP with her a number of times but he has not given us an answer. Can you enlighten us as to why this is happening? What should she do to help herself?

IN WHAT you’ve described is characteristic of a condition known as idiopathic burning mouth syndrome essentially it’s a diagnosis of exclusion, that is, where other conditions such as herpes simplex have been ruled out, and where there is burning pain on the tongue or the lining of the mouth that has occurred daily, for at least three months.

It is most common in middle aged women, and up to 50 per cent of cases resolve spontaneously. What triggers it is not clear, but it’s thought to be the result of problems with the sensory nerve fibres of the mouth and tongue.

The standard treatment is a low dose of a tricyclic antidepressant for a period of four to six weeks, which can help with the burning sensation, although dryness of the mouth is a potential side -effect.

However, with idiopathic burn ing mouth syndrome the tongue looks normal and the red patches you describe slightly flies in the face of that diagnosis.

My suggestion is that the problem may be one of three alter native diagnoses. First, atrophic glossitis, which is an inflammation of the tongue - it appears smooth, shiny, and red. It is caused by nutritional deficiency such as a lack of iron or vitamin B12.

Another possible cause is contact allergy of the tongue, caused by an allergy to dental materials, rubber latex, or to some foods such as cinnamon. However this condition is quite rare.

The third possibility is that it’s geographic tongue, which causes red patches. Usually there’s no discomfort, although on occasion, some patients do experience a burning sensation.

My suggestion is that your daughter discusses the use of a tricyclic with her GP and if atrophic glossitis is suspected, she has a blood test for iron and vitamin B12 deficiency.

If this is found to be what is causing the burning tongue, supplements should help ease her symptoms and clear up the patches eventually.